NOTTO’s 10-Point Plan, introduced by the National Organ and Tissue Transplant Organisation (NOTTO) in 2025, marks a transformative step in addressing gender disparities and enhancing fairness in India’s organ transplant system. This comprehensive advisory prioritizes women patients and relatives of deceased donors in organ allocation, aiming to create a more equitable and transparent process. By tackling longstanding issues of bias, strengthening infrastructure, and promoting public awareness, NOTTO’s 10-Point Plan sets a new standard for organ donation and transplantation in India, balancing medical urgency with social justice.
Addressing Gender Disparity and Donor Recognition
At the core of NOTTO’s 10-Point Plan is a commitment to reducing gender imbalances in organ transplantation. The advisory mandates that states and Union Territories assign additional points in organ allocation to women on waiting lists, ensuring they have a higher priority. Additionally, near relatives of deceased donors who require transplants are also prioritized, acknowledging the selfless contributions of donor families. To honor these contributions, the plan calls for dignified funerals and public felicitation of deceased donors and their families, fostering a culture of respect and gratitude for organ donation.
Enhancing Allocation Criteria and Transparency
NOTTO’s 10-Point Plan builds on existing organ allocation criteria, which include factors such as disease duration, waiting time, illness severity, and compatibility (e.g., blood group and organ size). To ensure transparency, every organ donor and recipient is assigned a unique ID, and all transplant centres are required to submit data to a national digital registry. Non-compliance with these requirements can result in legal action under the Transplantation of Human Organs and Tissues Act (THOTA), 1994. This emphasis on transparency strengthens accountability and ensures that the allocation process remains fair and traceable.
Strengthening Infrastructure and Training
A key component of NOTTO’s 10-Point Plan is the enhancement of infrastructure and training to support organ transplantation. The advisory urges states to establish permanent posts for transplant coordinators in hospitals performing organ transplants or retrievals. These coordinators play a critical role in managing the donation process and ensuring efficiency. Additionally, the plan recommends developing organ retrieval facilities in trauma centres and medical colleges in a phased manner. To improve early identification of potential deceased donors, particularly among accident and stroke victims, NOTTO emphasizes training for emergency responders and ambulance staff, enabling them to act swiftly and effectively.
Boosting Public Awareness and Participation
NOTTO’s 10-Point Plan places significant emphasis on increasing public awareness and participation in organ donation. Since the introduction of an Aadhaar-based online pledge system in 2023, over 3.3 lakh citizens have committed to becoming organ donors, reflecting growing public support. In 2024, India achieved a record 18,900 organ transplants, a significant rise from fewer than 5,000 in 2013, showcasing the impact of sustained efforts. To further boost awareness and dispel myths, the government plans to appoint state-level brand ambassadors to promote organ donation, encouraging more citizens to participate in this life-saving initiative.
Legal and Ethical Framework
The Transplantation of Human Organs and Tissues Act (THOTA), 1994, remains the cornerstone of India’s organ donation framework. NOTTO’s 10-Point Plan strengthens enforcement by linking compliance with legal consequences, ensuring that transplant centres adhere to the new guidelines. The advisory underscores the importance of equity and dignity in the transplant process, aiming to balance medical urgency with social justice. By prioritizing marginalized groups, such as women and donor relatives, the plan seeks to reduce bias and ensure that organs are allocated to those most in need.
A Vision for a Fairer Future
NOTTO’s 10-Point Plan represents a bold step toward a more inclusive and efficient organ transplant system in India. By addressing gender disparities, enhancing transparency, and strengthening infrastructure, the advisory tackles critical challenges in the donation and transplantation process. The plan’s focus on public awareness and ethical governance further ensures that organ donation becomes a widely accepted and respected practice. As India continues to see record-breaking transplant numbers, NOTTO’s 10-Point Plan lays the foundation for a future where equity, dignity, and accessibility define the organ transplant system, saving countless lives while promoting social justice.
