This is an undeniable fact that poverty not only affects the economic conditions of society, but also has an impact on the social life of citizens. The decrease in purchasing power of citizens leads to changes in their previous social habits, such as allocating expenses for leisure, clothing, suitable food, health and medical care, and as a result, a lifestyle is formed in which the sole goal is to meet basic needs, including a roof over their head and minimal food to survive.

With the spread of poverty and its increasing pressure on citizens, reducing expenses is no longer enough to meet the needs of families. Individuals are forced to change their source of income or find a new one in order to meet their basic needs. This is because, on one hand, with the rise in inflation, the purchasing power of their previous income has decreased, and on the other hand, the economic conditions are such that expecting an increase in income from their previous source is not realistic.

In such economic conditions, it is certainly not possible to change the source of income through customary and common methods such as seeking a higher paying job; because the job market, affected by the dire economic situation, does not have the capacity to attract higher paying workers. Therefore, the only way to maintain the so-called “existing status quo” is to increase income through unconventional, unhealthy, but legal methods; methods that are referred to by social and economic researchers as “false jobs”; jobs that, although not prohibited according to their own society’s laws, have a direct relationship with the spread of poverty in society and are spreading at the same rate and speed.

The direct relationship between poverty and organ sales in Iran.

The role of poverty in the spread of false jobs, especially the sale of body parts in Iran, is undeniable. Just a glance at the economic statistics of this year (1400) shows that the economic situation of Iranians is still as dire as it was four years ago, and poverty caused by it has only increased. In this regard, Mohammad Reza Pourabrahimi, the head of the Economic Commission of the Islamic Consultative Assembly, in November 1400, confirmed the increase in the poverty rate compared to last year, calling it a ten percent increase. According to him, the poverty index in Iran has risen from twenty-two percent last year to close to thirty percent this year.

This figure, however, does not match the official statistics and it seems that the situation is worse than what this representative of the parliament in Iran claims; because according to a report published by the Ministry of Cooperatives, Labor, and Social Welfare in August of this year, the poverty rate of 32% is related to the year 1398, in which the inflation rate was about 35%. This means that in 1398, more than 26 million people in Iran were living below the poverty line and in absolute poverty.

This figure has certainly increased in 1399 (2020-2021) with the rise in inflation rate to 26.5%, and as a result, it seems that with a 40% inflation rate this year and a 38% increase in the poverty line, currently at least 26 million citizens in Iran are living in absolute poverty. This situation, in which meeting basic needs such as access to housing, clean drinking water, food, and healthcare becomes a major and unattainable challenge for citizens, is a state that has the greatest potential for creating and expanding false jobs; because in it, the goal is only to provide basic needs for survival, not living.

In addition to the correlation between economic statistics and the increase in organ sales, this issue has also been confirmed by official authorities. In this regard, Hossein-Ali Shahriari, a member of the Health and Treatment Commission of the Islamic Consultative Assembly, in his statement in February 2017, considered the citizens’ selling of their organs, especially kidneys, as part of “resistance economy” and said: “When we talk about resistance economy, the best thing to do is to donate kidneys; because the costs are reduced as dialysis has very high expenses and a large number of machines need to be purchased.” This representative of the Iranian parliament also explicitly stated that poverty is one of the influential factors in citizens’ willingness to sell their organs, saying: “What is wrong with someone who is living in poverty and can change their life by receiving 20 to 30 million? Why shouldn’t they do this?”

Is “selling” prohibited by law and “donating” allowed?

Some believe that the legal vacuum in the field of organ sales in Iran has not had any impact on the spread of this phenomenon and that the issue of organ sales is not merely an economic issue arising from poverty. This means that despite the explicit criminalization of buying and selling organs in many countries for the purpose of transplantation, this issue is not mentioned in Iran’s criminal laws and is only addressed in the Ministry of Health’s circulars to organ transplant societies and medical centers mentioned in them.

In this regard, according to a memorandum issued by the Deputy of Health of the Ministry of Health in October 1999 entitled “Guidelines for Donation and Transplantation of Kidneys from Living Donors” addressed to all kidney transplant centers, it is stated that advertising for “kidney donation” and also “commercial intermediation in the donation process” is strictly prohibited and legal action will be taken against violators. However, despite the fact that even the Ministry of Health’s memorandum refrains from using the word “sale” to express its prohibition, the main issue here is that according to current criminal laws in Iran, there is no punishment for advertising kidney donation and it is unclear on what legal basis the Ministry of Health’s threat of action is based on.

On the other hand, this lack of explicit mention of the issue of selling body parts in this memorandum shows that at least the officials of the Ministry of Health do not have a problem with the sale of body parts by living individuals in general, and they have not even taken any action to directly prohibit it in their memorandum for the sake of appearance.

It is from this that even according to the regulations and current practices of the kidney patient support associations in the provinces, a mechanism has been created for receiving a sum of money from the kidney recipient and transferring it to the donor. Davood Norouzkhani, the head of the Central Province Kidney Patient Support Association, confirmed the existence of this mechanism for receiving and paying the amount for the kidney donation as a “sacrificial gift” from the recipient to the donor in December of this year and announced its ceiling to be up to eighty million tomans. However, he also acknowledged the fact that a financial agreement is made between the recipient and the donor outside of the association’s mechanism, and this agreement can reach up to three hundred million tomans in Tehran.

The pursuit of earning more income through wholesale sales has also led many sellers from other provinces and cities to go to Tehran and sell all their goods at a higher price in this city. However, this is not an easy task for non-Tehran sellers and comes with its own difficulties. According to the law, individuals can only donate in the city they reside in. Therefore, these individuals are forced to provide a formal lease agreement for a house in Tehran to prove that they are residents of this city. This is not a free task and as a result, it increases the cost of sales and raises the selling price.

Although the claim of a legal void role is somewhat acceptable from a legal perspective, social and economic realities show that the absence of preventive laws is merely a facilitator and these economic conditions play the main role in the issue of organ trafficking in Iran.

In this regard, Hossein Biglari, the head of the Association for Support of Kidney Patients in Kermanshah, confirmed in December of this year the role of economic conditions, especially the spread of poverty, in the increase of the “sacrifice donation” amount, and mentioned the influence of provincial support associations for kidney patients in this price increase. According to him, “Unfortunately, the associations themselves have increased the price of kidneys; previously, the price of a kidney was 18 million tomans, but it has now increased to 34 million tomans. In the past year or two, the price suddenly became 80 million tomans. When the price of a kidney was 34 million tomans, the parties would agree on prices close to 50 million tomans and the transplant would take place, but when the central support association for kidney patients raised the price to 80 million tomans, no one is willing to donate a kidney at lower prices.”

This position confirmed the role of economic agents in the donation of body parts, as well as in other opinions. According to him, since the transplantation of body parts from Iranians to non-Iranians is prohibited, some donors (read: sellers) go to Iraq with the intention of receiving more money for transplantation surgery and there they calculate the amount in dollars with the recipient; a practice that clearly shows the stabilization of the sale of body parts by citizens in Iran as a way to earn income and escape absolute poverty.

Selling body parts is not limited to only kidneys, some also sell a part of their liver to individuals who have liver problems in order to make a profit. Recently, there have been reports of hair being sold, indicating the depth of poverty. According to these reports, some parents, due to extreme financial poverty, sell their children’s hair to cover the cost of their education and food. Buyers, mostly hairdressers and producers of artificial hair, use the purchased hair for hair extension procedures. There have even been reports of exported hair to Turkey and other countries, showing the depth of this human trade. However, the sellers only receive a small portion of the profit, with their only goal being to make enough money to cover their basic needs. This is similar to kidney and liver sellers, whose only goal is to survive, as at this level of widespread and increasing poverty, no one becomes rich with this money.