Jan 19 , 2025
By BEZAWIT HULUAGER ( FORTUNE STAFF WRITER )


A recently passed Health Service Administration & Regulation Proclamation legalises the donation and transplantation of organs and tissues, consolidating health service regulations under a single legal framework. It allows individuals to consent to donate their cells, tissues, or organs after death, either while alive or through a written will. Donors can revoke consent at any time before transplantation.

The law now mandates that organ donations be directed to the Ethiopian Blood & Tissue Bank Service.

Transplantations are permitted only when a medical board confirms no viable alternative to save or stabilise the recipient's life.



The law prohibits the sale or gifting of cells, tissues, or organs. Harvesting is only allowed after professionals confirm the donor is biologically dead. If the deceased’s consent is unknown, a close relative may provide permission. In the absence of a relative, only the cornea can be harvested.

Living donations to next of kin are allowed with institutional consent. Donors must be legally capable, provide written consent, and pass a health assessment to ensure no risk to their life. Expenses related to donation and transplantation are excluded from being classified as payments or gifts. The use of organs or tissues obtained outside the legal donation system is strictly forbidden.

Ashenafi Tazebew (MD), director general of the Ethiopia Blood & Tissue Bank Service, says that, until now, no institution was formally responsible for overseeing organ donations. Transplants were mainly carried out in hospitals like St. Paul’s. He noted that the new law will help expand donations and collections. Ashenafi also hinted at the possibility of renaming the Bank and revising its bylaws in the future.

“We expect fewer people to travel abroad for transplants now,” said Ashenafi. He noted that Tiqur Anbessa Hospital has been sending 10 bone marrow transplant patients overseas monthly, costing 700,000 dollars. With the new proclamation, the hospital plans to start domestic bone marrow transplants.


“We can work towards heart transplants step by step,” he told Fortune. “But it requires a large financial investment and a strong human resource.”

The new legislation also includes rights and protections for health sector employees. It grants them priority access to healthcare services for work-related health issues. The government will fully cover health insurance contributions for public sector health workers.



However, Fikadu Mazengiya, executive director of the Ethiopian Midwives Association, voiced worries about the scope of the insurance, saying it may not cover cancer, transplants, or other treatments requiring foreign care. He pointed to the risks healthcare workers face, including disc injuries, radiation-related cancer, and infectious diseases, which also pose threats to their families.

Fikadu said that the lack of essential medical equipment and medicines increases indirect costs for healthcare workers. He stated that of the 347,000 healthcare workers in Ethiopia, about 3pc contract diseases from needle-related incidents.


“Healthcare workers are facing inhumane conditions,” he said.

A 2023 study revealed that 30.6pc of Ethiopian healthcare workers experienced needlestick and sharp injuries. Those in delivery and emergency units face sixfold and fivefold higher risks, respectively. Older workers are three times more likely to sustain injuries, while those logging fewer than 40 hours a week reported reduced risks.

The proclamation introduces new regulations on the use of cadavers for health services, research, and education. Cadavers can only be used if the deceased consented to donate their body while alive. If close relatives do not claim the body within seven days, it can be used for education or research after notifying the relevant government body.


Surgical expert Mesfin Alemayehu opposes using unclaimed bodies for research, arguing it conflicts with the country’s cultural practices.

The proclamation also regulates the use of animal parts or products in transplants, subject to Ministry of Health (MoH) approval. While animal or biotechnology-derived products are allowed, the law strictly prohibits cloning, copying, regenerating, or modifying human cells, genes, or body parts using technology. Mesfin criticised the use of animal body parts in transplants, citing cultural concerns and potential long-term health risks, including cancer.

The proclamation shifts the Ethiopian Food & Drug Authority’s regulatory oversight of health institutions and professionals to the MoH.

It also permits terminating life support in specific cases, such as brain death or irreversible medical conditions. Ventilator-assisted breathing can be discontinued only after confirming irreversible failure of cardiovascular or respiratory systems, or brain death.

The proclamation includes provisions for assisted reproductive technology (ART). ART services are restricted to legally married couples medically confirmed to be unable to conceive naturally. Couples who have a child through ART will be recognised as the child’s legal parents.

Endalkachew Tsedal, lead executive of health professionals' regulation at the Ministry, said the next step is to issue directives for implementing the proclamation.

Tsegaye Berhanu (MD), director of the transplant department at St. Paul's Hospital Millennium Medical College (SPHMMC), revealed that the hospital has performed nearly 170 transplant cases with a 98pc success rate. Due to capacity constraints, up to four kidney transplants and three liver transplants are referred overseas each month.


Tsegaye views the proclamation as a chance to expand transplant services and allow donations from non-relatives. He says it will protect donors from familial pressure. He stated the hospital plans to expand transplant capacity, supported by its four transplant surgeons, six kidney doctors, and two transplant surgery trainees.

He said that donation logistics which need swift transportation, possibly using helicopters could be difficult. "A national transplant database is critical," he stated. The global average wait time for a kidney transplant is eight-and-a-half years, according to him.

Surgical medicine expert Mesfin criticised the provision that prevents donors from choosing recipients. "It should not be restricted," he said. “It may encourage public donations.”

Tegbar Yigzaw (MD), president of the Ethiopian Medical Association, stated that the proclamation will remain ineffective unless the 2010 social medical insurance law is implemented.

Birhanu Ayika, head of the Ethiopian Health Insurance Agency’s Addis Abeba Office, said the agency is awaiting approval from the Ministry to start Social Health Insurance (SHI). He mentioned that while the insurance has been delayed, plans are underway to launch it within six months.

Insurance consultant Assegid Gebremedhin argues that SHI must cover overseas expenses and family members to provide adequate coverage. He said that improving workplace safety for healthcare workers would enhance service quality. “If healthcare workers feel safer, service quality will improve,” he said. “The movement for SHI began 20 years ago but was halted eight years ago.”

He urged the MoH to prioritise insuring healthcare practitioners. “Though costly for the government, the benefits are immeasurable,” he said.



PUBLISHED ON Jan 19,2025 [ VOL 25 , NO 1290]


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