Every year, over 5 lakh Indians die waiting for a second chance at life through an organ transplant. The numbers are staggering — 2 lakh need kidneys, 50,000 need livers, and thousands await hearts and lungs. Yet, our deceased donor rate remains under 0.65 per million population, which is among the lowest in the world.
World Organ Donation Day (August 13) is an occasion to reflect on what needs to be done to build a transplant ecosystem where no life is lost because of a lack of organs.
Countries like Spain have shown what is possible when organ donation is embedded into national policy and everyday civic engagement with structured systems, public campaigns, and regulatory consistency.
In 2024, Spain showed it was a global leader in organ donation and transplantation with a historic rate of 52.6 donors per million population, the highest in the world. India, in contrast, lags behind despite having world-class hospitals and surgical capabilities.
What we lack is not clinical skill, but system readiness and public will.
That said, all is not bleak. Some Indian states have emerged as models for the nation.
Tamil Nadu stands out as a model achieving a deceased donation rate above the national average of 1.8 per million population. It has been truly heartening to learn that in Tamil Nadu, the impact of the strategies including ceremonial honour walks for deceased donors and state recognition, training and reorientation of medical college faculty, and Non-Transplant Organ Retrieval Centres (NTORC) status for Government Institutions have led to the highest number of donations in 2024 with 1,500 organs and tissues retrieved from 268 deceased donors.
Other states are catching up their own transplant programs and networks. Andhra Pradesh’s Jeevandan programme with the introduction of mobile transplant coordinator teams, financial and funeral support to donor families, and state‑honour recognition has helped the state to cross 200 deceased organ donations in 2024. Last year saw Telangana awarded for leading the cadaver organ donation program, achieving high donation rates compared to the national average.
Lifesaving legacy
India’s journey with organ donation began in earnest with the passage of the Transplantation of Human Organs Act in 1994. I recall passionately supporting the passage of this law, appealing to the then Prime Minister with one vital truth: What is lost to ashes can instead be turned into the miracle of life. Today, three decades later, I have the same conviction to drive the movement forward with fresh momentum to overcome new challenges.
India is at a critical inflection point. Apollo Hospitals’ Health of the Nation Report 2025 shows that while medical capability in India is advancing, especially in tackling non-communicable diseases such as liver disease and kidney failure, the real bottleneck is often timely access to transplants. As cases of lifestyle-induced conditions rise, the need for transplants will only grow. A preventive approach is vital, but for those already at end-stage organ failure, transplants are the only option.
The Ministry of Health’s initiatives like the “One Nation, One Policy” framework and the strengthening of NOTTO (National Organ and Tissue Transplant Organisation) are important steps. As a part of “Azadi ka Amrit Mahotsav”, organ donation was promoted as a “Jan Andolan”. With the right momentum, India is now poised to lead the world not only in medical excellence, but in turning compassion into action — one life, one donor, one family at a time.
However, these initiatives need to be matched by three key enablers to truly transform India’s transplant ecosystem:
Make Pledging a Civic Norm: Much like how voters are registered or Aadhaar is linked to public services, pledging organs must become part of common citizen touchpoints. Whether applying for a driver’s licence, updating Aadhaar, or opening a bank account, the question should be asked: “Would you like to pledge your organs?”
Expand ICU Readiness: Many willing families are unable to proceed with donation simply because the hospital lacks transplant-ready ICU beds or trained coordinators to manage the logistics. Infrastructure upgrades and staff training must go hand-in-hand across both government and private sectors.
Build a Unified, Transparent Registry: A centralised, Aadhaar-linked donor and recipient registry will prevent misuse, ensure equitable allocation, and bring transparency to the system, thereby also restoring public trust.
The time is ripe for a national campaign that makes organ donation a dinner table conversation in every Indian home. Much like polio eradication or the Swachh Bharat Abhiyan, organ donation too must become a mission embraced by every citizen.
Collective duty
World Organ Donation Day is not just a symbolic event but a reminder of what we owe each other as human beings. We must reframe the narrative - organ donation is not a sacrifice; it is a continuation of life. Every deceased donor is not someone lost, they are a person who saved many others. Families who make the difficult decision of organ donation during moments of grief become heroes in someone else’s story.
The Indian Army in a campaign in Mumbai with NOTTO achieved the highest-ever pledge registration by a single institution with 26,000 army personnel pledging their organs. Let us follow in their footsteps and renew our collective commitment to pledge our organs. The future of organ donation in India depends on it. The gift of life must not go in vain!