Incentive (Mis)alignment in India’s Deceased Organ Donation Value Chain

Deceased organ donation in India remains critically low at less than one donor per million population, far behind global leaders like Spain, despite its potential to save lives. This article highlights a key barrier – Incentive mismatch between the different stakeholders stifling the program. Donor hospitals, especially those without transplant facilities, lack motivation to participate due to unrewarded efforts and costs, severely limiting organ supply and affecting donor maintenance. Similarly, donor families gain no tangible benefit, facing emotional and logistical burdens without incentive. Conversely, transplant hospitals and recipients reap substantial rewards – revenue, reputation and life-saving outcomes. This imbalance, alongside other systemic issues in the value chain, hampers the supply of brain-dead organs for transplants. With half a million annual deaths from organ scarcity, the crisis demands systemic reform to align incentives, enhance participation, and boost donation rates effectively.