HOW COULD WE IMPROVE THE PHILIPPINE ORGAN DONATION SYSTEM?

HOW COULD WE IMPROVE THE PHILIPPINE ORGAN DONATION SYSTEM?

I find it hard to believe that in a country of more than 110 million people, we have barely over a hundred registered organ donors. That is not even a fraction of one percent. Compare that with countries like the United States, where roughly 60% of adults are registered donors, and the gap becomes not just alarming—but tragic.

What happened to us?

We cannot say that we lack laws. We already have Republic Act No. 7170. The legal framework exists. The intent is clear. But as in many other areas, we seem better at writing laws than implementing them.

So where is the real problem?

At first glance, one might think it is technical. It is not. We already have systems like the Philippine Network for Organ Sharing, and we are more than capable of building modern databases for matching donors and recipients. Technology is not our bottleneck.

Is it financial? Again, I doubt it. The cost of building a functional system is minimal compared to the value of lives saved.

In my view, the biggest barrier is culture.

Let us admit it: organ donation is simply not yet part of the Filipino mindset. Many still associate it with fear—fear of body mutilation, fear that doctors may not do their best to save a registered donor, or even religious hesitation. Whether these fears are valid or not is beside the point. They exist, and they influence decisions.

But culture is not fixed. It can evolve.

We need to make organ donation part of our national consciousness. Not as a medical procedure, but as an act of heroism. After all, one donor can save up to eight lives. Imagine that—eight families given a second chance because of one decision.

The numbers are heartbreaking. Around 2,000 Filipinos die every day. Of these, an estimated 30 to 35 could have been potential organ donors. Yet, in reality, we barely recover even one donor per day. On the other side of the equation, about 13 to 17 Filipinos die daily waiting for a transplant that never comes.

This is not just a system failure. This is a moral crisis.

So what can we do?

First, we must seriously consider shifting from an “opt-in” to an “opt-out” system, similar to what countries like Spain have successfully implemented. In an opt-out system, every citizen is presumed to be a donor unless they explicitly refuse. This simple change in default has dramatically increased donation rates in many countries.

Second, we must strengthen hospital-based systems. Every major hospital should have trained transplant coordinators who can identify potential donors and speak with families at the most critical moments. Timing is everything in organ donation. Without a prepared system, opportunities are lost forever.

Third, we must integrate donor registration into everyday transactions. Why limit it to driver’s licenses? Why not include it in the national ID, passports, or even voter registration? The easier it is to sign up, the more people will do so.

Fourth, we must invest in logistics. Organs have a very short lifespan outside the body—sometimes just a few hours. We need a “green lane” system for rapid transport across islands, supported by both air and land networks.

Finally, and most importantly, we must win public trust. Transparency is key. People must be assured that organs are allocated fairly, not based on wealth or influence. Without trust, no system will work.

At the end of the day, this is not just about policy or infrastructure. It is about values.

Are we willing to give life even after death?

If we can answer that question as a nation, then improving our organ donation system will not be difficult. Until then, we will continue to lose lives—not because we cannot save them, but because we chose not to.

RAMON IKE V. SENERES

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