Poverty, Power and Organ Trafficking in China

Published with The Borgen Project.

RENO, Nevada — Organ trafficking and forced organ harvesting are not domestic issues; these are crimes against humanity that have become a national ethical crisis. China’s organ transplant system remains one of the most compromised practices in modern medicine. Evidence shows organ trafficking from unwilling prisoners and the removal of organs before brain death.

Debate continues over whether Chinese prisons and health organizations have met legal requirements for organ removal. At the intersection of poverty and state power, inequities in organ supply and demand fuel a shadow economy that exploits the disenfranchised and incarcerated for organ trafficking in China.

Historical Context and Reform Claims

Historically, China procured organs from prisoners. Peer-reviewed research confirms that “[more than]90% of the organs transplanted in China before 2010 were procured from prisoners.” Yet “no regulatory adjustments or changes in China’s organ donation laws followed.”

Cheng Pei Ming is the first known survivor of forced organ extraction. Authorities shackled him to a hospital bed after performing surgery he never consented to. Surgeons removed part of his liver and lung. Ming had been imprisoned in 2002 and illegally operated on while still serving his sentence.

“They said that I had to undergo an operation, but I firmly refused. They held me down and gave me an injection and I quickly lost consciousness,” Ming shared. “When I woke up, I was still in the hospital and felt terrible pain in my side. There was a bloody tube connected to me. I was shackled to the bed.”

Cheng’s story confirms what investigations and human rights reports have long alleged: forced organ harvesting in China is ongoing and calculated, thriving in secrecy and the erasure of its victims. In December 2014, authorities announced the end of the practice, declaring voluntary donation the sole legal source of organs. Research raises doubts, showing that China’s voluntary donation data since 2010 was statistically implausible.

Ethical Violations and the Persistent Shadow System

Chinese transplant teams continue to violate ethical frameworks like the Dead Donor Rule, which requires brain death before organ procurement. “We demonstrate that [China’s organ procurement] not only violates international ethics standards, it is also associated with neglect of fundamental human rights… procurement of organs from incompletely executed, still-living prisoners,” N.W. Paul stated.

A study identified 71 medical articles from 1980 to 2015 where organ transplants were conducted without confirming donor brain death. “The nonconsensual taking of a human organ… violates ethical principles, including autonomy, informed consent and human rights…” Anne Zimmerman stated.

Organ harvesting can cause death, circumventing accepted standards. These violations suggest organ trafficking in China remains state-tolerated.

Accountability, Resistance and International Advocacy

Organ trafficking in China has triggered global resistance. From investigations to legal battlegrounds, key players are working to expose the atrocity, though enforcement lags. End Transplant Abuse in China (ETAC) spearheaded the China Tribunal. In 2019, the Tribunal concluded “beyond a reasonable doubt” that forced organ harvesting from Uyghurs and Falun Gong practitioners constitutes crimes against humanity.

Doctors Against Forced Organ Harvesting (DAFOH) fills a void where medical ethics and moral outrage collide. This global network of physicians emphasizes that prisoners of conscience are targets for their organs. Between 2006 and 2008, U.N. experts, including the Special Rapporteur on Torture, raised questions about discrepancies between transplant volumes and legitimate donors in China.

Despite these inquiries, consequences remain elusive. Governments have avoided sanctions and Chinese authorities refuse independent monitoring. Global resistance is active from the courts of the China Tribunal to DAFOH. Yet the world faces a choice: escalate enforcement or let this atrocity continue.

Trafficking, Poverty and Coerced Supply

The organ trade in China thrives on poverty, repression and authoritarian control. Officials claim reform, but vulnerable groups face a different reality. For decades, prisoners have been prime targets due to their lack of legal agency. Ming’s case is not isolated—not all legal reforms in China apply to prisoners.

Former U.K. judge Geoffrey Nice stated, “Forced organ harvesting has been committed for years throughout China on a significant scale.” The Falun Gong and the Uyghurs each qualify as a group for purposes of the crime of genocide.

Poverty plays a critical role. Impoverished citizens, especially in rural and targeted regions, are vulnerable because they lack the money, education or power to resist. When citizens cannot afford a lawyer and perpetrators are connected to government agencies, it creates a cycle of coercion and control.

Lawmaker Lin testified, “The short wait times achieved by transplant hospitals suggest that people are killed on demand for their organs.” In regions like Xinjiang, mass incarceration creates a captive supply of bodies profiled and blood-typed for compatibility. Advocacy groups have sounded the alarm for more than a decade and peer-reviewed research confirms these are systemic patterns preying on disadvantaged citizens.

Transplant Tourism in China

Evidence shows rapid transplant rates, unusually short wait times and overseas patients flying in for “on-demand” surgeries. Reports show liver transplants with wait times as short as 1–2 weeks. On-demand surgeries are not features of a voluntary donor system but of a coerced supply chain. Wealthy patients—many from abroad—participate in transplant tourism, where poverty becomes a transactional asset.

DAFOH’s Dr. Torsten Trey warned, “Every person who travels to China for an organ causes the death of another human.” Despite reports, the practice persists. Transplant tourism contributes to inequality, secrecy and global indifference. The demand is international, but the supply begins in prison cells and rural villages. Addressing poverty alongside accountability is essential.

Zimmerman stated, “…experts suggest the regulatory change will not lead to transparency, bring an end to China’s transplant tourism business or protect prisoners of conscience and ethnic groups from crimes in organ transplantation.”

Conclusion

Peer-reviewed evidence paints a dire picture: despite reforms, organ trafficking in China remains steeped in violations and predatory coercion. Data manipulation, disregard for consent and exploitative supply chains target vulnerable and imprisoned citizens. To dismantle this system, global health equity demands action through transparency, oversight and addressing the poverty that enables such abuse.

– Nicole Fernandez

Nicole is based in Reno, NV, USA and focuses on Global Health and Politics for The Borgen Project.