This study investigates why the illegal traffic of kidneys exists and remains resilient in the Ph... more This study investigates why the illegal traffic of kidneys exists and remains resilient in the Philippines. It also evaluates the efficacy of the legal and regulatory framework for kidney (and organ) transplantation, and the corresponding implications for health policy. The experiences of comparable countries are noted.Three surveys were employed in this study: 1) a review of related literature on kidney black markets; 2) questionnaire-based interviews of a multi-stage probability sample of 131 kidney vendors from the two largest supplier regions in the Philippines; and 3) a comparative content analysis of pertinent legal and regulatory measures to address the underground kidney trade.Survey results, based on a 4.0 percent statistical margin of error, indicate that kidney vendors are typically males (98.4 percent) who belong to the lower income classes/groups D and E (88.5 percent). The vast majority of vendors (89.2 percent) were unrelated to kidney recipients, many of whom were of foreign descent (60.3 percent). The study finds that certain key elements underpin the kidney black market in the Philippines: an open, brokered and compensation-based contractual system between unrelated donors and sellers. These elements are sustained and reinforced by a robust supply-and-demand interface anchored on brokerage pricing, government incapacity, policy contradictions and public tolerance or indifference.The study suggests that the relative ambiguity of, and continuity between, the legal and underground kidney transplant systems be carefully addressed prior to enacting more specific reforms. The study also calls attention to the unintended consequences of various reform efforts, which are often neglected in formulating health policy and evaluating its costs and benefits.
Skin whitening is a big and booming industry in many developing countries. Its popularity owes ma... more Skin whitening is a big and booming industry in many developing countries. Its popularity owes mainly to post-colonial, internalized racism. This study examines whether government intervention is necessary and more efficient than market-driven approaches in addressing the health risks and harms associated with skin whitening. We gathered empirical data on the quality and quantity of health-related information about skin whiteners with a multi-stage probability sample of consumers in two cities in the Philippines (n=110; α=0.05). Regardless of their socio-demographic characteristics, we find that cognitive biases and information asymmetries build and sustain consumers' trust in manufacturers and distributors of skin whiteners while, paradoxically, breeding uncertainties over the integrity of these products. The results are product adulteration and misbranding, leading to pricing advantages for toxic whiteners over safer products. This has impeded regulatory efficacy. We recommend anchoring government intervention in transaction cost-reduction, containing the externalities of skin bleaching, and institutionalizing third party partnerships. Failure to do so would leave consumers extremely vulnerable to the forces of supply and demand that favor toxic whiteners, particularly in a market where voluntary collective action is difficult to organize.
Aim This quantitative study seeks to determine why the underground organ commerce exists and thri... more Aim This quantitative study seeks to determine why the underground organ commerce exists and thrives in Colombia, and how it responds to global donor shortages, public opposition and government initiatives to curtail it. Policy lessons and insights from the Colombian experience in organ donation and transplantation are identified in this study. Subjects and Methods Statistical random samples of 169 living and paid Colombian donors (or vendors) were apportioned between the key organ supplier cities of Bogotá and Medellín based on population. A pre-tested and interviewer-administered questionnaire was designed for organ vendors in these multi-stage samples. Qualitative analysis of pertinent Colombian laws and regulations forms the other half of this study. Results Survey results from Bogotá and Medellín tend to indicate shared demographic characteristics between Colombian vendors and their counterparts in developing countries that are major destinations for organ trafficking. The organ trade in Colombia is generally open, brokered and without price competition and provisions for vendors’ postoperative care, which help attract many foreign buyers. These factors also increase the vulnerability of vendors to unscrupulous third parties. The study finds that public indifference, state/institutional incapacity, corruption, and constantly changing trade environments, rules and operations subvert the legal and regulatory framework for organ donation and transplantation, which in Colombia is rather unique for its extent of coverage, complexity and detail. Conclusion The empirical evidence obtained from Bogotá and Medellín offers a challenge for governments to look beyond the availability of legal and regulatory restraints and remedies. Why and how these can be effectively undermined by organ trade participants without necessarily affecting or reversing their economic behavior are pressing issues that demand immediate attention.
The mismatch between the demand for, and supply of, health products has led to the increasing inv... more The mismatch between the demand for, and supply of, health products has led to the increasing involvement of courts worldwide in health promotion and marketing. This study critically examines the implementation of one country's Milk Code within the framework of the International Code of Marketing of Breast-Milk Substitutes, and the efficacy of the judicial process in balancing corporate marketing and state regulatory objectives. Drawing upon the Philippine experience with its own Milk Code, it evaluates the capacities of courts to determine policy costs and risks against the benefits of delineating and containing corporate marketing strategies for milk substitutes and supplements. The study finds that the methodological and information-based challenges faced by courts in resolving multi-dimensional health issues may not be overcome without serious questions concerning the legitimacy of the judicial process itself. Despite the deficiencies of litigation and adjudication, the study notes the catalytic potential of a judicial decision in opening up vital policy space for future renegotiations among rival parties and interests. Third-party intervention is explored relative to this catalytic function.
The purpose of this article is to examine organ trafficking and transplant management from a supp... more The purpose of this article is to examine organ trafficking and transplant management from a supplier’s or vendor’s perspective, and identify its corresponding health policy implications. A probability sample of living organ vendors from Colombia was surveyed using interviewer-administered questionnaires. The study found that trafficking and relative abundance in the supply of human organs in developing countries, like Colombia, are
This study investigates why the illegal traffic of kidneys exists and remains resilient in the Ph... more This study investigates why the illegal traffic of kidneys exists and remains resilient in the Philippines. It also evaluates the efficacy of the legal and regulatory framework for kidney (and organ) transplantation, and the corresponding implications for health policy. The experiences of comparable countries are noted.Three surveys were employed in this study: 1) a review of related literature on kidney black markets; 2) questionnaire-based interviews of a multi-stage probability sample of 131 kidney vendors from the two largest supplier regions in the Philippines; and 3) a comparative content analysis of pertinent legal and regulatory measures to address the underground kidney trade.Survey results, based on a 4.0 percent statistical margin of error, indicate that kidney vendors are typically males (98.4 percent) who belong to the lower income classes/groups D and E (88.5 percent). The vast majority of vendors (89.2 percent) were unrelated to kidney recipients, many of whom were of foreign descent (60.3 percent). The study finds that certain key elements underpin the kidney black market in the Philippines: an open, brokered and compensation-based contractual system between unrelated donors and sellers. These elements are sustained and reinforced by a robust supply-and-demand interface anchored on brokerage pricing, government incapacity, policy contradictions and public tolerance or indifference.The study suggests that the relative ambiguity of, and continuity between, the legal and underground kidney transplant systems be carefully addressed prior to enacting more specific reforms. The study also calls attention to the unintended consequences of various reform efforts, which are often neglected in formulating health policy and evaluating its costs and benefits.
Skin whitening is a big and booming industry in many developing countries. Its popularity owes ma... more Skin whitening is a big and booming industry in many developing countries. Its popularity owes mainly to post-colonial, internalized racism. This study examines whether government intervention is necessary and more efficient than market-driven approaches in addressing the health risks and harms associated with skin whitening. We gathered empirical data on the quality and quantity of health-related information about skin whiteners with a multi-stage probability sample of consumers in two cities in the Philippines (n=110; α=0.05). Regardless of their socio-demographic characteristics, we find that cognitive biases and information asymmetries build and sustain consumers' trust in manufacturers and distributors of skin whiteners while, paradoxically, breeding uncertainties over the integrity of these products. The results are product adulteration and misbranding, leading to pricing advantages for toxic whiteners over safer products. This has impeded regulatory efficacy. We recommend anchoring government intervention in transaction cost-reduction, containing the externalities of skin bleaching, and institutionalizing third party partnerships. Failure to do so would leave consumers extremely vulnerable to the forces of supply and demand that favor toxic whiteners, particularly in a market where voluntary collective action is difficult to organize.
Aim This quantitative study seeks to determine why the underground organ commerce exists and thri... more Aim This quantitative study seeks to determine why the underground organ commerce exists and thrives in Colombia, and how it responds to global donor shortages, public opposition and government initiatives to curtail it. Policy lessons and insights from the Colombian experience in organ donation and transplantation are identified in this study. Subjects and Methods Statistical random samples of 169 living and paid Colombian donors (or vendors) were apportioned between the key organ supplier cities of Bogotá and Medellín based on population. A pre-tested and interviewer-administered questionnaire was designed for organ vendors in these multi-stage samples. Qualitative analysis of pertinent Colombian laws and regulations forms the other half of this study. Results Survey results from Bogotá and Medellín tend to indicate shared demographic characteristics between Colombian vendors and their counterparts in developing countries that are major destinations for organ trafficking. The organ trade in Colombia is generally open, brokered and without price competition and provisions for vendors’ postoperative care, which help attract many foreign buyers. These factors also increase the vulnerability of vendors to unscrupulous third parties. The study finds that public indifference, state/institutional incapacity, corruption, and constantly changing trade environments, rules and operations subvert the legal and regulatory framework for organ donation and transplantation, which in Colombia is rather unique for its extent of coverage, complexity and detail. Conclusion The empirical evidence obtained from Bogotá and Medellín offers a challenge for governments to look beyond the availability of legal and regulatory restraints and remedies. Why and how these can be effectively undermined by organ trade participants without necessarily affecting or reversing their economic behavior are pressing issues that demand immediate attention.
The mismatch between the demand for, and supply of, health products has led to the increasing inv... more The mismatch between the demand for, and supply of, health products has led to the increasing involvement of courts worldwide in health promotion and marketing. This study critically examines the implementation of one country's Milk Code within the framework of the International Code of Marketing of Breast-Milk Substitutes, and the efficacy of the judicial process in balancing corporate marketing and state regulatory objectives. Drawing upon the Philippine experience with its own Milk Code, it evaluates the capacities of courts to determine policy costs and risks against the benefits of delineating and containing corporate marketing strategies for milk substitutes and supplements. The study finds that the methodological and information-based challenges faced by courts in resolving multi-dimensional health issues may not be overcome without serious questions concerning the legitimacy of the judicial process itself. Despite the deficiencies of litigation and adjudication, the study notes the catalytic potential of a judicial decision in opening up vital policy space for future renegotiations among rival parties and interests. Third-party intervention is explored relative to this catalytic function.
The purpose of this article is to examine organ trafficking and transplant management from a supp... more The purpose of this article is to examine organ trafficking and transplant management from a supplier’s or vendor’s perspective, and identify its corresponding health policy implications. A probability sample of living organ vendors from Colombia was surveyed using interviewer-administered questionnaires. The study found that trafficking and relative abundance in the supply of human organs in developing countries, like Colombia, are
Uploads
Papers by Roger Mendoza