An official in charge of overhauling China's organ transplant programme has said the country may still be using organs from executed prisoners in some cases, even though there is technically zero tolerance for the practice.
The admission by Huang Jiefu, a former Chinese deputy health minister, came as human rights activists and medical ethics experts voiced strong objections to his inclusion at a Vatican summit designed to tackle illicit organ trafficking.
The activists said that by giving Huang a platform, the Vatican risked giving China's practices an air of legitimacy. Huang told reporters on Tuesday that the controversy was "ridiculous" and repeated assertions that the use of organs from prisoners is now "not allowed".
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"There is zero tolerance. However, China is a big country with a 1.3 billion population so I am sure, definitely, there is some violation of the law," he told reporters at a conference in Rome.
Pope Francis has called illicit organ trafficking a form of modern slavery. At the start of the conference on Tuesday participants painted a bleak picture of the scale of the problem, with patients who are desperate for life-saving procedures flocking to countries like Egypt, India, and Mexico to buy organs cheaply.
Huang, who has long been a controversial figure in the world of transplantation, said trafficking could be stemmed through the creation of a global taskforce headed by the World Health Organisation.
But experts have questioned Huang's assessment of the situation, saying China probably still systematically uses the organs of executed prisoners in order to meet an overwhelming demand.
Last year, China's alleged use of prisoners' organs was debated at an international conference after two doctors said it was premature to declare China an ethical partner in the international transplant community.
Nicholas Bequelin, the east Asia director for Amnesty International, said it was known at the time that the vast majority of organ transplants in China came from executed prisoners.
The number of prisoners China executes annually is a state secret, but Bequelin said estimates ranged from 3,000 to 7,000. He said experts had cast doubt on Huang's claims that China had outlawed the practice. "They haven't stopped the practice and won't stop. They have a need for organ transplants that far outpace the availability of organs," Bequelin said.
Details of the process are grim. Bequelin said China did not adhere to World Health Organization recommendations on how doctors should determine whether a person is legally dead. In some cases, organs have been removed before the prisoner would be considered medically dead by international standards.
"The timing of the execution is – we think – sometimes dependent on the need of a particular transplant surgery. You will execute this person at this time on this day, because that is when the patient has to be ready," Bequelin said. "It is very secret and there is not a lot of reliable information."
The Vatican has released new bioethics rules that say organ transplantation must involve the free consent of living donors or their representatives and that in ascertaining the death of a donor, it must be diagnosed with certainty, especially when a child is involved.