After more than two hours of debate, the National Assembly yesterday afternoon passed the ground-breaking Human Organ and Tissue transplant bill.
The bill was passed despite calls from APNU+AFC for it to be sent to a special select committee for a “detailed” discussion.
With the passage of the bill, a Human Organ and Tissue Transplant Agency will be established to facilitate the removal, donation and transfer of human organs.
The agency will be headed by a team which will include a Chairperson appointed by the minister, the Chief Executive Officer (CEO), the Chief Medical Officer and the chairperson of the medical council.
It will provide for the donation and removal of human organs, tissues, cells, bio fluids for transplantation and blood for transfusion, for their use for regenerative medicine including cell therapy, gene therapy and stem cell therapy, and other therapeutic purposes, for medical education and for scientific research purposes including stem cell research, cell explant research and cell line research, and for connected matters.
According to the bill’s explanatory memorandum, the agency will be charged with facilitating, coordinating and managing the donation process for organs, tissues, cells and bio fluids for transplantation. It will also be responsible for implementing a donation process which will involve close collaboration with agencies designated to conduct organ and tissue transplants.
Among other things, the agency will be in charge of facilitating, coordinating and managing the procurement, storage, preservation, distribution and delivery of organs, tissues, cells and bio fluids; collect, analyse and publish information relating to the donation and use of organs, tissues, cells and bio fluids
A National Donor and Transplant Registry will also be established for persons to register consents, amendments and revocations of consents of adults in relation to the donation of their organs, tissues, cells or bio fluids after death. The registry will facilitate both in-person and online registration for donors.
Minister of Health, Dr Frank Anthony who opened the debate told the House that over the years, transplants have helped to expand the life expectancy of many patients and have been accepted as the best therapy for patients with terminal and irreversible organ failure.
He said several studies have showed that for patients with end organ failure, transplant is the most effective form of treatment. Between 2008 and 2014, Anthony said 30 kidney transplants were done in the country using living donors.
In 2015, a transplant unit was established at the Georgetown Public Hospital (GPH) and 36 transplants were successfully done for patients who were diagnosed with end stage renal disease.
According to Anthony, the legislation would allow the development of a local eye bank which would recover and store ocular tissues from donors for transplant for eligible recipients. “This local Eye Bank would recover and store ocular tissue from donors for transplant to eligible recipients. This measure will assist hundreds of persons in regaining their sight at very affordable costs,” he said.
To date, 93 cornea transplant surgeries have been successfully completed at the GPH, Anthony said. He added that currently, there are close to 200 patients receiving dialysis, requiring at least three sessions per a week. “Mr Speaker cornea transplantation has been a game changer for many patients who generations ago would have been blinded permanently. They now can have their sight restored,” he said.
He described the bill as one of the most advanced pieces of legislation in regenerative tissues and human organs, tissues and cells transplantation in the region in keeping with the World Health Organization’s (WHO) principles and guidelines. “Mr Speaker, while we have transfused blood for several decades and we have been transplanting kidneys since 2008 and we have been transplanting corneas since 2014, there has been no legal framework in place to regulate the donation of blood, organs, cells or tissues. This legislation is now going to put that framework in place so that this can be done ethically and safely and in keeping with the global best practices,” Anthony explained.
Safeguards
Although she said recognized that the bill is filled with pluses, Opposition Member of Parliament, Dr Karen Cummings said that it has the potential to kill if placed in the hands of the “reckless” government. “…Let’s mash the brake and slow the pace. I cannot support the bill because of its potential to kill in the hands of a reckless government,” she said.
While organ transplantation is considered a “medical miracle” and an important milestone of the 20th century, Cummings said organ donations will continue to be an issue for societies around the world.
As such, she said a topical issue such as human organ and tissue transplantation in a multi-ethnic and diverse country like Guyana could be a complex one. “The bill represents a good start… If not seriously protected, this bill puts public health against private wealth,” Cummings stated.
Though the bill is timely, Cummings contended that the populace doesn’t have a full understanding of the subject as there are human rights issues involved.
She therefore urged that the bill be sent to a special select committee before passage and that there should have been a “broad” campaign explaining all of the information in the new legislation. “It is our wish that the interest and the freedom of all participants would be accepted and that the principles and procedural justice be practiced,” she said.
Cummings further stated that it is “problematic” to trust the current regime as to whether the vulnerable will benefit from the distribution of these medical and scientific technologies to save lives. “…. Citizens would want to know…if with the passing of this bill if there will be any act of corruption and the flourishing of commercial human organ harvesting, transplant tourism and organ trafficking,” she said.
PPP/C Member of Parliament (MP), Dr Vishwa Mahadeo said the bill is multifaceted since it includes provisions for penalties to be imposed on anyone who attempt to sell organs.
“This Bill includes all that needs to be done including penalties Mr. Speaker, including the deterrence to organ transplantation tourism, for example, including those who might want to go down the road of selling organs and so it has all of that encapsulated here Mr. Speaker. So I have no hesitation Mr. Speaker, in supporting. It says five years jail if you’re found guilty. Mr. Speaker, I have no hesitation in supporting this bill”, Mahadeo said.
“Knock off”
APNU+AFC MP, Dr Nicolette Henry also spoke on the bill which she admitted has the potential but was prepared with “copy and paste” from the Trinidad legislation. “…. This legislation would be a reflection of us and we don’t want to be a laughing stock…The bill is a knock off of the Trinidad act,” Henry told the House.
She too asked that the bill be sent to a special select committee so that a more detailed discussion can be held on issues such as record keeping among others.
However, in the Government’s defence, Attorney General Anil Nandlall said the bill is a comprehensive and modern one which has a series of protective mechanisms.
“…..That is what they do, Mr. Speaker, they come here, they don’t read the bill. I don’t know if they read it, they don’t have understanding, they don’t understand what they read. But they gave their mouth a lot of liberty and contribute to an avalanche of misinformation,” Nandlall stated.
As a matter of fact, Nandlall said the public health sector is the most important and will be the target for massive, modern reforms in the years to come. “Mr Speaker this is obviously a very complex, highly expert and a very sophisticated piece of legislation,” he noted.
He added that it will be an “ongoing, evolving” exercise which will advance medical and public health welfare of the people and country in whole.
Deputy Speaker and Liberty and Justice Party leader, Lenox Shuman also fully supported the bill. However, he said that every component should be accessible to members of the indigenous community. “It is my sincere hope that all of the things that are contained in this bill are given access to indigenous communities”.
In closing the debate, Anthony said the government thought it was important for them to put the safeguards, rules and laws in place and to specify the penalties for any person who breaches the law. “So we are coming from a place where we had nothing and we are now putting that structure in place,” he said.
Anthony said that the bill is “colour blind” and there will be no discrimination as to who will benefit. “….This bill is colour blind. The people who will benefit from this bill. We won’t look at their colour. Anybody regardless of your race, regardless of your ethnicity, you will benefit from this bill,” he said.
“This is a forward-thinking bill because the work that we want to do in regenerative medicine, the kinds of things that we want to do would be a first in the Caribbean,” Anthony added.
