India showed a remarkable progress in its deceased donation rate from 2010 to 2016, when its deceased donation rate went up 9 times in the period of 6 years. In 2010, it had done a mere 100 donations but by 2016, over 900 donations had been undertaken (Figure 1). The key factors for this success were government and hospital initiatives with public-private-civil society organisation partnerships, capacity building in the program through training of transplant coordinators, intensivists and surgeons, and the positive publicity the program obtained from the media in India. While the capacity building has continued but the donation rate after 2016 has seen a decline or stagnation and one of the reasons has been the growing distrust created first by the visual media and then by the print media.

The trust factor for organ donation has been low in India due to multiple kidney scams in the past. However, the increase of the deceased donation rate from 2010, saw some extraordinary positive reports coming out in the media very frequently of donations and often these were coming from ordinary people. The saving of multiple lives by one donation created the ‘feel good’ factor in the society and more and more people opted for organ donation of their loved one. To transport organs like hearts from one part of the city to another, green corridors were established and the traffic would be stopped to give the movement of organs a ‘Very Important Person’ (VIP) status.

These ‘green corridors’ creation caught the imagination of a cinema director who made a very sensational movie called ‘Traffic’ that became a box office success and it was then translated into many Indian languages. While the dramatic theme of the movie was how a heart was moved over 100 miles through busy roads but the story also indicated possible organ commerce and showed this aspect in poor light. This movie was followed by another one that repeated the plot of the English movie ‘Coma’ that showed that donors were being killed in a hospital for organs. Another film ‘Andhadhun’ showed kidneys, liver, and corneas being sold in India. A Tamil movie ‘Yennai Arindhaal’ depicted Indians involved in an international organ theft network - killing local people and stealing their organs. Many more such movies came up with plots that grossly distorted organ donation and transplantation and some plots were downright ludicrous. Similar sinister plots were created in television serials in different Indian languages including one on the newly launched Amazon Prime series called ‘Breathe’ where a father who is a policeman is shown killing registered organ donors of a rare blood group because his son needed a lung transplant. ‘I want to sell my kidney for money’ is used quite frequently in movie dialogues and has become relatively common parlance without even an afterthought in Indian television serials as well. The law of the country that makes such acts of organ commerce a punishable offence through imprisonment for up to 10 years and a fine that can go up to US $150,000 is disregarded. India produces the maximum numbers of movies in the world in different Indian languages and the visual media is one of the key in the general distrust so created also made the print media hostile to the deceased donation program and some crime reporters have started reporting organ donation stories without any understanding with distorted facts and sensational implications. Often the investigation from authorities would prove the stories to be wrong but this was never reported or acknowledged in the press. Over the last two years many people who pledged organs have withdrawn consent and many families have point blank refused donation fearing that organs would be sold.

Being perhaps influenced by the movies and print media stories some social activists too started looking at organ donation with suspicion and started making complaints to government authorities on hearsay and with no firm evidence especially against private hospitals. One such activist literally brought down the deceased donation program in the state of Kerala.

The trust factor that takes many years to build can very easily be lost when the media plays truant with a topic as sensitive as organ donation and transplantation. Very often it is the ‘Bad news’ that gets more eyeballs or readership than ‘good news’ and this makes ‘bad news’ good business sense for media houses. Organ donation has become a victim of this sensationalism and unless this wave passes it is going to be difficult to regain the confidence and trust of the people. It is imperative therefore for the government to make information about organ donation and transplantation available in the public domain to ensure transparency and credibility.