Introduction — a growing, hidden industry
The global shortage of transplantable organs has created a lucrative underworld in which the poorest are often turned into suppliers. United Nations agencies estimate the organ trade is a multi-hundred-million-dollar business, with some estimates putting its annual value between roughly USD 840 million and USD 1.7 billion. That market — partly legal in a handful of settings and largely illegal elsewhere — is increasingly supplied by people selling kidneys and other tissues to survive economic collapse, pay debts, or support families.
Why poverty and migration feed the trade
Experts say two structural forces push people toward selling organs: (1) chronic economic distress — high inflation, unemployment and crushing personal debts — and (2) mass displacement and irregular migration, which leaves people vulnerable to exploitative intermediaries. Where social safety nets and legal transplant systems are weak or inaccessible, brokers and trafficking networks exploit those gaps. International agencies now classify trafficking for organ removal as a form of human trafficking and have urged states to strengthen prevention and protection measures.
Regional snapshots
Iran: legal markets, social media ads and alarm
Iran remains unique for permitting compensated living-unrelated kidney donation under a regulated system, which has dramatically reduced waitlists. Yet, that legality has not prevented signs of distress-driven sales, with reporting showing people — including teenagers — advertising kidneys and other organs on social platforms or travelling abroad to sell organs to pay debts. Social-media listings and investigative coverage indicate the practice often reflects deep economic hardship rather than true informed choice.
South Asia: syndicates, cross-border flows and new probes
Recent investigative reports and police probes across parts of India and neighbouring Bangladesh show brokered networks recruiting impoverished labourers for transplants, sometimes in collusion with medical actors. Al Jazeera’s mid-2025 investigation highlighted villages in Bangladesh where many residents had sold kidneys to meet debts and where brokers exploited porous borders and loopholes. Authorities in parts of India (Tamil Nadu) have opened inquiries into alleged rackets and suspended facilities amid mounting evidence.
Other hotspots and migration routes
Reporting and NGO investigations have documented cases across Egypt, Pakistan, the Philippines and in migration corridors — especially where migrants and refugees lack protection. Vulnerable irregular migrants are often promised payment, then under-compensated or abandoned after surgery; sometimes their consent is coerced or falsified.
How the trade operates (overview)
- Recruitment: brokers target indebted people, seasonal workers and migrants via word of mouth, social media adverts, or local recruiters.
- Facilitation: promises of payment, travel documents, or fake paperwork are used to move donors across jurisdictions.
- Medical collusion: some illegal operations involve complicit clinicians or corrupt facilitation within hospitals; in other cases transplants happen in clandestine clinics.
- Aftercare gap: post-operative care is often poor or absent, leaving donors with chronic health problems and little legal recourse.
These mechanisms make detecting and prosecuting cases difficult and raise serious ethical and public-health concerns.
Health and social costs for donors
Medical evidence shows many donors who sell kidneys receive inadequate pre-surgical screening, insufficient follow-up care and lower long-term health outcomes — compounded by loss of income during recovery and broken promises of full payment. Multiple studies and victim testimonies report long-term physical pain, mental health damage and financial disappointment.
Legal responses and international policy
International bodies (WHO, UNODC, the UN and several state agencies) have stepped up the framing of organ removal for profit as trafficking and called for criminalization, victim protection, improved transplant access and stronger national oversight. The World Health Assembly and WHO have pushed member states to increase ethical access to transplantation to help reduce incentives for illicit markets.
Cases and enforcement — gaps remain
Despite arrests and exposés, enforcement is uneven. Recent police inquiries and hospital license suspensions in parts of India show action is possible — but investigators often face falsified documents and cross-border murk. Meanwhile, social media platforms have become an advertising ground for desperate sellers, complicating detection.
What experts and survivors say
Victims and advocates emphasize that criminalizing sellers alone is not enough. Survivors say they sold organs because of urgent needs, not because selling was a rational or safe livelihood choice; many later regret the decision after health setbacks and inadequate compensation. Advocates call for social protection, expanded legal transplant programs with safeguards, anti-corruption measures in health systems, and cross-border cooperation to dismantle broker networks.
What must change — policy recommendations
- Expand safe, ethical access to transplantation (living and deceased donation programs, transparent waitlists).
- Strengthen anti-trafficking enforcement across borders and clamp down on medical collusion.
- Target root causes — social protection, debt relief and job programs to reduce the economic pressure that pushes people to sell organs.
- Regulate online platforms to detect and remove organ sale adverts and work with civil society to provide alternatives and outreach.
Methodology and sources
This report synthesizes reporting from international outlets, UN and WHO publications, national investigations and academic studies, as well as recent local news investigations (Iran social-media reporting, Al Jazeera’s July 2025 Bangladesh-India reporting, and local India probes in 2025). See key sources below.