Firstly, the Act doesn't apply throughout the country, which limits the impact of its implementation. All the states need to endorse the law if it is to succeed in the regulation of transplants, and prohibit commercial dealing in human organs.

The Act makes written consent by prospective donors mandatory. But if relatives are not cooperative enough, the consent is of no use. To overcome such an eventuality, many countries go by presumed consent, which means that the organs of a brain-dead person, who has not prohibited their transplant, can be removed by doctors on their own. The decision vests with the authorities, rather than the prospective donors and their relatives.

Incorporating such a provision in the Indian law could make asea-change difference.

Besides, the law provides for a pittance of a fine for offenders. (Jail terms are substantial, though). Doctors who carry out removal or transplant without authority are punishable with a fine of up to Rs 10,000 in addition to a jail-term of up to five years. Similarly, touts are punishable with a fine of Rs 10,000-20,000 plus imprisonment ranging from 2-7 years. The fine is hardly a deterrent considering that even a single kidney transplant can earn the doctor a sizeable fee, and the tout a hefty commission.

Apart from the legal lacunae, the general state of health services in India doesn't make the implementation of the law any easier. Conditions have hardly been created to promote more transplants from cadavers. All major hospitals should have trauma centres, and the authorisation to certify people brain-dead.

Hospitals where cadaver transplants can be undertaken also require equipment such as ventilators for the storage of organs so that they can be kept artificially alive.Besides, hospitals should have exhaustive databases of donors and recipients so that the right matching can be done the moment an opportunity for a transplant arises.

Para-medical help is also important. Transplant hospitals should be staffed with specialists to counsel relatives of brain-dead people. This is necessary to enable the relatives of a confirmed donor to cooperate with doctors after his death. Proper counselling can even prompt a person lawfully in possession of the body of a brain-dead person, who has neither authorised nor prohibited anyone from removing his organs, to authorise a transplant.

But whether the relatives have to carry out a brain-dead person's wish or exercise their own discretion, they need to be counselled sensitively. Apart from facing the crisis arising out of a near one's death, they also have to reconcile to the fact that a brain-dead person is really dead. Care needs to be taken to ensure that they neither get offended due to the perceived mutilation of the dead body nordiscouraged by the fear of cumbersome formal paperwork.

Obviously, merely banning trade in human organs in isolation is not enough in a country where the demand for kidneys is estimated to be 80 lakh a year, with rates being upwards of Rs 50,000 per kidney. Juxtapose this against the fact that 46 per cent of the Indian population lives in absolute poverty, earning less than $1 per day, and is only too easily tempted to sell their organs. The need is not only to give the law more teeth, but also to create amenable conditions for its proper implementation.