South Asia is a densely populated region which comprises the sub-Himalayan countries and includes Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, India, Pakistan, and Sri Lanka. The South Asian Association for Regional Cooperation (SAARC) is an economic cooperation organisation which was established in 1985 and includes all eight nations from 2 South Asia. South Asia covers an area of about 5.2 million km , which makes up 3.5% of the world’s land surface area. The region is densely populated with about 1.749 billion people and this accounts for about one fourth of the world’s population. Tamil Nadu has maintained its lead position in terms of the number of deceased donor transplants in India since 1995 when the transplant law was first passed in the state and it accepted brain stem death for organ donation. In the last three years it has officially received awards for the best state in deceased donation from NOTTO (National Organ and Tissue Transplant Organization) during the annual celebration of organ donation day at Delhi as it has had the highest number of deceased organ donors as shown in the table. The increasing number of deceased donors has meant a rise in the number of patients benefitting from such transplants. Hospitals that do not generate their own deceased donors too have benefitted from the 'common pool' waiting list for kidneys.

The region is also home to about 171 million diabetics (2010) and this is expected to exceed 262 million by 2030. The high incidence of diabetes and hypertension is a major cause of organ failure, especially kidney failure and the estimated incidence of end-stage renal disease is 225-275 per million population in the region.

Due to poverty, lack of universal health insurance and high cost of treatment in the private sector, the majority of the patients who suffer from end-stage organ failure in this region do not have affordable access to treatment. For example, the estimated number of new patients who develop end-stage kidney failure every year in India is about 200,000, but only a quarter are able to sustain some form of treatment whereas others withdraw and are condemned to death. Many are young, in the prime of their lives - family breadwinners or homemakers and their loss is a loss not only to the family, but also to society. Hence although the projected demand for organs is very high, when it comes to actual demand in terms of financial affordability for treatment, the numbers are much lower. It is estimated that about 50 to 60,000 new patients are having dialysis and against this only 10,000 live and about 2,200 deceased donor transplants are undertaken annually.

The current status of organ transplants in the region is as follows:

Data are appropriate figures and may not be accurate

Shortage of organs has resulted in exploitation of the poor and marginalized of the society, thus making the region prone to illegal organ trafficking. The growth of the deceased donation programme has been slow and only two (India and Sri Lanka) of the eight countries in the region have been able to take up the deceased donations programmes. Sri Lanka has recently invited MOHAN Foundation to conduct a workshop to help the deceased donation programme and improve the deceased donation rate in the country. The Buddhists in Sri Lanka have a high eye donation rate and Sri Lanka has been world famous for its successful eye donation programme and is a net exporter of corneas. If Sri Lanka can set systems in place it has generally been felt that it can improve on the deceased donation rate and help it to achieve some degree of self-sufficiency and overcome the organ shortage