The Chamber of Deputies on Wednesday, October 19, adopted the relevance of the draft law regulating the use of human organs, tissues and cells, which seeks to determine their utilisation for therapeutic, educational or scientific purposes, with a view to save lives. While explaining the relevance of this bill to MPs, the Minister of Health, Daniel Ngamije, said that once enacted into law, it will among other functions, help patients who go abroad to seek kidney and liver transplants and other transplant services, to get them within the country. He told lawmakers that Rwanda will start with kidney transplants, and later introduce liver transplants. The bill comes as the Ministry of Health plans to launch a transplant surgery at King Faisal Hospital, and the Ministry said it was needed before February 2023 for the Hospital to start kidney transplant services. The following are 10 key provisions proposed by the bill, which the public should know. 1. Age required for organ donation According to the bill, the [minimum] required age for donors of organs, tissues and products of the human body is 18 years. The Government said that this is in line with the general practice globally, and Rwanda’s legislation which states that a person aged 18 and above is not a child. This age is lower than the minimum 21 years which was provided for by the law of 2010 revised in 2018. 2. Donation by a living person A living person who is willing to donate his or her body, organ, tissue, cell or products of the human body, gives his or her consent in writing after being informed of the benefits and complications related to the donation. 3. Donation by will A person aged at least 18 years may make a will for the use of his or her body, organ, tissue, cell or products of his or her body for therapeutic, educational or scientific purposes, after death. A person who wishes to donate by will his or her body, organ, tissue, cell or products of his or her body for such purposes, fills a designated form issued by a legatee institution (to which the will was left). 4. You can’t sell your organ No price shall be offered to anyone who offers his or her body for experiment, or one who accepts that organs or products of his or her body be used for therapeutic purposes. Amputation (surgical removal) and transplantation of organs, tissues and products as well as use of the human body for experiment shall be carried out without commercial or lucrative purposes. 5. Confidentiality Transplantation centres and medical doctors must keep confidential information on donors and recipients, according to the bill. However, a transplantation centre may disclose such information to another person for therapeutic purposes, except if the donor decides to keep confidential his or her personal information. 6. Payment of the cost of transplantation In the explanatory note of the bill, the Government said there was a gap in the previous law, concerning who covers the cost for health services rendered to the donors. Now, the bill proposes that all services related to the harvesting from a living donor and post-operative care incurred during the donation of an organ, tissue, cell or products of the human body for transplantation, are covered by the recipient’s health insurance until the donor is discharged. When the total cost is not covered according to the subscribed insurance, the remaining cost is paid by the recipient. 7. Establishment of a ‘bodily’ bank The bill puts forward a proposal that an institution that intends to establish a bank (required storage facility) of human bodies, organs, tissues, cells or products of the human body registers it with the Ministry [in charge of health]. The institution applies in writing to the Ministry for authorisation before starting using the bank of human bodies, organs, tissues, cells or products of the human body. An Order of the Minister [in charge of health] determines the standards for licensing an institution to have a bank of human bodies, organs, tissues, cells or products of the human body banks. 8. Harvesting health safety An organ, tissue, cell or products of the human body cannot be used for therapeutic purposes, if they are scientifically and medically proven that the risk [to be] incurred by the recipient is greater than the expected benefit for him or her, the bill stipulates. Harvesting for therapeutic purposes is subject to health safety rules, particularly those governing screening tests for communicable diseases. It is prohibited to harvest an organ, tissue, cell or products of the human body from persons who have diseases that can affect the donor or the recipient’s health. An Order of the Minister establishes the list of diseases that a donor must be tested for before the donation. 9. Modalities of harvesting Harvesting from a deceased person for therapeutic purposes is performed after confirmation of his or her brain death – the permanent, irreversible, and complete loss of brain function – by three medical doctors, who were not involved in the treatment of the deceased person or recipient of the organ, tissue, cell or products of the human body. Those medical doctors affirm the death and establish a death certificate which they all sign. It is worth mentioning that harvesting is carried out in accredited health facilities with a licence issued for that purpose by the Ministry in charge of health. And, such a licence is valid for a period of five years renewable. 10. Offences and penalties The bill proposes offenses, some of which are punishable by imprisonment for a term of not less than 20 years, but not more than 25 years, and a fine of not less than Rwf20 million, but not more than Rwf25 million, or one of these penalties. Among those offenses punishable by such penalties, there is harvesting or transportation of an organ, tissue, cell or products of the human body without consent or authorisation; harvesting them from a person who is mentally incapacitated; harvesting them from a person below 18 years (children); and harvesting a single or remaining organ from a living person. However, there are two exceptions where harvesting from a person below 18 years is accepted, hence not an offence. It is the case of the donation of stem cells between siblings (with stem cells considered the body’s raw materials — cells from which all other cells with specialised functions are generated); and for a deceased donor, provided there is consent from his or her parents or guardians. There are offenses for which the convicts are liable to imprisonment for a term of not less than 10 years, but not more than 15 years, and a fine of not less than Rwf10 million, but not more than Rwf15 million, or one of these penalties. These include the purchase or sale of human body, organ, tissue, cell and products of the human body; paying a donor or receiving payment; and importation or exportation of such human body products without a license. Broadcasting, advertising or disseminating information related to purchase or sale collects a jail term of not less than three years, but not more than five years and a fine of not less thanRwf3 million, but not more than Rwf5 million. A physician who, knowingly, harvests from a donor an organ, tissue, cell or products of the human body without a death certificate, commits an offense and is liable to imprisonment for a term of less than five years and a fine not exceeding Rwf5 million, or one of these penalties. A person who claims payment or recognition, either in cash or in nature, in order to give a human body, organ, tissue, cell or products of the human body commits an offense is liable to a jail term of less than three years and a fine of not more than Rwf2 million, or one of these penalties.