Challenges

Many countries in Latin America lack both donation and transplant systems that are fully installed and functioning, and donation policies that cover all procedures. This could place both organ patients and donors at risk and such a situation is due primarily to the costs associated with such procedures and the country’s level of technical capacity.

Toward a Solution

The Argentine National Institute for Coordinating Ablation and Organ Transplants (INCUCAI) leads, regulates, coordinates and supervises the donation and transplant activities of organs, tissues and cells. It also promotes, regulates and coordinates the procurement and transplantation of organs, tissues and cells at the national level, guaranteeing transparency, equity and quality. The Institute aims to build a system embedded in the health structure that can respond to the multiple demands of transplants, supported by the community’s trust and positive attitude towards donation.

The cooperative actions developed by this institution of excellence address the goals of SDG 3: Ensure a healthy life and promote well-being for all at all ages.These actions facilitate access to quality essential health services, while also encouraging alliances among the region’s institutions, which is also a goal of SDG 17.

For over 25 years, the Argentina Fund for South-South and Triangular Cooperation (FO.AR), under the aegis of the General Directorate for International Cooperation of the Ministry of International Affairs and Worship, has established and sustained development partnerships. It is supporting INCUCAI in order to share its experiences with donation and transplant agencies in Bolivia, Costa Rica, Paraguay and Peru, which were interested in developing bilateral cooperation projects to improve their national systems.

Its purpose is to build capacity through the exchange of knowledge, technologies and best practices and to create instruments that enable more dynamic development processes via technical assistance provided in the context of international cooperation projects.

By designating INCUCAI as a Pan American Health Organization (PAHO)/WHO Collaborating Center, this institution has become the centre of reference in the region and the third in the world (the other two are in Italy and Spain). With the support of FO.AR, the INCUCAI cooperates with countries in the region, including by:

• strengthening implementation of the institutional management model, which involves a regulatory reorganization of the clinical and administrative management for donation and transplantation processes;
• providing tools to enable the health authorities in the countries referred to with a view to establishing the legal and ethical schemes for developing donation and transplantation processes based on harmonized criteria;
• exchanging experiences with regulatory frameworks that guarantee a single waiting list for national transplantation and registration;
• conducting capacity transfer with the institutions to improve management practices for and attention to the donation and transplantation of organs, tissues and cells, including early diagnosis of encephalic death and cadaveric preservation, and in procuring, preserving and distributing musculoskeletal tissue; and,
• offering training to health personnel in improved administrative and clinical practices to implement a unique histocompatibility laboratory and serum supply to support institutional donation and the transplantation network.

With support from FO.AR, INCUCAI has collaborated to offer professional training to approximately 300 people in the region. In addition, as a result of cooperation with INCUCAI, the National Registry of Donors of Hematopoietic Progenitor/Stem Cells (CPH ) was created in Peru. It maintains a list of candidates willing to donate cells for use in transplantation. In Paraguay, the waiting list and criteria for organ distribution were developed through the project with FO.AR.

INCUCAI has made progress in preparing training materials, which are available on its website. A free access online course, which is being developed jointly with PAHO/WHO, will be available at the OPS Virtual Campus: https://www.campusvirtualsp.org/.

In summary, South-South cooperation actions, promoted by the FO.AR, can strengthen ties of reciprocity within the entire region in terms of donation and transplantation. This has facilitated dialogue among the institutions involved and exchanges on successful management models, positioning this issue on the ministries’ agendas (always in keeping with bioethical principles of equity, quality and transparency) and facilitating the improvement of transplantation indicators in the region’s countries. The expertise provided has been used to develop regulations and policies in this area. The Ibero-American Network/ Council of Donation and Transplant Network/Council (RCIDT), with Spain as its chair and Argentina as vice- chair, also develops recommendations that serve as the basis for drafting regulations in the region. The replicability and impact of this good practice depends significantly on the priority that the country’s agenda assigns to donation and transplantation.

Sustainable Development Goal Target(s): 3.8, 17.9