This document is a catalogue of all significant, recent (as of early 2015) public statements of Huang Jiefu on China’s organ transplantation system—it is incomplete, and a work in progress. Entries are ordered by date, and excerpts from the respective item are provided below with English translation. The original Chinese is retained so researchers can easily compare the original to the translation. Potentially important material is highlighted.
2015/1/11 黄洁夫：我只看过一次摘取器官 觉得需要改变
2015/3/13 黄洁夫: 使用死囚器官是历史难堪一页
2015/10/19 黄洁夫：器官来源转型 移植数不降反升
2015/11/23 黄洁夫：死囚可否捐器官是伪命题 北京青年报
Last updated: Nov. 30, 2015
Publication: Beijing Times
Title: “Huang Jiefu: 38 Hospitals in China have already stopped using death row prisoner organs” | 黄洁夫：内地已有38家医院停用死囚器官
谈器官捐献 On Organ Donation
38家医院停用死囚器官 38 hospitals stopped using executed prisoner organs
Beijing Times: How was the organ donation situation last year?
Huang Jiefu: Our country’s organ transplant has entered a new era. The era of reliance on executed prisoner organs will end. Since last year when we officially started the organ donation work, until March 2 of this year, there have been 1,570 donors and about 5,000 people received organs. This number has already surpassed the number of organs donated by executed prisoners. [Translator’s note: Prisoners organs are fewer than 5,000. Where did the rest come from?]
Beijing Times: Already gradually stopping the use of executed prisoner organs?
Huang: 38 big transplant centers in Guangdong, Beijing and Zhejiang province have already stopped. We’re actually not against executed prisoners donating their organs. We don’t want to deprive their right to donate organs. Executed prisoners are also citizens, and have the right to donate their organs. The key is to have the regulations. From now on, executed prisoners donation also requires the prisoner and the family members’ consent, which is the same as citizen donation. In the meantime, based on our country’s law, they [executed prisoners] will be entered into the computerized system for fair organ distribution.
Beijing Times: Are you saying that these 38 hospitals have completely gotten rid of the reliance on executed prisoner organs?
Huang: There is not any other country in the world that uses executed prisoner organs—the executed prisoners can voluntarily donate their organs. Once the voluntarily donated executed prisoner organs are entered into our distribution system, they belong to citizen donation. So there is no longer such a saying as executed prisoner organs. We need to improve human rights, be fair and righteous. Everyone agrees with that. Death row inmates can fill out the application, sign the application, and can also enjoy humanitarian aid and so on. It is not that we do not use organs from executed prisoners, instead we do not allow hospitals and doctors to privately trade human organs.
Beijing Times: When will [our country] completely move away from using executed prisoner organs? Is there a time frame?
Huang: Our country’s organ donation work has just started. It’s still in its infancy. Now, it’s almost 1 year old. I hope we work together to ensure the healthy growth of this newborn. This is a reform process. Many hospitals in Guangdong province have voluntarily promised not to use privately traded organs from executed prisoners. Their organ procurement and distribution is open, transparent and fair. It is a kind of corruption to privately trade organs. There are many chains and black holes in the middle. The previously used organ procurement method cannot be brought to the daylight [cannot be exposed to the public].
Plans to create laws for organ donation and transplant
Beijing Times: What new development will happen this year?
Huang: March 1, our country established Organ Donation and Transplant Committee. Under the leadership of our State Council, the Committee is set up under the National Health and Family Planning Commission (NHFPC) and China Red Cross. The NHFPC is mainly responsible for it. The honorary directors of the Committee are Hua Jianmin, Li Bin, etc. I am the director. The deputy directors are Zhao Baige, Ma Xiaowei, etc. On March 20, we will set up the OPO alliance to propel the fair distribution of organs. About half of the organs donated last year by 1,570 persons have already been entered into our country’s distribution system.
Beijing Times: Is there a plan to set up the nationwide law?
Huang: We already have a regulation on organ transplant. We will revise it and change its name to China Human Organ Donation and Transplant Regulation. It is going through the legal process. There will be a common guideline for the humanitarian aid [i.e. financial payment], but it is not a common standard. Life is priceless. Don’t talk about how much an organ costs. Those poor families whose family member donated organs will receive humanitarian aid. There are many different types of aid.
[Sub-heading] Hope to include organ transplant in the medical insurance system to be reimbursed
Beijing Times: It was said that every year there are about 300,000 people who need organs. But there are only 10,000 registered and waiting. How to explain the gap?
Huang: The gap has to do with organ sources, socio-economic conditions, give and take, etc. Our organ transplants cost money. A liver or kidney transplant costs tens of thousands of yuan. This is not something common people can afford. Therefore, there is a gap between those registered and those in need of organs. Some people need a transplant, but it will bankrupt the family. So this person might decide not to do the transplant. This is a very common phenomenon. Every year, there are 1,000,000 people who go through dialysis. About one third of these people will need liver and kidney transplant. So we scientifically estimate that about 300,000 people need transplants.
Beijing Times: Is organ transplant covered by medical insurance?
Huang: I hope so of course. This is a choice between life and death. I hope society can work together so that those who need organs will not lose their chances because of financial reasons. We are in the process to set up a human organ transplant foundation. I wish the government can give some money, the society can donate some money, hospitals can donate some money once the foundation is setup, so that it can help those in need.
Archive of video interview: https://drive.google.com/file/d/0ByxwXcZlX2dXNjhZNndTYklRZk0/view?usp=sharing
Title: “Huang Jiefu: I’ve only seen an organ extraction once; I think there should be changes” | fi黄洁夫：我只看过一次摘取器官 觉得需要改变
Full version of item: https://docs.google.com/document/d/1w7MFiqIiDejdEK6Kh6CYcCwKZi75qb9AyiXcdwT7hjI/edit
Key Content: See full version.
Title: “Huang Jiefu, Robin Li, and Yu Minhong talk about livelihood issues (transcript)” | 黄洁夫李彦宏俞敏洪谈民生（实录）
Europe Times [A Chinese newspaper managed by Beijing located in Paris]: My question is for Minister Huang Jiefu. Starting Jan. 1 this year, China ended using organs from executed prisoners for transplant. The organs entirely come from citizen voluntary donation. What is the reason behind this decision? Will this create a shortage of organs? How is the citizen voluntary donation situation in China? Thanks.
Huang: Thank you for asking me this question. I thought today’s first question for me would be about organ transplant. During these few days of meeting, there have been about a dozen reporters, foreign and domestic, asking me this question. So I am very happy to answer this question. Why do we want to get rid of the executed prisoners as organ source?
Huang: First I want to tell everyone, prior to 2009, in order to save lives, we had to use organs from executed prisoners. This is because there was no citizen voluntary donation system. We had no options but to make this bad decision. This does not fit into the World Health Organization guidelines and has created many years of human rights issues [for our country] in the international community. The decision to end the usage of executed prisoner organs is to propel our citizen donation program. It is a decision beyond medical services. It signifies the advancement of Chinese judicial system and the progress of China’s human rights situation. It especially shows the purity and nobility of China’s transplant industry, not making medical personnel in a gray zone when they are carrying out sacred life-saving missions.
Huang: Will there be a shortage of organs? Just the opposite. We want to rid of executed prisoner organs precisely to solve the problem of organ shortage. This is because in recent years China’s human rights situation has been improving, the reform of the judiciary system has been progressing, and our policy is to use less or cautiously use the death penalty. If our organ transplant still rely on executed prisoners, our transplant industry will be out of resources.
Huang: As executed prisoners become fewer and fewer, in 2014, we started the transparent voluntary donation system. 80 percent of the organs are from citizen donations. Last year, we held an important meeting – the 4th plenary Session of the 11th Central Committee – the main theme was to govern the country with the rule of law. According to the rules, especially the criminal law amendment, we must completely obey the law. This is what the people are asking for. We must have an open and transparent organ transplant system.
Huang: After we announced this decision, we received warm support from the entire society, as well as the international community. All organ transplant magazines around the world support us. The pope accidentally heard the news and he also applauded. This is a progress of our nation’s human rights situation, medical and health industry and the entire society.
Huang: People worry about organ shortage. But 80 percent of organs in 2014 came from donation. This year from Jan. 1 to March 4, over the Chinese New Year, although death is a forbidden topic during this time, many people died of accidents. Their lives were elevated because one family’s misery brought new life to many families.
Huang: From Jan. 1 to March 3 this year, 381 citizens donated almost 1,000 organs. This is twice the number of 2014. It proves that our citizen donation is full of sunshine, transparent and has a great future. We say goodbye to our shameful past. China’s organ transplant turned a new page. We are very hopeful. Thank you.
Title: “Huang Jiefu: The use of death row prisoner organs is an embarrassing page in history” | 黄洁夫: 使用死囚器官是历史难堪一页
Full version of item: https://docs.google.com/document/d/1S2-Er2fUd7CkIQW4PcVoAUEfDJwQLF8lJT__GWfe5TE/edit
Huang Jiefu is a Standing Committee member of the the 12th Chinese People’s Political Consultative Conference (CPPCC) National Committee; Director of the National Organ Donation and Transplantation Office; former Deputy Ministry of Health
Reporter: At the end of 2014, there was news that the [recipient transplant] kidney of Zhang Hanzhi might be from Nie Shubin who was executed in 1995. Although the daughter of Zhang Hanzhi denied this, she was not exactly sure whether the kidney was from an executed prisoner. In the past, organs from executed prisoners were the main source for organ transplant in China. Have you personally been involved in obtaining organs from executed prisoners?
Huang Jiefu: I hope that I can lead people to flip this page over as soon as possible and look at [what is happening] now. It [using organs from executed prisoners] is, in the history of organ transplant, an embarrassing page, even for ordinary Chinese people. Now we’ve turned the page. From January 1, 2015, under the call from the CCP Central Committee on the spirit of the rule of law, China has fully stopped using organs from executed prisoners.
What is the story about using organs from executed prisoners? We must fully understand it before we can discuss Zhang Hanzhi, Nie Shubin, Li Shubin or Wang Shubin [well known cases in China where the individuals either received organs by dubious means, or had their organs removed after death.] Using organs from executed prisoners for organ transplant is before the establishment of the voluntary organ donation system. It is a very helpless expediency. As long as there is the donation system, doctors will never use it (organs from executed prisoners). Because we need to save lives, to rescue another life, so only when there is no other way will we turn our sight toward using organs from executed prisoners. In fact, the state has very strict laws about using organs from executed prisoners. The laws regulate that using organs from an executed prisoner must obtain consent from the person’s family members. Actually the organs are actually donated by the executed prisoner.
However, our country is very big, the economic development varies among places. At the same time, the enforcement of local laws is also uneven. Using organs from executed prisoners is not in line with the principles of ethics, as the World Health Organization and the global legal communities all ban the use of organs from executed prisoners. We, as a big political power, are the only ones who rely on organs from executed prisoners. This is very unfavorable to the image of the country and the quality of organ transplants for ordinary Chinese people.
In such a case, according to the rule of law, which law to accord to? One is the "Human Organ Transplant Ordinance" issued in 2007, the second is the crime of organ trading in the Criminal Law Amendment issued in 2011, and the third is a very important legislation "Procurement and Allocation Regulations on Donated Human Organs" issued by the Health and Family Planning Commission in August 2013. These three documents regulate that the source of the organ must be voluntary, unpaid, open, transparent and traceable. That is knowing where the organ is from and where the organ is to go. According to this spirit, we announced the cancellation of the use of organs from executed prisoners on January 1, 2015.
So what is the foundation then? One is the law. The other is that there was a breakthrough in citizen donated organs in 2014. In 2014, 80% of the organs were from voluntary donations of citizens, while the proportion of organs from executed prisoners was very small. In addition, judicial reform requires less, or cautionary use of the death penalty. Meanwhile, the death penalty must be granted by the Supreme Court. Now, the number of death penalties has reduced and people who commit economic crimes will not be sentenced to death. This provides evidence that our country is continuously improving in terms of administration of justice and human rights.
So now the time is ripe to stop the use of organs from executed prisoners. In addition, if the organ transplant system is not open and transparent, ordinary Chinese people will not get this service, because it will become a black-box operation and is not open and transparent. For all the countries, organ transplants are put in the first place in severe illness aids and health insurance, because organ transplant is a life-saving surgery. With organ transplants, there will be survival. No organ transplants, there will be death. Therefore, as long as we are transparent to the sunlight, we can consider, after the formation of the climate of citizen voluntarily donating organs, to suggest the state to include organ transplants into severe illness aids in Medicare for All. This way, all the people can enjoy this service. The state will do this.
So, we shouldn’t always dwell in the past, always concerned about the page of death row inmates. Flip over the page and look at the future. Do not dwell in the question of who Zhang Hanzhi is. It must have been an organ from an executed prisoner, because there is no citizen voluntary donation system. So there is nothing interesting to pay attention to in this. We should pay attention to the future, not the past.
Reporter: Now there’s this call to stop using [organs from executed prisoners], will it make the originally "lawful" behaviour turn into underground activities?
Huang Jiefu: We must make this clear to the public. It is actually the opposite. Because if there is a system which is not transparent to the sunlight, there will be unstoppable state organ trades and organ black market. Now, we established the citizen voluntary donation system which is sunny, transparent, fair and traceable (system). The allocation of organs is an expanded allocation which is done by computers. In such, the evil road will be blocked and we will walk on the sunny road.
Reporter: China is fully stopping use of organs from executed prisoners as a source of donors, but what if death row inmates want to donate their organs, is this possible?
Huang Jiefu: You need to learn better. Read "Global Times," there is a commentary article titled "By respecting death row prisoners, there will be more people who will participate in donation." (If we say that) the transparent system of donations is mixed with the untransparent system of using death row prisoner organs, then there will not be such a system. People will not believe this system.
I want to tell you a story, you know that there is a 22-year-old French boy who came here during the Spring Festival. He died in an accident and his parents came. The parents heard that China has stopped using organs from executed prison from January 1 this year, and felt that the Chinese organ donation system is now at the world's standard, it is the sunny and transparent, so he [should be ‘they’] found the local Red Cross of Zhejiang Province, and donated the boy’s liver, two kidneys, and two lungs. Through our expanded allocation system, the organs saved four people in Hangzhou and Wuxi. Why did they do that? It’s because our organ donation system is transparent. Will people be willing to put their organs together with organs sourced from executed prisoners?
美国总统林肯曾说，“A house divided against itself cannot stand.”他说的是一个建筑是由两个不同的材料建的，这个房子很快就会垮掉。所以说在建立公民自愿捐献的时候，不要老是说死囚愿意捐献行不行，其实都是一些伪命题，都是“被捐献”。
The US President Abraham Lincoln once said, "A house divided against itself cannot stand." What he said is that a building constructed by two different materials would soon collapse. So when establishing the citizen voluntary donation system, do not always ask if it is OK for death row inmates to donate organs. In fact, these are false propositions. They "were made to donate."
Meanwhile, recently there was a death row inmate who said he was willing to donate organs. Then the media said all death row inmates were willing to donate organs. In fact, in China, there is an important organ donation principle. That is it must be agreed by the prisoner’s family. If his family, his parents, complain, none of them agrees with his receiving the death penalty, then how could they agree to donate his organs?
So do not change this false proposition into a real fairy tale. We need to face reality, under the sun. Do not always look at the past embarrassing page, do not cling to the past.
Reporter: Like before, we are all very, very interested in the question of the use of organs from executed prisoners. There are a lot of comments mentioning an interim provision, the "Provisional Regulations on the Use of the Death Penalty Criminals or Cadaveric Organ of the Body of Criminals," enacted in 1984. This provision has not been abolished even now.
Huang Jiefu: Look to the future, the 1984 document is not a law, this provision is a secret, and I have not seen it before, why are you able to see it? That is not the law, at the state open level, on the government level, there has never been an acknowledgement that the use of organs from executed prisoners is legal, it is an embarrassing page, it is drinking poison to quench one’s thirst, it is expedient. Now we have the sunny system, why do you always want to abolish something? Who acknowledged the existence of the 1984 document?
We now have open and aboveboard law and regulations: the “Human Organ Transplant Ordinance” issued in in 2007; the crime of organ trading in Criminal Law Amendment; "Procurement and Allocation Regulations on Donated Human Organs" issued by the Health and Family Planning Commission in August 2013.
Reporter: We now have another concern. After we stopped using (organs from executed prisoners), the current demand for organs is relatively large, will this gap become further widened?
Huang Jiefu: Stopping [the use of] death row [prisoner organs] is indeed to solve the problem of the shortage of organs. Why do we rely on death row inmates for organs, and why over the years the number of organ transplant cases was just around thousands? it’s because the system is not sunny and transparent, so organs are always in shortage and people could never get high-quality organ transplant services. This is because in that kind of environment, fungi rate and bacterial infections are particularly high. Therefore, it is to solve the problem of organ shortage that we need citizens to voluntarily donate their organs.
After announcing the end of organs from executed prisoners, from January 1 to March 3, in the Chinese mainland, there are 381 cases of organ donation and 937 organs. Adding donations from family members, there are over 1,200 organ transplant cases, including cornea, up until now in China. This is just within two months and during Spring Festival when Chinese people are most taboo to talk about death. So I wrote an article published in the "People's Political Consultative Conference Report". I think maybe it is the appeal from the singing of Yao Beina [a famous singer who recently died] in heaven, or maybe it is that our people begin to believe this sunny and transparent donation system, so the number of donation is increasing. This number of donations in these two months has doubled compared to last year. So we see hope.
3. There are regulations but obsolete, should introduce "Human Organ Transplant Act" as soon as possible
Reporter: Speaking about advocating citizens to voluntarily donate organs, in fact, a big reason that holds them back in the past is that they are worried about the openness and transparency of the system. How do we ensure the openness and transparency?
Huang Jiefu: "China Youth Daily" did a poll in 2014 and surveyed 43,000 people. The survey participants included the elderly, the middle aged and the young people. The results showed that 45% of people were willing to donate, another 45% were unwilling to donate and the other 10% did not provide an answer. We then asked these 45% of people who did not want to donate about why they did not. Among these people, 64% expressed that they felt the current donation system was not open, transparent and sunny, especially that it was mixed with organs from executed prisoners.
So what do we do now? The first thing is to abolish the use of organs from executed prisoners. I think there will be a large number of people who start to trust us. The two cannot mix together. In addition, of course, we need to develop some good policies, including policies suitable for China's conditions, humanitarian policies for the donor’s family. Also this includes the construction of the rule of law, that is what I have just said, the 2007 regulations is not suitable for current situation, we must put together the regulations in 2013, the Criminal Law Amendment in 2011, the more than 30 documents from the organ donation collaborative work between Red Cross and Health and Family Planning institution, to build a China’s Human Organ Transplant Act. With the construction of the rule of law, problems will slowly get resolved.
Reporter: What is the progress of the Human Organ Transplant Act now?
Huang Jiefu: We need to rely on you, all the media to help us to broadcast the news, let the society know the importance of this case. In this way, we will be able to quickly develop it, because law is very important! We say that resolving a specific problem is small wisdom, resolving people’s issues is medium wisdom, resolving the law is the big wisdom. Now, the key is to start with laws. I hope that through the construction of the rule of law, we can make clear the duties and powers of the Red Cross, the Health and Family Planning, hospitals, and transplant doctors.
Organ donation work will be developing in a big way. At the same time, with the improvement of the citizen donation system, we also need to develop the country's organ transplant as a basic health service for people, so that people can access this service without worrying about money and economic problems. The meaning here is significant. If we cling to the past, ordinary people will never have a chance to access this life-saving service, because it is very expensive. But if it becomes part of the country’s severe illness aids, (ordinary people will be able to enjoy this service). In all developed countries, organ transplantation is put at first in severe illness aids. So, as long as there is a sunny and transparent system, we can make it. You need to promote this, do not talk about death row inmates everyday.
Reporter: What do you think is the most critical problem to solve currently in the organ transplant work?
Huang Jiefu: The first is to amend the Organ Transplant Ordinance, constructed it by law. Now every day there are news about organ donation and many touching stories in the society has gone into the deep hearts of people. The improvement of a society and the change in the notion of a country, there needs to be a process. The original notion of Chinese people is to “protect the integrity of the dead body” and “respect the dead”. The current notion is kindness, mutual aid, dedication and “saving a life to build a seven-storey pagoda”. The new notion has quickly replaced the original negative side of our national culture. The positive side is emerging.
IV. Currently there are only about 200 skillful organ transplant doctors
Reporter: Since 2007, after the "Human Organ Transplant Ordinance" was enacted, the former Ministry of Health carried out a re-examination to more than 600 organ transplant hospitals nationally, and the first batch of 169 hospitals were determined to be OPO qualified hospitals and these hospitals were allowed to continue on with their organ transplant operations. You've said that at around mid-2014, those 169 previously determined to be OPO qualified hospitals will be re-examined and re-evaluated, those hospitals failed in complying with the resolution, their qualification (in OPO) will be revoked, this is a re-shuffling. I would like to ask what was the results of the re-evaluation? For what reasons would a hospital's qualification be revoked? Will there be an increase in the numbers of qualified organ-transplanting hospitals in the future?
。Huang Jiefu: Prior to the 2007 regulation, there were more than 600 hospitals that were performing organ transplants. The quality of organ transplanting among them varied tremendously. Some were with very poor quality, and many of them did not qualify to do organ transplants but were doing organ transplants. So the yearly survival rate was the lowest in the world that year.
Under that circumstance, after the 2007 regulation was issued, in order to protect the safety of people's lives, the health and quality is the first priority for consideration. At that time it had not come to the subject of organ donation, the first step was to assess the hospital's qualifications and technologies, 164 of them were found to align with the level required for organ transplant, that these hospitals were with qualified doctors and good equipments.
After 2010 when the civic voluntary donation were promoted, there was a new policy: any hospital that wants to apply for the permit in doing organ transplantation needs to have complete high-quality health services, and on top of that, there needed to be more than 10 cases of active participation of citizens who declared a voluntary donation with that hospital. Consequently there were five more hospitals who passed, so the total number of qualified hospitals becomes 169.
With more voluntary donor citizens coming to light, the environment of transplant is becoming more mature, I think China will have more than 169 qualified hospitals, maybe 200? Preferably 300, so as to meet the medical needs of people. There are 169 altogether now, and only more than 70 liver transplant capable ones, for kidney transplant capable ones, it was just a bit more than 80, and there are less than 20 heart transplant capable hospitals, and only just above 10 of them for lungs. Many organs are wasted, there are too few of the heart and lung specialist doctors, nor are there many capable hospitals. So I think that with more citizens joining in the donation program, the number of China's organ transplant hospitals must continue to increase. Organ transplant qualified doctors are numbered, as far as I know only slightly more than 200 people. So for a big number of health insurers in place, there would be a lot more organ transplant patients. So we must have an open, transparent environment for organ transplant, with more training of transplant doctors. I hope that within three to five years, the number of National Organ Transplant hospitals can reach 300, and I hope we can have 1,000 to 2,000 transplant doctors, then there is hope for the cause of organ transplantation.
Reporter: For those already qualified hospitals, is there any chance that any of them be brushed down [i.e. their qualification stripped]?
Huang Jiefu: Organ transplantation is a very professional operation, there are a lot of scoring systems; if any is found to be below the standard, then of course they will be brushed down. Of course the answer is yes (that there were brushed down examples), this number of 169 is dynamic.
Reporter: The area distribution of the transplant hospital in the country is quite uneven, this means that many people from the cities that do not have the transplant hospitals will have to come to places such as the north, and the situation will be further exacerbated by the lack of organ resources. What is to be done for the areas that do not have transplant hospitals but with identifiable potential recipients?
Huang Jiefu: Why is it that now it's focused in large hospitals doing [transplants]? Because in the past they relied on that kind of source (referring to organs from executed prisoners), so it must be concentrated in large hospitals. So when the transplant system became more transparent and open, the county hospitals and district city hospitals can also apply for an organ transplants. It’s a process. So I think with the development of the cause of organ transplants, kidney transplants can be carried out in good county hospitals later on, and there will be a number of services to carry out organ transplants at county hospitals and district city hospitals. It can be nation wide, but there is a process to achieve that. We rely on propaganda and mobilization.
V. Red Cross's help in establishing the organ transplant system
Reporter: At the medical level, we don't really encourage living donor transplant?
Huang Jiefu: Yesterday there was a document which showed that in the national waiting list for organ transplants there are 22,000 people, according to the previous two months' statistics in voluntarily organ donation citizens, at least 10,000 cases of organ donation, it is actually in a ratio of 1: 2, for 1 organ there are two individual needs, not what you think of 1: 150, which was too far from the true facts.
As for living donor transplants you've just mentioned: if (we have) registered organ donors, why use living donors then? In medicine there is a Hippocratic oath which states 'do not cause harm to the object of your service'. First of all, the living organ donation is damage done (to donor's body), whether it is to get a kidney or taking out half a liver. The surgeries are major ones, especially when taking out half a liver, it's a high-risk surgery operation. In order to save a person, if it is with the expense of risking another person's life, then this thing is not encouraged by the state. However, it can be a last resort, if there are registered organ donors, then of course we’ll encourage the big-hearted donations. Living organ donation needs to be controlled.
Reporter: In March 2014, China set up the Committee of Organ Donation and Transplantation, and you served as the first chairman. You have said in the interview, that it was a way of having third-party intervention to ensure that the entire donation and use (of organs) was an open and transparent process. Can you talk about the results of the work for the past year?
Huang Jiefu: The establishment of the Organ Donation and Transplantation Committee was under the leadership of the Health Planning Commission and the Red Cross, under the care and support of the leaders of the State Council, to form a committee on the top of the whole organ transplant services to complete the structural design, but also for developing relevant policies. Above of it there would be leaders from the People's Committee and the CPPCC National Committee, as honorary chairmen of this committee to guide the work.
I chaired the committee, and why? I am 69 years old soon, and according to logic I should be out of the administrative work now, because I am an organ transplant doctor, also because the community of transplant doctors, and ordinary people, trust me, so they told me to set up this committee. But people need to retire, and I am now actively working against my age and encouraging myself. I hope in an another year or more I can build up this framework, so that the prime comrades can continue to lead this work. Because the organ donation transplant work has the need for a professional, and a domestically and internationally influential person who can command the team, I think we have a lot of such young and middle age people in the team, they will become mature (in this profession) quickly.
Reporter: Currently part of the organ donation work has the need of corporation from the Red Cross, it needs the propaganda and mobilization from the Red Cross, or to help the donor families with humanitarian aid. However the Red Cross now has a very poor in reputation in China, so will this affect the work of the Red Cross in organ donation tasks?
黄洁夫：我很不同意你的讲话，红十字会的声誉特别的差，我不想你这么说。在建国以后，红十字会在国家的慈善事业上发挥了巨大的作用，做出了很难被人否定的贡献。Huang Jiefu: I am very much not in agreement with your speech , especially the bit about the poor reputation of the Red Cross, I do not want you to say it this way. After the establishment of the country [i.e. founding of the PRC], the Red Cross has made great contributions to national philanthropy, its contribution are difficult to negate.
Red Cross is the nation's largest humanitarian relief organization, the Red Cross Spirit is: love, devotion. Many of which are deeply rooted in the land of China. One should not negate all its merit because of one "Guo Meimei incident" [a scandal that tarnished the reputation of the China Red Cross]. I feel there is a need to clearly separate the good contribution and the mistakes from the Red Cross organization for all these years. Red Cross’s role in our country is irreplaceable: the Red Cross' blood donation, bone marrow donation, and now the organ donation program, these three offerings is important work from the Red Cross.
In 2009, we began to organize the Red Cross and the health administrative departments work together to complete the organ donation program, the Red Cross has made a significant contribution. The facts prove that without the involvement of the Red Cross, there is no Chinese voluntarily organs donation industry. How many touching stories! Guangdong Province's Red Cross memember Zhao Lizhen, coordinator Gao Min, Li Jindong to name a few, there are just too many such examples.
要知道器官捐献协调员工作是很伟大的，他要在一个家庭失去亲人的痛苦中，能够安慰这些家人，能够把生命的挽歌形成一次生命的升华，上到天堂去。同时他也把家属的悲痛用另外一种救人的行为减轻。红十字会的协调人员是相当不简单的，他要有很好的人文素养，他要有科学知识。所以不要对红会永远留下“郭美美事件”的成见，我相信通过公民自愿捐献事业的不断发展，红十字会的作用、地位将进一步地显现，多点宣传红会。To know that organ donation coordinator was so great, he needs to work on a family in pain, a family which just lost loved ones and is in pain, it is possible for them to comfort the family, for them to able to form a life-time elegy when lives go on to heaven. He also put the grief of the families in another rescue act. Red Cross coordinator is quite extraordinary, and he must have a very good human qualities, he must have scientific knowledge. So do not think of Red Cross forever as "Mei Mei Guo event" stereotypes, I believe that as the continuous development of the citizens' voluntary donation program, the important role of the Red Cross will become more apparent. So we need more publicity of the Red Cross.
记者：您刚才也提到了协调员，在我们整个器官捐献系统中，协调员是第一步的，去发现器官。但是我们也看到不少协调员在抱怨工作的难以开展，待遇和地位都不怎么好，您怎么看？Reporter: You just mentioned that the coordinator in the organ donation in our system, the coordinator's role is most important in finding organs. But we also see a lot of complaining about the work from the coordinator that it is difficult to carry out their, also the treatments the received and their status is not that good, what do you think of it?
Huang Jiefu: What you have said is right, the coordinator's work is quite extraordinary, requirements to coordinators are very high. He should be a high interpersonal person in the society, at the same he has to have a very profound humanistic spirit and a literate person. But now things are at the starting point. the National Commission on organ donation and transplantation program was established at 1st of March, 2013. The cause of this organ donation program is just a newborn baby, one can not demand perfection on newborn babies, one should care for it, cultivate it, take care of it, let it grow up healthily, it includes the coordinators, too, we need to care for them, give them proper treatments, social status, working conditions through work, rather than just working hard on our lips. We must take a positive attitude to their development to provide positive energy.
VI. World Health Organization removing sanctions against Chinese organ transplant research
Q: Nowadays, people say China performs the second largest number of transplants. Some say that this is simply because of China’s large population.
HJ: This “hat” was determined by the WHO based on the types of transplants done, such as liver, kidney, lung, heart, pancreas-kidney combined, and multi-organ transplants; as well as the 10,000 transplants performed per year in China. According to the principles defined by WHO, we are number 2 in the world.
Q: What do you think about this “hat”?
HJ: If citizen voluntary donation became the norm, then we are for sure number 2 in the world, without reservations. If we remain the same as before, then we feel shameful of ourselves. I think we should not be called a “big transplant nation.”
实际上世界卫生组织根据数字说我们是第二大国，但从来没有承认过我们是世界的器官移植大国，连国家都不承认。世界卫生组织对我们是三不，不同意我们器官 移植的医生在国际会议上宣读论文；中国有关器官移植的文章，包括临床文章，在世界所有著名的杂志上不能发表；不接受中国成为世界上任何器官移植协会的会 员。这是三不。目前在国际上真正参加TTS（国际器官移植协会）的就剩我一个人，你能说是大国吗？
In fact, WHO said we are number 2 in the world based on numbers. But they never acknowledged that we are a “big transplant nation.” They don’t even recognize us as a country. The WHO has 3 sanctions against us: no allowing our transplant surgeons to read their thesis at international conferences; transplant papers from China, including those clinical research papers, are not allowed to be published in international medical journals; China is not accepted as a member of any international transplant committee. This is the so-called “3-No.” Currently, I am the only remaining member of the TTS. How can you say that China is a big (transplant) nation?
Q: Is the “3-No” still in effect now?
HJ: After we ended using the executed prisoners’ organs, we have received enthusiastic praises from all the transplant committees in the world, including the Pope, who said that it is an important progress in China’s transplant industry, judiciary system and the human rights. All media in the world are praising China. Their original wordings are, they are prepared to welcome China into the big worldwide family of transplantation with open arms.
所以在这个时候，我正在筹备，今年下半年举行一次中国光明正大地登上世界移植舞台的会议。我想，到时候世界卫生组织的，还有全球器官移植协会的主席，还 有伊斯坦布尔宣言的145个国家的器官移植团体的主席，他们都向我发来了贺信，同时他们都说一定要来参加这个会议，他们会在那个会议上宣布废除这个三不， 你们要把这个消息告诉老百姓。
Therefore, at this point, I am preparing to organize a conference in the second half of this year. This is to showcase China’s entry to the world’s stage of transplantation in an open and dignified manner. I believe, the chairperson of WHO, the directors of all the transplant committees in the world, as well as the chairpersons from all 145 member nations of the Istanbul Declaration have sent congratulatory letters to me and promised that they will for sure attend the conference (that I am planning). They also said that they will formally declare the “3-No” ineffective at the conference. You (the media) should tell this news to the general public.
Publication: Phoenix (via Caijing)
Title: “Former Health Minister: Zhou Yongkang’s downfall broke the profit chain using death row prisoner organs” | 原卫生部副部长：周永康落马打破死囚器官移植利益链
Xu Gehui (reporter with pro-Beijing Phoenix Television): Minister Huang, we know that shortly after this organ donation and transplant, you personally delivered a thank-you letter to the French Embassy.
Huang: This young man’s parents came to Hangzhou from France. When they were told that China has stopped using executed prisoners’ organs, they made the decision. Therefore, this has a very important meaning.
Xu: Right. What on earth does this mean?
Huang: He donated the organs. This means that China’s organ donation system is already transparent (foreigners say). In the meantime, their participation of the donation system is in fact a significant acceptance of our donation system. Because this is a gift of life, if it was a filthy and unclear area, foreigners would not want to do this.
Xu: Such an ordinary incident has such great impression in your mind, must because China’s road to organ donation has been turbulent. Let’s look back at what we’ve been through.
Narrator: According to statistics, there are over 300,000 people in China waiting for organs. But each year, only about 10,000 transplants are performed. In the No. 1 Affiliated Hospital of Sun Yat-sen University in Guangzhou, there are many kidney failure patients waiting in line for kidneys.
Patient: There were very little kidneys. Now even executed prisoners’ organs are gone. I feel there will be fewer and fewer (organs), and (my) chance is getting more and more scarce.
Zhang Ling (Resident Physician, No.1 Affiliated Hospital of Sun Yat-sen University): Many people gave up during the long wait, because they felt there was very little chance.
Narrator: China’s first human organ transplant was done in 1972 in Sun Yat-sen Hospital in Guangzhou. Nowadays, it has become one of the largest transplant centers in China.
He Xiaoshun (Deputy Director of No.1 Affiliated Hospital of Sun Yat-sen University, Director of the East Campus): As early as 1972, we did a kidney transplant, which was Asia’s first living donor kidney transplant between family members. China’s first thyroid transplant was done in 1978. China’s first liver transplant was done in 1993. All the way until now, the history is quite long.
Narrator: According to sources, prior to 2010 when there was no citizen donation system in China, the organs mainly came from executed prisoners. With the hard work of Huang Jiefu and others, the Ministry of Health announced an end to using executed prisoners organs in 2015. This is a great progress for China after implementing an executed prisoners donation system for 20 years.
Xu: Exactly how many people are waiting for organ transplant?
Huang: 22,000. This data comes from Haibo. In mainland China, not including Hong Kong and Taiwan, there are 22,000 people waiting for organ transplant. This is the exact number. Why? Why do we have this exact number now? Because after we eliminated the executed prisoners’ organs, it transformed into a transparent, sunny, traceable organ transplant system.
Xu: You said because there is no more executed prisoners’ organs for transplant, this matter became transparent. But how come this number of how many people need organs was not transparent before?
Huang: Death penalty is a state secret, right?
Xu: But illness is not a secret. I am sorry, I really don’t understand.
Huang: The source of organs was executed prisoners.
Xu: Yes. That is to say the source of organs can be a secret. But this number of how many people are waiting for organs does not have to be a secret, right?
Huang: [rumbling half sentences, no logically connection between sentences, hard to translate] You take (organs) from the prisoners, how many (transplants) you did, then wouldn’t everyone know the state secret?
Xu: Then the number (waiting for prisoners’ organs) should be smaller than the number now. There is another reason. [incomplete sentence]
Huang: What you just said is too sensitive, so I can’t talk about it too clearly. You think about it, you will understand. Because if your country has no transparency, you don’t know how the organs were obtained, the transplant numbers are also secrets. Therefore, in fact many things were messed up, you cannot be clear about it. But in fact, it is not that as soon as you have the match you can do the transplant. First, money is required. Simply put, organ transplant is not categorized as an advanced medical service in our country. It’s very difficult for ordinary persons to pay the tens of thousands yuan medical expenses. But then there are also post-surgical procedures. A liver transplant costs at least 600,000 yuan. A kidney transplant costs at least 300,000 yuan. This is an impossible amount of money for ordinary people. Many people can’t afford it so they don’t want to do it.
Xu: So they are not on this (wait) list?
Huang: It is impossible for them to be on the wait list. We have only 169 hospitals [allowed to perform organ transplant]. Do you know? They can’t even get in the door of these hospitals, how can they be on the wait list. Organ transplant is a very very important illness, because it is between life and death. So the government’s influence to those patients with organ failures should be paying for the transplant from the health insurance. This way, the poor people in our country also have the right and possibility to obtain an organ transplant.
Xu: Looking back at 2005 when you, for the first time, said China uses organs from executed prisoners at an international conference. It’s been ten years.
Huang: ten years, ten years sharpening one sword.
Xu: so when we think about these ten years, it must not be easy.
Huang: Haibo might be the one with the most experience (with the difficulties).
Wang Haibo (China Organ Transplant Response System advisor): right, very turbulent.
Xu: From your perspective, what is the most difficult part?
Wang Haibo: We’ve overcome the technical difficulties, were able to establish a computerized organ distribution system with high efficiency and fairness; and were able to meet the international standards. After all these were accomplished, came the most difficult part. From my perspective, it has to do with using the system in our country, getting everyone to accept the system and to use the system.
Huang Jiefu: The most helpless period we've been in... is when we decided to stop the reliance on executed prisoners for organ transplants. Because [we’ve been using] these executed prisoners’ organs for several dozens of years… First I want to put it this way, to be accurate, we are grateful for most comrades in the judiciary system. Without their cooperation, without the donation from executed prisoners, there would have been no transplantation in China, and there would not be any advancement in [transplantation] technology in China. Do you agree? In the meantime, I believe most of them in the judiciary system abide by the law. But our country is very big. This source of using prisoner organs, this kind of situation naturally would come to have all kinds of murky and difficult problems in it. You know what I'm trying to say? So.
Xu Gehui (reporter with pro-Beijing Phoenix Television): In the midst of all this there must be every kind of entanglement, intertwining of interests, and a profit chain, so it would have become very filthy.
Huang Jiefu: It became filthy, it became murky and intractable, it became an extremely sensitive, extremely complicated area, basically a forbidden area. Last year was the most crucial year.
Wang Haibo: Right
Huang Jiefu: 2014 was the transitional test period for Chinese organ transplantation. We really thank the Party Central State Council for having the kind of attitude and atmosphere. What was this atmosphere? Anti-corruption. If there was no attacking the tigers and smashing the flies, we wouldn't be here today abolishing the system. You know what I'm saying? So the domestic and international environment, especially the climate of anti-corruption, clean government, that's the only way we were able to publicize this.
Xu Gehui: Why, after attacking the big tiger, were you able to overturn this system of using executed prisoner organs? Who is this big tiger, after all?
Huang Jiefu: It's just too clear. Everyone knows the big tiger. Zhou Yongkang is the big tiger; Zhou Yongkang was our chief of Political & Legal Affairs Committee, originally a member of the Politburo Standing Committee. Everyone knows this. There are newspapers every day talking about his background. So as for where executed prisoner organs come from, isn't it very clear? Actually, this work received the support from the previous General Secretary, Hu Jintao, and premier Wen Jiabao, and currently serving Xi Jinping and premier Li Keqiang's support. Otherwise we couldn't have done this.
Narrator: In 2010, the Ministry of Health (MOH) launched a trial system for organ donation. In order to be more scientifically oriented in the organ distribution and management, prior to the trial, the MOH asked experts to design a computerized system for organ distribution.
Jiang Wenshi (COTRS research center): The nation’s complete organ distribution guideline is over 390 pages. We estimated roughly 60 hours to manually go through the guideline to determine the organ distribution. So now, we have computers to do this task for us. The computers will do this loyally based on the guideline.
We are now showing how a liver is being distributed. After all the required information is filled in, our OPO (Organ Procurement Organization) can start the process of systematic matching. Then a transplant center will receive a message from the system telling them there is a match for one of its waiting patients. Every time, we select 5 recipients. In this case, this center is told that they are the number five. Here is a button. If the administrative monitoring agency discovered something suspicious during the distribution process, they can reverse the decision even though the organ has been distributed.
Narration: Sept. 1, 2013, National Health and Family Planning Committee (NHFPC, formally the Ministry of Health) mandated the use of the computerized system. This started the computerized organ distribution in China. Starting 2014, the system is formally managed by China Organ Transplantation Development Foundation.
Xu: I’d like to know if the system is based on internationally proven guidelines and if they have been adapted to our country’s specific situation?
Wang Haibo: We started the research of organ distribution policy in 2009. People have this misunderstanding that the main entity of the system is the computer.
Xu: Isn’t it so?
Wang Haibo: It is actually surrounded.
Xu: Isn’t it fair if the main entity is the computer?
Wang Haibo: The computer is a technical platform. It is designed according to the policies of our country. Any country is the same. We looked at the organ distribution policies of a dozen countries. We summarized them and came up with our own draft. I remember Huang Jiefu went through it word by word. It was a difficult process. Then this draft was issued by NHFPC. It can be found on its website. Then the computerized system was made. A trial was started in April 2011. Until Sept. 1, 2013, it became a mandate system used nationwide.
Huang: a mandated implementation.
Wang Haibo: a mandated implementation.
Huang: a mandated implementation. All must be entered into this system. This is the reason why we abolish the executed prisoner organs.
Publication: Beijing Youth Daily 北京青年报
Title: 全面停用死囚捐献器官 我国公民自愿捐献今年达历史最高 黄洁夫：器官来源转型 移植数不降反升 | Complete stop of using executed prisoners' organs, Chinese citizen voluntary donation reached historical high this year Huang Jiefu: Shift in organ sources, number of transplants did not drop but increased
Full version of item:
Huang Jiefu: Now in the citizen donations, many hearts and lungs are wasted because there aren't many doctors who can perform the transplant. In addition, the system of organ procurement and transportation is not yet mature. There are only 20 doctors in the country who can do heart transplant. Only 100 heart transplants and 200 lung transplants were done in one year in the entire country.
Publication: Beijing Youth Daily 北京青年报
Title: Huang Jiefu: Whether Death Row Inmates Can Donate Organs is a Pseudo-proposition | 国家器官捐献与移植委员会主任委员黄洁夫今日将获颁顾氏和平奖 黄洁夫：死囚可否捐器官是伪命题
Full version of item:
In addition to the number of transplants done, this article also talked about Huang's encounter with Didi Kirsten in the Philippines after her NYT article was published questioning the organ sources. The NYT articles referenced are listed below:
China Bends Vow, Using Prisoners’ Organs for Transplants
Nov. 16, 2015
Fresh Doubt Over China’s Pledge to Amend Transplant Policy
By Didi Kirsten Tatlow
November 18, 2015
Transplant Chief in China Denies Breaking Vow to Ban Prisoners’ Organs
Nov. 25, 2015