Vatican officials have defended their decision to invite a Chinese former deputy health minister to a conference on organ trafficking despite concerns that China still relies on the organs of executed prisoners in its transplant programme.

Medical ethics experts and human rights activists have decried the move by the Pontifical Academy of Sciences to invite Huang Jiefu to a two-day conference starting on Tuesday that aims to expose organ trafficking and seeks to find “moral and appropriate solutions” to the issue.

Wendy Rogers, a medical ethics expert at Macquarie University in Australia, said Huang’s inclusion in the conference, where there could be a meeting with Pope Francis, risked giving a propaganda boost to China and an “air of legitimacy” to its transplantation programme.

“The Pontifical Academy of Sciences should be aware of how the endorsements – even indirect – of prestigious foreign bodies are used by China’s propaganda apparatus to burnish the reputation of its unethical transplant system,” Rogers wrote in a protest letter to a Vatican official.

“We urge the summit to consider the plight of incarcerated prisoners in China who are treated as expendable human organ banks. There is no evidence that this practice has ceased in China,” she wrote.

At the heart of the controversy lies a daunting question for the Vatican at a time when it is desperately seeking to re-establish ties to China: whether dialogue with Communist party officials could help spur reform on issues such as human rights and religious freedom, or whether such interactions offer legitimacy to practices that are deeply at odds with Catholic teaching, including the church’s objection to capital punishment.

In an address last year, Francis said he considered illicit organ trafficking to be a “new form of slavery”.



In his response to Rogers’ letter, which was obtained by the Guardian, Marcelo Sánchez Sorondo, an Argentine bishop and chancellor of the Pontifical Academy of Sciences, said the conference was meant to be an “academic exercise and not a reprise of contentious political assertions”.

Huang, who has led an effort to overhaul China’s transplantation processes, has been under fire before. China’s alleged use of prisoners’ organs was debated at an international conferencelast year after two doctors said it was premature to declare China an “ethical partner” in the international transplant community.

In 2015, Huang claimed China would no longer use organs from executed prisoners to meet the country’s high demand.

Nicholas Bequelin, regional director for East Asia for Amnesty International, said it was known at the time that the vast majority of organ transplants in China came from executed prisoners. The number of prisoners China executes every year is a state secret, but Bequelin said estimates ranged from 3,000 to 7,000 people annually.

Bequelin said experts had cast doubt on Huang’s claims that China had outlawed the practice, in large part because the country is yet to develop an effective national donor programme of willing participants.

“They haven’t stopped the practice and won’t stop. They have a need for organ transplants that far outpace the availability of organs,” Bequelin said.

Details of the process are grim. Bequelin said China did not adhere to World Health Organization recommendations on how doctors determine whether a person is legally dead. In some cases, organs have been removed before the prisoner would be considered medically dead by international standards.

“The timing of the execution is – we think – sometimes dependent on the need of a particular transplant surgery. You will execute this person at this time on this day, because that is when the patient has to be ready,” Bequelin said. “It is very secret and there is not a lot of reliable information.”

At the same time, Bequelin said, Huang has appeared to sincerely desire a change in China’s practices and may at least deserve credit for trying to reform the system.

Francis Delmonico, a professor of surgery at Harvard Medical School who was appointed to the Pontifical Academy of Sciences by Pope Francis, defended Huang’s inclusion in the Vatican summit, saying China’s current proclamation prohibiting the use of organs from executed prisoners occurred thanks to Huang’s leadership.

“Dr Huang’s understanding of the worldwide objection to that practice was the impetus for his relentless pursuit of the change in China culminating in the ban on the use of organs from the executed prisoner in January 2015,” he said in an email to the Guardian.

But in testimony before a US congressional committee examining the issue last year, in which he also defended Huang’s efforts, Delmonico acknowledged that he could not assure the committee that the practice had been completely eradicated.

Amnesty’s Bequelin said the decision on whether or not to include Huang in a Vatican summit raised a legitimate question of whether it was better to take a principled stand against any human rights violation, or try to boost those who seek to reform the system.

“They’re not inviting the executioner-in-chief. They are inviting the person who is energetically – unsuccessfully so far – trying to reform it,” he said.

“It is a very optimistic view of the lay of the land in China if you think that conversations and dialogue can be on its own a significant factor. China is a system. There is a risk of naiveté about what can be achieved through rapprochement and meetings.”