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In a revelation that stunned even hardened observers of Iran’s crisis-ridden society, Iranian authorities recently uncovered a transnational organ trafficking ring operating in plain sight in Tehran. The gang—composed of Iraqi and Iranian nationals—exploited the desperate, harvesting kidneys and corneas from impoverished foreign donors and selling them on Iran’s underground transplant market for up to 70 billion tomans — just under $1 million at the free-market exchange rate.
But this isn’t just a criminal story. It is a political one. What unfolded in Tehran is not an anomaly—it is a predictable consequence of a system designed to commodify human suffering, with the blessing and legal framework of the regime itself.
The Only State-Sanctioned Kidney Market in the World
This scandal did not unfold in a vacuum. Iran is the only country in the world where the sale of kidneys by living unrelated donors is not only legal but fully institutionalized through state-approved charities. Since the 1990s, the Islamic Republic has maintained a program where a government foundation registers buyers and sellers, matches them, and sets a nominal fixed price — originally around $4,600. On paper, it’s a controlled, equitable system. But in practice, as exposed by analysts like Nancy Scheper-Hughes and Francis Delmonico in 2018, it has created a state-engineered “kidney market” where the poor compete to sell their organs, and “regulation has not ended the black market — it has simply made it an official policy.”
In the heart-wrenching saga of a nation teetering on the brink of economic collapse, a hauntingly lucrative enterprise emerges, reaching unprecedented heights in Iran: the shameless trafficking of human organs.#IranRevolution https://t.co/bnNkbNYYnt
— NCRI-FAC (@iran_policy) May 16, 2023
Worse still, the system has failed to protect even its own rules. Transplant tourism, officially banned, remains rampant: according to a nurse from Namazi Hospital, Saudi patients regularly arrive during the summer for surgeries. In reality, prices are still brokered by middlemen and shaped by unregulated market forces. As one medical expert put it: “The poor remain poor following a vendor sale, and then with one less kidney.” What the regime presents as policy is, in fact, a legalized mechanism for monetizing poverty, where state legitimacy serves to mask systemic exploitation.
Trafficking, Disguised as Policy
The latest case involved foreign nationals—primarily from Iraq, Sudan, and Syria—recruited by a so-called charity foundation operating in Iraq. Lured by small payments or misled about medical risks, these individuals were flown to Iran, housed in makeshift safehouses in Shahr-e Rey, and forcibly prepared for surgery. According to the investigation, their blood types were recorded, and “high-value” organs were prioritized for sale to wealthy Iranian recipients. Some surgeries were reportedly conducted in unsanitary conditions inside residential apartments, putting lives at serious risk.
The victims received only a fraction of the millions exchanged between brokers and buyers. One man who attempted to withdraw from the process was threatened with “debt collection” for his airfare and medical tests. His escape and contact with Iraqi authorities eventually led to the ring’s dismantlement.
#Poverty by Design: How #Iran’s Rulers Keep the People Hungry and the Streets Quiethttps://t.co/0ZV46nr4CK
— NCRI-FAC (@iran_policy) March 25, 2025
While Iranian police have since claimed credit for the operation’s exposure, the question remains: How did such a network function for months—possibly years—within a state-run organ economy, without state awareness or complicity?
A System Built to Exploit the Desperate
The real culprit lies deeper: the clerical regime’s policy framework and its catastrophic economic governance. Over the past decade, Iran’s economic collapse has fueled the growth of black markets, informal labor, and survival economies—from child labor to organ sales. With inflation above 50%, unemployment at record highs, and access to healthcare increasingly out of reach, selling a kidney has become a rational, if desperate, choice for the poor.
The regime’s refusal to reform or address structural poverty—combined with its embrace of “managed misery” as a tool of control—has created an environment where trafficking becomes indistinguishable from policy.
And while officials continue to claim that the legal system prevents abuse, multiple studies have shown otherwise. A 2011 Harvard Health Policy Review found that Iran’s state-monitored system “has facilitated underground networks of brokers, middlemen, and forged paperwork”, especially in urban centers like Tehran and Mashhad.
Under the Rule of #Iran Regime, in an Oil Rich Country, Selling Body Organs to Pay off Debts https://t.co/0xQwzN915q pic.twitter.com/lVlOhKUU5f
— NCRI-FAC (@iran_policy) October 15, 2017
Political Denial, Social Collapse
The Iranian regime’s response has been predictably hollow. Instead of launching an inquiry into how a billion-toman business operated under its nose—or reforming a system that monetizes the poor—it has focused on arresting the perpetrators and moving on. Meanwhile, those who speak out against the system, including whistleblowers in the medical profession, face surveillance, interrogation, or professional retaliation.
This is not just corruption—it is policy by design. A regime that controls every major industry, monitors hospitals, and restricts civil society has no excuse for ignorance. The tragedy of organ trafficking in Iran is not the work of rogue actors, but of a regime that outsourced its responsibility to protect human dignity in exchange for short-term economic and political survival.
State Owns the Market—Even for Kidneys
As Tehran’s billion-toman kidney scandal continues to make international headlines, it’s time to call the problem by its name. This is not just a black market—it is the shadow of a system the clerical dictatorship itself legalized, enabled, and silently expanded.
The only real cure is not regulation. It’s political change. Because in Iran today, even your body is for sale—and the state still gets a cut.