28. September 2020

Instagram used as platform for illegal organ trafficking

Organ trafficking is increasingly taking place online, including on Instagram, according to an investigation by the Iranian exile media Zamaneh. Instagram is only obliged to remove content that the service becomes aware of. Experts call for legislation on digital liability

Between 7.000 to 14.000 transplant operations are conducted every year with organs bought on the black market, according to the World Health Organisation, WHO

“Hi Sister, do you want to sell your kidney?”

This is the question posed by an eager middleman when the Iranian exile media Zamaneh recently created a fake profile on Instagram to reveal how illegal organ trafficking takes place in Iran.

Within a few days, the journalists received numerous offers from middlemen and desperate patients offering up to 300 million toman for a kidney. According to the official Iranian exchange rate, this is around 6.000 euro.

The buyers are wealthy kidney patients who are willing to pay to get a kidney, bypassing the official Iranian waiting list.

Among other things, Zamaneh reveals that up to half of all kidney transplants in Iran take place with organs purchased on the black market – a trade that has increasingly shifted to the openly accessible part of the internet, including Instagram.

The French lawyer Dan Shefet, who is a specialist in digital responsibility, is shocked that yet another criminal activity has found its way to the social media platforms.

“It is shocking that it is now going on openly, on e.g. Instagram. In the past, illegal activities took place especially on the dark network, where people surfed around using the Tor browser, so that no one could track their IP address “, says Dan Shefet.

Illegal organ trafficking

Organ trafficking is banned in most countries, but there is no international legislation forbidding it. In Iran it is legal to receive state compensation when donating an organ, but it is not legal to sell and buy organs freely. According to Zameneh’s research, the Iranian authorities are turning a blind eye to the illegal organ trafficking. 

  • There are no accurate estimates of the global scale of illegal organ trafficking.
  • The World Health Organization (WHO) estimates the number of illegal transplants to be between 7,000-14,000 a year.
  • The total number of transplants worldwide was 146,840 in 2018.
  • Of these, 95,479 were kidney transplants.
  • The number of patients in need of organs is much greater than the number of organs available.
  • In 2010, 2.6 million patients were on the waiting list for an organ transplant. 
  • By 2030, 5.6 million patient are expected to be on the waiting list. 
Sources: WHO, WELL, Council of Europe

“It means that everything else being equal, it has become significantly more accessible”.

Organ trafficking is banned in the majority of countries worldwide, but according to experts in digital responsibility Instagram cannot be made legally responsible for content posted on the Facebook-owned platform.

A worldwide problem

In Iran, the digital market for organs is run by a network of discreet intermediaries who connect buyers and sellers and provide the practicalities of the transplants, which among other places take place at a well renowned hospital in Tehran.

But the problem of organ trafficking is neither new nor limited to Iran.

In recent years international media have reported on major problems with organ trafficking in places like  Lebanon, Egypt, and Asia, where especially desperate refugees resort to selling their organs.

According to the World Health Organization WHO between five and ten percent of all organ transplants in the world take place with illegally acquired organs.

In 2018 146,840 transplant operations were performed worldwide according to the Global Observatory on Donation and Transplantation. If the WHO estimates are correct this means that somewhere between 7,000-14,000 of these operations were carried out with illegally acquired organs.

According to the WHO, the need for organs is at least ten times greater than the number of operations performed, creating the perfect conditions for an illegal market. Especially the need for kidneys is growing rapidly. In 2010, 2.6 million kidney patients were on the waiting lists and the number is expected to grow to 5.4 million by 2030, according to the International Society of Nephrology.

The WHO emphasizes that the organ trafficking is characterized by wealthy patients buying organs illegally or unethically from poor and vulnerable people, either in their own country or abroad.

And the organization warns that illegal organ trafficking is unlikely to decrease in the coming years.

“Poverty, unemployment, and the lack of socio-economic opportunities are factors that make people vulnerable to organ trafficking. In the current situation of many refugees and migrants and the financial crisis the world is facing (due to corona, red), we must pay extra attention to protecting the affected populations,” a WHO spokesman says.

Experts hold Instagram accountable

Illegal organ trafficking is not a new phenomenon, but it is new that trade takes place openly on the internet.

As Zamaneh’s research shows organ trafficking takes place in many places on the web, for example on special websites, in the comments under ordinary media articles on the subject, and on social media such as Instagram.

Like attorney Dan Shefet, several other experts on digital responsibility believe that Instagram has a shared responsibility when their platform is being used for illegal activities.

However, with the current legislation it is not possible to hold Instagram accountable for crimes committed on the service’s platform.

“The starting point is that social media has immunity. In the EU, however, they must remove illegal content when they become aware of it”, says Dan Shefet.

This means that instagram is committed to e.g. remove the accounts that Zamaneh’s research has uncovered.

“Organ trafficking is illegal, and Instagram must of course remove postings from the group of people who buy and sell organs”, says Dan Shefet, an advisor to UNESCO, the EU and other international bodies on digital responsibility.

Sten Schaumburg Müller, professor of media law at the University of Southern Denmark, agrees.

“EU law requires information services to remove illegal content as soon as the media becomes aware of it,” he says.

Instagram accounts removed

Despite several inquiries, neither Instagram nor its owner, Facebook have agreed to an interview about organ trafficking on their platforms.

A spokesperson for Facebook does however declare in an email, that “Facebook does not allow the use of our platforms for trafficking in organs”.

“We have clear rules against human exploitation on Facebook and Instagram, which includes organ trafficking. We use a combination of humans and proactive detection technology to identify and remove violating content as quickly as possible, and we encourage people to report content they see that they think breaks our rules”, the Facebook spokesperson writes.

Facebook further informs us that the service has removed three of the instagram accounts mentioned in the investigation by Zamaneh.

The service has not been able to locate two additional instagram profiles.

Legislation needed

Dan Shefet and Sten Schaumburg Müller are emphasizing that this is how far Instagram responsibility goes at the moment.

“The lack of responsibility is the same whether the issue is organ trafficking, the sale of rhino powder, ivory or pedophilia,” said Dan Shefet, noting that the European Court of Justice recently acquitted the Amazon digital market place of liability in connection tothe illegal sale of counterfeit goods.

“The next thing will probably be that you can buy and sell organs on Amazon”, he predicts,and emphasizes the need to tighten legislation on digital responsibility.

Ask Hesby Krogh, deputy chairman of the Danish advocacy group Digital Responsibility agrees.

“So far, big social media have been able to avoid any responsibility for what goes on on their platforms. Social media has almost been regarded as a kind of telecommunications company, which is also not responsible for what people use their telephone connection for”, he says.

“It would be nice if the moderation systems that the social media industry has created was working, but they do not. Legislation is needed,” he says.

According to Digital Responsibility, services like Facebook and Instagram should be responsible for user-generated content.

“It may be resource-intensive to keep track of what’s going on on a large platform, but it must be something that companies take into account when designing their business model,” he says.

“Facebook creating an internal appeal system is not enough. It should be democratically elected politicians who legislate on digital responsibility”, he says. “Single countries should move ahead with national legislation. They do not have to wait for the EU or the UN to act. It is better to have legislation in some countries than no rules at all,” he says.

Holding social media responsible

There are no international laws on social media responsibility for user content. In recent years, several countries have chosen to legislate nationally to combat the spread of illegal and harmful content via social media.


Denmark has no law regarding the responsibility of social media, but a majority in the parliament has said that they want to legislate about it.

There have been changes in the Danish penal code – i.a. caused by cases of illegal image sharing – but the responsibilities of social media have not yet been clearly established.

According to Danish criminal law, “anyone who has contributed to the act by incitement, advice or deed” can be punished, but there has not been a judicial review of the liability of social media under applicable law.


For all EU countries, however, the so-called E-Commerce Directive applies. It provides an exemption of liability for “information services” that provide a platform for the exchange and storage of information.

The precondition for being exempted from liability is that the service has no knowledge of the illegal content.

If an information service is made aware of illegal content, they must respond and remove the content. A so-called “notice and take down” system.

Today, anyone can draw attention to illegal content on e.g. Facebook, Twitter and Youtube. If the information service itself has edited the content, the service usually has knowledge of the content and is therefore liable.


In 2017 Germany passed a law on social media responsibility known as The Facebook law. The law complies social media with over two million users to remove manifestly illegal content within 24 hours and other illegal content within seven days – after the social media has received a complaint about the content.

If social media service does not comply with the law, they risk fines of up to 50 million euros. 87 pct. of the Germans support the new law, which is considered to be pioneering.


In 2019, France adopted a law on social media, modeled on the German law.

The french law requires social media to remove manifestly illegal content within 24 hours of becoming aware of it.

If the content is not removed within 24 hours, social media can be fined up to about 100 million euros or – in the case of extremely serious violations – up to four percent of their global income.

The law is supported by 82 percent of the French.


In 2019, Australia passed a law on social media responsibility in the wake of the so-called Christchurch massacre – two mass shootings against mosques in Christchurch, New Zealand, one of which was live streamed on Facebook.

The law obliges social media to remove postings of a particularly violent nature – such as murder, rape, kidnapping and terrorism. The notices must be removed quickly and the police must be informed. If social media do not do this, they risk fines of up to 10 percent of their annual profits.  

In addition, employees of social media can be sentenced to three years in prison.


Since 2019 the UK has tested a legislative model that complies social media to improve the quality of their monitoring and editing.

Among the initiatives, an independent regulator has been set up, that can both monitor what is shared on social media and issue fines to social media that do not remove harmful content quickly.

The regulator will initially be funded by social media, but the government is considering introducing a tax to make the model sustainable in the future.

With the UK model, social media will still have to hire moderators to assess and remove offensive content, but in future the moderators will have to follow the standards of the independent authority. 82 pct. of the British support the initiative.


In the United States, social media cannot generally be held accountable for the content on their platforms. The so-called Communications Decency Act from 1996, the social platforms provide immunity.

But the matter is being widely debated at the moment.

In 2019, the US Consumer and Competition Authority fined Facebook nearly 4.5 billion euro for violating users’ privacy by passing on information on 87 million users in the so-called Cambridge Analytica case on the impact of the US election in 2016. The case is considered a breakthrough.

69 pct. of Americans support a law on social media responsibilities.

Sources: Digitally Responsible, E-Commerce Directive, The Penal Code

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