Congress Ends Blanket Ban on HIV Organ Donation

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November 14, 2013

Tuesday, the House of Representatives passed the HIV Organ Policy Equity (HOPE) Act, a bill that will end the blanket ban on the donation of organs from HIV-positive individuals, clearing the way for transplantation of such organs into people living with HIV to become routine practice in the near future. The Act will phase in this change in two stages, first paving the way for research on such transplants and later, based on the results of that research, allowing the Secretary of Health and Human Services to authorize widespread and routine utilization of this procedure. Overturning a statutory ban in place since 1988, the bill has received strong bipartisan support and is expected to be signed into law by President Obama.

This policy change is an important life-saving step forward for people living with HIV that has long been supported by the medical community but delayed because of the statutory ban, which was rooted in outdated ideas regarding HIV and concerns about the safety of the pool of available organs. The HOPE Act ensures the continuing safety of organ transplants and addresses the need for transplantable organs for people living with HIV as a result of the significant advances in the ability to treat and prolong the lives of people living with this condition. The need for transplantable organs is especially acute for long-term survivors, whose organs—particularly the liver and kidneys—are more susceptible to failure as a result of the powerful medications used to treat HIV.

The organs of HIV-positive donors, which had previously gone to waste, should gradually become more widely available to people living with HIV who need them. When they are, there could be as many as 600 additional organs per year available, resulting in hundreds of lives saved.

Lambda Legal applauds this important step along the path to more sensible policies regarding HIV, but recognizes that much work remains to be done. The next logical step would be to allow research regarding transplantation of organs from HIV-positive individuals into HIV-negative individuals, who should be permitted to make a fully informed choice to accept such an organ in the face of life-threatening organ failure. And as the HOPE Act does with respect to positive-to-positive transplants, Congress should generally allow the appropriate agency to amend policies regarding safe organ transplantation, with the guidance of the scientific experts and medical ethicists best equipped to make such decisions. HIV exceptionalism, untethered to the facts, leads to bad results.

The HOPE Act will save lives, and potentially kick-start a conversation about HIV that will allow us to stop singling out people living with this condition (and those at higher risk) for restrictions that prevent them from participating fully in society. Consonant with the name of this important legislation, we “hope” that incorporating up-to-date scientific evidence about HIV transmission risks in the organ donation guidelines signals that the government is ready to move forward on revising other archaic policies based on misconceptions regarding HIV. Outdated policies on blood donation, military service, and HIV criminalization are incongruent with current testing technologies, our more comprehensive understanding of the actual routes and risks of HIV transmission, and the progress we have made in making HIV a chronic, manageable condition through early discovery, proper care and treatment.

Our government should be leading the charge in combating stigma and discrimination and dismantling the barriers to care and treatment they trigger, and the bipartisan passage of the HOPE Act gives us hope that things are heading in the right direction to accomplish that goal.