Malaysia must do better with organ donation

IN 2024, Malaysia recorded about 200,000 deaths, or roughly 550 every day. Based on global experience, only about 1% of all deaths qualify for organ donation – typically those who die in hospital under controlled conditions such as brain death, with organs still viable for recovery.

That means Malaysia could potentially be performing around 12 cadaveric kidney transplants every day, or about 4,000 a year. Yet the reality is shocking: we only do around 20 such transplants a year.

This means that out of the 55,000 Malaysians currently undergoing dialysis, 99% will never receive a life-saving kidney transplant.

The reason behind the “1% rule” is simple but sobering: most deaths happen outside hospitals or under conditions where organs cannot be recovered. Even among those eligible, family consent, medical readiness, and logistical challenges reduce the final number of donors further.

However, what makes Malaysia’s situation even more concerning is the sharp drop in new organ pledges.

According to official data: In 2022 there were 51,700 new pledges, in 2023 there were 28,000, and in 2024 there were only 15,486, the second-lowest figure since 2019. At a time when awareness should be growing, these numbers are collapsing.

On Dec 15, Malaysia will mark 50 years since our first successful kidney transplant, yet we have only around 400,000 organ pledgers when a nation of our size should have at least three million.

The good news? Registering as an organ donor has never been easier. Through the MySejahtera app, Malaysians can now pledge their organs in under 30 seconds, without forms or hospital visits. It’s a small act that could one day save multiple lives.

But technology alone isn’t enough. We need a radical change in approach, a pivot towards a coordinated, national effort to normalise organ pledging, support donor families, and modernise our transplant ecosystem.

After half a century, Malaysia must move from good intentions to meaningful action – to save lives, reduce dialysis dependency, and restore hope to thousands waiting.

Malaysia can, and must, do better.

RAVINDER SINGH

Petaling Jaya

The letter writer is an advocate for organ donation and social takaful reform.