Introduction:

The Commonwealth Tribute to Life project was initiated in 2018.

The Birmingham 2022 Commonwealth (CW) Games present a unique opportunity to showcase organ and tissue donation and transplantation. We have sought the support of all Commonwealth nations to join this noble and humanitarian effort to save lives.

Through the sharing of knowledge and expertise we will increase ethical organ and tissue donation and transplantation, regardless of transplant infrastructure, for the benefit of all Commonwealth citizens. We would empower health professionals to achieve a step towards equality for 2.3 billion citizens of CW countries, approximately one third of the world population.

The World Health Organisation’s Global Observatory on Donation and Transplantation estimates that there were over 146,000 organs transplanted in 2018. This gift of life came from the generosity of over 40,000 living donors (most commonly through the donation of a kidney) and from nearly 39,000 deceased organ donors. Yet organ failure and the need for transplantation remains high in all nations.

The rate of donation varies from zero donors in some Commonwealth Nations to over 20 per million population in countries like Australia, Canada, Malta and the UK. We face common challenges to increase rates of donation across all social groups, ethnicities and religions.

Such unmet need can lead to the death of those on the transplant waiting list or commercially driven transplantation to the detriment of both organ donors and recipients. The Declaration of Istanbul and the resolutions of the World Health Organisation's Guiding Principles on Organ Transplantation call on every nation to strive toward self-sufficiency in clinically safe and ethically sound organ and tissue donation and transplantation. No nation has yet to achieve this ambition of self-sufficiency.

What we are promoting:

1. The value of organ and tissue donation and transplantation in saving and transforming lives

2. The need to ensure safe and ethical practice in accordance with the Declaration of Istanbul and the resolutions of the World Health Organisation's Guiding Principles on Organ Transplantation

3. The benefits that can be shared by all Commonwealth nations through learning and sharing solutions with each other about the common challenges we face

Using the historical ties and established relationships of our Commonwealth Citizens and governments, we believe more can be done through Commonwealth Nations working together to share knowledge and expertise.

Structure:

NHS Blood and transplant (NHSBT) is part of NHS UK. NHSBT created a board for Tribute to life. The board has two advisory panels, UK Advisory panel to connect the board with parliamentarians and other key stakeholders within UK to achieve the objectives, chaired by Baroness Finlay. International Advisory Panel (IAP) has members for each CW nation to carry out the functions, chaired by Dr Dale Gardiner. It would be expected that IAP member would create an implementation group within the country to include a team of enthusiastic professionals to carry out the aims.

There are six regional co-ordinators, currently Dr Dale Gardiner, (Europe), Dr Sunil Shroff (Asia),Ms Lucinda Barry (Oceania),Dr Maragret O’Shea (Caribbean),Dr David Thomson (Africa), Catherine Butler (Americas)

Achievements:

From Antigua to Zambia, with support from nations in Africa, Asia, the Americas, Europe and the Pacific, at the time of writing 41 (76%) nations have supported the project. This covers the 98.6% population of the commonwealth nations. The disconnect between percentage of countries and the population is due to the fact that some small countries which have a population of less than half a million are not connected, these may never be able to create transplantation facilities. Some countries in African continent feel that the limited resources should be directed towards other priorities such as combating starvation or coping with natural calamities such as earthquakes and floods. We understand these difficulties but know that xenotransplantation, if successful could be a game changer. Equally, life of each citizen has same value and wherever possible, should be saved. All Governments should be honour bound to save the life of every citizen.

We have debated the Memorandum of Understanding (MoU) with all 41 representatives and this has been agreed, available through the link on the webpage;

https://www.odt.nhs.uk/odt-structures-and-standards/clinical-leadership/commonwealth-tribute-to-life-project/

The MoU is for five years, renewable after the term, financially neutral and not legally enforceable but provides a template for cooperation in this complex field. The MoU would also not promote transportation of organs across counties which can cause difficulties. However, it will allow members to communicate with each other without any restrictions to encourage best practice.

Action Plan:

The project will be launched on the Commonwealth Day on 14the March 2022 in Wolverhampton, UK. We wish to monitor progress made annually thereafter through the board. The project will have inaugural celebration on 22.7.22, a week before CW games to inform the general public and wider audiences within CW nations.

We hope that creation of this platform will allow participants to use it fully to derive benefits through health professionals to reach the citizens. The success of project will be through the creation of implementation groups and active participation of nations as well as enthusiasm of IAP members.