Report flags Communist Party control over China’s transplant system

A new investigation says the Chinese Communist Party is embedded in China’s organ transplant network, identifying 19 cases of transplant surgeons or centre directors who also hold Party positions across 12 provinces. The report argues the structure makes independent oversight impossible and casts doubt on Beijing’s claims of reform.

Why it matters: - The report argues that political control over China’s transplant system may block independent oversight of organ sourcing, ethics review and transplant decisions. - The findings raise questions for foreign hospitals, journals, professional societies and governments that work with Chinese transplant institutions. - The report says claims of reform cannot be reliably verified without institutional independence and protection for whistleblowers.

What happened: - A new investigation published this week details how the Chinese Communist Party is embedded throughout China’s medical establishment and organ transplant sector. - The study identified 19 cases across 12 Chinese provinces in which transplant surgeons or centre directors are also CCP members. - In six of those cases, the individual was the hospital’s Party Secretary or Deputy Secretary. - The findings appear in Chinese Communist Party Control: The Party’s Hold on China’s Medical Profession and Transplant Sector. - China researcher Sarah Cook authored the report for the International Coalition to End Transplant Abuse in China, or ETAC. - The report is the first in ETAC’s new “Red Flags” investigative series.

The details: - The report maps CCP authority over China’s organ transplant system and says Party loyalty, political control and lack of independent oversight undermine reform claims. - Several identified surgeons and centre directors lead programmes or hospitals in regions with large populations of prisoners of conscience, including Uyghurs in Xinjiang and Falun Gong practitioners in northeastern China. - The report draws on Chinese hospital websites, government sources, academic papers and an interview with a former doctor from Liaoning Province. - Under official regulations, the Party secretary outranks the hospital director and clinical leadership, the report says. - The report says Party penetration of public hospitals has intensified since 2018 under directives from the CCP Central Committee. - Doctors who are CCP members take a lifelong oath to carry out Party decisions, observe Party discipline, protect Party secrets, remain loyal to the Party and “never betray the Party.” - The report says violating those commitments can carry more severe personal and professional consequences than breaching medical ethics. - The report says the entire chain of activity — from identifying a donor through procurement, ethical review, allocation and transplantation — occurs inside institutions operating under direct CCP political leadership. - The report says CCP members also dominate the leadership of the National Organ Donation and Transplantation Committee, the Chinese Medical Association and hospital ethics committees. - Organ procurement organisations operate inside hospitals and under those hospitals’ Party leadership, according to the report. - The report argues that the institutions expected to identify or investigate unethical organ sourcing remain accountable to the same political authority that directs the medical establishment. - The report says that structure leaves no external mechanism to reliably verify claims of voluntary organ sourcing, ethical compliance or reform. - Cook said every entity presented internationally as independent or a “third party” is part of the same Party-controlled system. - Cook said unethical organ sourcing could be continuing yet remain concealed. - Distinguished Professor Wendy Rogers, clinical ethicist and chair of ETAC’s International Advisory Board, said Chinese transplant doctors are placed in an impossible situation because professional ethics can be overruled by state-enforced demands for CCP loyalty. - Rogers said no part of China’s transplant oversight system operates independently of the Party-State hierarchy. - The report says a doctor who encountered evidence of non-voluntary sourcing would face the hospital Party committee as the first line of authority. - The report says reporting concerns outside the institution could expose the doctor to Party disciplinary action, extralegal detention under the liuzhi system or criminal charges for revealing state secrets. - A former internal medicine doctor from Liaoning Province told researchers that people in China live under intense CCP pressure and fear disappearing if they speak up. - The report concludes that the incentives to participate in or conceal potential abuses are structurally stronger than the incentives to protect victims or expose wrongdoing. - The report does not present those conditions as proof that abuses are continuing. - The report says the mechanisms needed to enable and conceal such abuses remain in place.

Between the lines: - The report is as much about governance as medicine: if Party officials sit above clinical leaders, an internal review process may not be able to police itself. - The findings also fit a broader warning from human-rights and transplant experts that transparency claims are hard to assess when all oversight runs through the same political chain. - In March 2020, the independent China Tribunal concluded that forced organ harvesting from prisoners of conscience had occurred on a substantial scale in China and identified Falun Gong practitioners as the principal source. - The tribunal also found evidence of medical testing on detained Uyghurs, raising concerns about their potential use as an organ source. - A 2022 legal advisory report and policy guidance by Global Rights Compliance previously flagged legal and human-rights risks tied to transplant collaboration with China. - The report comes as international transplant collaborations with China rise and foreign governments consider new legislation.

What's next: - The report recommends separating CCP political authority from clinical decisions. - It calls on foreign governments and international civil society to act. - It specifically urges medical institutions, journals and professional societies that collaborate with Chinese hospitals and doctors on transplant-related activities to respond. - ETAC’s “Red Flags” series is expected to continue examining possible indicators of ongoing transplant abuse in China between 2020 and 2025.

The bottom line: - The report says China’s transplant system cannot be trusted to police itself while the Communist Party controls the institutions meant to oversee it.