From Policy to Practice: A SWOT Analysis of India's Organ Transplantation Regulatory Framework

Background India's regulatory framework for organ transplantation, governed by the Transplantation of Human Organs and Tissues Act (THOA) and its amendments, aims to promote ethical practices and equitable access to organs to all its citizens. Systemic challenges, including mistrust, inequities, and inefficiencies in implementation, however, persist. Materials and Methods This qualitative study utilizes SWOT analysis to examine the strengths, weaknesses, opportunities, and threats within India’s organ transplant policies. Data were collected through desk reviews and interviews with 10 key stakeholders, including policymakers, transplant coordinators, and civil society representatives. The findings were analyzed using the ecological perspective framework. Results The strengths of the Indian transplant regulatory framework include a multi-tier arrangement with institutions like the National Organ & Tissue Transplant Organization and robust safeguards against coercion. Weaknesses involve inadequate accountability, underutilized deceased donation programs, and limited financial accessibility. Opportunities exist in regulatory reforms, expanding organ-sharing networks, and adopting state-level best practices. Threats that hinder progress include the prevailing social inequities, poverty, corruption, gender disparities, and cross-border trafficking. Conclusion India’s organ transplantation system, while comprehensive, still requires reforms to address accountability gaps, inequities, and cultural barriers. Aligning domestic practices with global ethical standards can create a transparent, effective, and equitable system, providing valuable insights into international transplantation frameworks.