[Joint House and Senate Hearing, 118 Congress]
[From the U.S. Government Publishing Office]




                                 


 
     STOPPING THE CRIME OF ORGAN HARVESTING_WHAT MORE MUST BE DONE?





=======================================================================

                                HEARING

                               before the

              CONGRESSIONAL-EXECUTIVE COMMISSION ON CHINA

                    ONE HUNDRED EIGHTEENTH CONGRESS

                             SECOND SESSION

                               __________

                             MARCH 20, 2024

                               __________

 Printed for the use of the Congressional-Executive Commission on China
 
 
 
 
 [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] 
 
 
 
 
 
 
 

              Available at www.cecc.gov or www.govinfo.gov
              
              
              
              
              
                              ______
                           
              U.S. GOVERNMENT PUBLISHING OFFICE 
 55-350          WASHINGTON : 2024 
           
              
              
              


              CONGRESSIONAL-EXECUTIVE COMMISSION ON CHINA

                    LEGISLATIVE BRANCH COMMISSIONERS

House

                                     Senate

CHRIS SMITH, New Jersey, Chair       JEFF MERKLEY, Oregon, Co-chair
JAMES P. McGOVERN, Massachusetts     STEVE DAINES, Montana
BRIAN MAST, Florida                  MARCO RUBIO, Florida
JENNIFER WEXTON, Virginia            TOM COTTON, Arkansas
MICHELLE STEEL, California           ANGUS KING, Maine
SUSAN WILD, Pennsylvania             TAMMY DUCKWORTH, Illinois
ANDREA SALINAS, Oregon               DAN SULLIVAN, Alaska
ZACHARY NUNN, Iowa                   SHERROD BROWN, Ohio
RYAN ZINKE, Montana                  LAPHONZA R. BUTLER, California

                     EXECUTIVE BRANCH COMMISSIONERS

               DANIEL K. KRITENBRINK, Department of State

                  MARISA LAGO, Department of Commerce

                   THEA MEI LEE, Department of Labor

                     UZRA ZEYA, Department of State

                   ERIN BARCLAY, Department of State

                      Piero Tozzi, Staff Director

                   Todd Stein, Deputy Staff Director

                                  (ii)


                            C O N T E N T S

                              ----------                              

                               Statements

Opening Statement of Hon. Chris Smith, a U.S. Representative from 
  New Jersey; Chair, Congressional-Executive Commission on China.     1
Statement of Hon. Michelle Steel, a U.S. Representative from 
  California.....................................................     4
Statement of Hon. Jeff Merkley, a U.S. Senator from Oregon; Co-
  chair, 
  Congressional-Executive Commission on China....................     4
Statement of Ethan Gutmann, China Studies Research Fellow, 
  Victims of Communism Memorial Foundation, and author of The 
  Slaughter......................................................     7
Statement of Matthew Robertson, Doctoral Candidate, Australian 
  National University (Canberra), and co-author of ``Execution by 
  Organ Procurement: Breaching the Dead Donor Rule in China,'' 
  American Journal of Transplantation............................     9
Statement of Maya Mitalipova, Director, Human Stem Cell 
  Laboratory, Whitehead Institute for Biomedical Research, MIT...    11
Statement of Tom Oliverson, M.D., Texas State Representative and 
  Chair, Insurance Committee, Texas House of Representatives.....    14

                                APPENDIX
                          Prepared Statements

Gutmann, Ethan...................................................    31
Robertson, Matthew...............................................    33
Mitalipova, Maya, Ph.D...........................................    44
Oliverson, Tom, M.D..............................................    46

Smith, Hon. Chris................................................    46
Merkley, Hon. Jeff...............................................    48

                       Submissions for the Record

Statement entitled ``EU's Responses to Forced Organ Harvesting by 
  the CCP and Urgent Measures To Be Taken'' by Lebin Ding, human 
  rights advocate and Falun Gong practitioner,...................    49
Statement of Cynthia Sun, researcher, Falun Dafa Information 
  Center.........................................................    53
Statement of Anne Zimmerman, J.D.................................    59

CECC Truth in Testimony Disclosure Form..........................    71
Witness Biographies..............................................    73

                                 (iii)


                          STOPPING THE CRIME 
                         OF ORGAN HARVESTING--



                        WHAT MORE MUST BE DONE?

                              ----------                              


                       WEDNESDAY, MARCH 20, 2024

                            Congressional-Executive
                                       Commission on China,
                                                    Washington, DC.
    The hearing was held from 10:03 a.m. to 11:46 a.m., in Room 
1334, Longworth House Office Building, Representative Chris 
Smith, Chair, Congressional-Executive Commission on China, 
presiding.
    Also present: Senator Jeff Merkley, Co-chair, and 
Representatives Steel and Nunn.

   STATEMENT OF HON. CHRIS SMITH, A REPRESENTATIVE FROM NEW 
   JERSEY; CHAIR, CONGRESSIONAL-EXECUTIVE COMMISSION ON CHINA

    Chair Smith. Good morning. This hearing will come to order. 
It's an important hearing which addresses one of the most 
persistent and horrific human rights abuses of our time, but 
sadly, one which has not received widespread attention and 
scrutiny and the condemnation that it absolutely deserves.
    Almost 2 years ago, Sir Geoffrey Nice testified before a 
hearing I chaired on forced organ harvesting at the Tom Lantos 
Human Rights Commission. For those who don't know, Sir Geoffrey 
was the lead prosecutor of Slobodan Milosevic at the 
International Criminal Tribunal for the former Yugoslavia. He 
is a serious man who engaged in a serious attempt to 
investigate the evidence of forced organ harvesting, as the 
chair of the Independent People's Tribunal into Forced Organ 
Harvesting from Prisoners of Conscience in the People's 
Republic of China, or simply, the China Tribunal.
    Sir Geoffrey summarized for us that day the final judgment 
of the China Tribunal and he put it this way: ``The Tribunal 
found unanimously, and sure beyond a reasonable doubt, that in 
China forced organ harvesting from prisoners of conscience has 
been in practice for a substantial period of time, including a 
substantial amount of victims.'' Among those victims, he said, 
are most certainly the most vulnerable populations in China 
today: prisoners, Falun Gong practitioners, and Uyghurs.
    Forced organ harvesting on an industrial scale in China is 
an atrocity unmatched in its wickedness, one we have to go back 
to the horrific crimes committed in the 20th century by Hitler, 
Stalin, Mao, and Pol Pot to find a comparatively systematic 
type of atrocity. The number of those executed for their 
organs, some even before they were brain dead, is staggering. 
Thus the China Tribunal final assessment was that state-
sanctioned forced organ harvesting in China amounts to ``crimes 
against humanity.''
    So here we are, to again contemplate--and this is the third 
hearing that I have chaired on this issue--an unimaginable and 
un-
acceptable crime. We're here because the Chinese communist 
government is the world's largest jailer of political 
prisoners, and responsible for a genocide targeting the 
Uyghurs. We are here again because there are those who doubt or 
ignore the Tribunal's findings, pointing to the PRC's 2015 
bogus promise to only source organs from voluntary donors, even 
though evidence presented by one of our witnesses here today, 
Matthew Robertson, demonstrates that this data has been 
falsified.
    We are here again because nearly 1 year ago the House 
passed the Stop Forced Organ Harvesting Act by an overwhelming 
majority, 412 to 2. We need to see the Senate pass it, and to 
do it immediately. It's been a year. With respect, I do ask 
again that the Foreign Relations Committee and the full Senate 
simply pass the bill. It was bipartisan. We vetted it with the 
U.S. Department of State. We had tremendous input from so many, 
and it is ready to become law. I hope and pray that the Senate 
will move.
    That landmark and bipartisan legislation authorizes the 
Secretary of State to deny passports and visas to any 
individual involved in illegal organ trafficking in China and 
globally. It also mandates annual reporting by the State 
Department on forced organ harvesting globally and authorizes 
sanctions for individuals and entities that facilitate forced 
organ harvesting. In December 2023, a group of civil society 
groups, religious freedom advocates, trade unions, bar 
associations, and human rights solidarity groups wrote to 
Senator Ben Cardin and Senator Jim Risch, the chair and ranking 
member of the Senate Foreign Relations Committee, urging the 
committee to pass the bill. They said the bill represented 
``the strongest legislation ever introduced by any country to 
combat the grotesque atrocity of illegal forced organ 
harvesting.'' We await Senate action, and I am confident--
because I know Ben Cardin and others--they are very honorable 
men. I am confident that they will indeed take up the bill.
    Since the China Tribunal's final judgment, researchers have 
continued to investigate the Chinese communist government and 
do a deep dive into the data on organ harvesting. Indeed, we 
will hear from two of the absolute best--Ethan Gutmann and 
Matthew Robertson. All of you are tremendous leaders, but these 
individuals have done amazing investigative work. It is 
reliable. It is actionable. And we're so grateful to have them 
here.
    We will also look at how medical journals, bar 
associations, human rights groups, the United Nations, 
corporations, and U.S. state legislatures are grappling with 
the legal, ethical, and human rights issues associated with 
being complicit in forced organ harvesting. Dr. Maya Mitalipova 
from MIT and Dr. Tom Oliverson, a Texas state representative 
who actually wrote a law for Texas on this kind of atrocity in 
terms of tourism--and I want to thank him for that leadership 
which is being replicated by other states--they will discuss 
what has been done and what more needs to be done to address 
the PRC's transplantation abuse, including the issue of organ 
tourism, which often fuels the illegal organ trafficking 
market.
    For more than two decades, I have tried to shed light on 
forced organ harvesting in China. As a matter of fact, at one 
of the hearings of my subcommittee--and this goes back to the 
1990s when Harry Wu put us in touch with a police officer who 
had pictures and documentation of executions that were 
occurring, with the ambulances right next door, all lined up in 
a queue to take those prisoners and to steal their organs 
before they died. Then they had the audacity to charge the 
parents or the family members, the wife or husband, for the 
bullets. I mean, you talk about--well, they are just incredibly 
cruel in how they mistreat people.
    In the 1990s, Chinese doctors, nurses, and security guards 
came forward again to describe all of this. Today, I'm 
announcing an initiative to seek firsthand witnesses' 
information on forced organ harvesting in China. We hope that 
people will come forward and tell their stories. They will do 
it anonymously, to protect their identities and those of their 
loved ones. We are absolutely committed to that. We need that 
information to build this case further. When we passed the bill 
last March that went over to the Senate, the Chinese Embassy 
here in Washington claimed it was all lies and, you know, 
completely repudiated it, from their point of view.
    They also said, Anybody want to come to Xinjiang, we have 
nothing to hide. This was said separately, but they said it 
there as well. Come on. Get your tickets and come on over. We 
immediately wrote a letter to them saying I wanted to lead a 
congressional delegation to Xinjiang. We have repeated that 
offer over and over, and today at this hearing I'm asking the 
Chinese Embassy to allow me to lead a delegation to Xinjiang 
immediately. Let's work out the details.
    During the worst days of the Soviet Union I went to Perm 
Camp 35 with Frank Wolf, a Congressman from Virginia. It seemed 
like it was mission impossible. We talked to the procurator 
general for all of the Soviet Union, who said: We've got 
nothing to hide. So we went to Perm Camp 35, where Natan 
Sharansky and many political prisoners were, and we videotaped 
every single prisoner there. We worked for their release with 
very good, keen information. I hope the Chinese will 
reciprocate and show a very similar openness, since they're 
claiming they have nothing to hide. Well, let us come. My bags 
are packed. My staff's bags are packed, and we will have a 
delegation all ready to go. Just give us the green light.
    Finally, I will be sending a letter to Secretary of State 
Blinken asking him to offer rewards for information from 
witnesses that will disrupt and deter the forced organ 
harvesting industry in the PRC and bring accountability to 
those engaged in this absolutely gruesome practice. The State 
Department has programs offering rewards for information on 
crimes against humanity and human trafficking, so this would, I 
think, be a very good part of that initiative. I invite any of 
my colleagues to join me in signing this letter, copies of 
which are available for your consideration.
    Silence is unacceptable. Silence is not an option, 
particularly from medical associations and corporations. They 
remain silent, but they are the most at risk of complicity in 
this heinous crime against humanity. We all bear some 
responsibility to act. This is an ongoing fight to demand 
transparency and justice, and an end to this egregious human 
rights abuse. If we don't act now, many more lives will be 
lost. I can't thank our witnesses enough for being here and for 
throughout the year and years being the source of so much 
credible, actionable information that has informed what we do 
on this Commission.
    I'd like to turn to my good friend and colleague, 
Commissioner Steel, for any opening comment.

                  STATEMENT OF MICHELLE STEEL,
                A REPRESENTATIVE FROM CALIFORNIA

    Representative Steel. Thank you, Mr. Chairman. You know, I 
think this is one of the most important committees; we are here 
to show the whole world what the CCP has been doing. So thank 
you to the witnesses for your courage in raising awareness of 
this sensitive and prolific problem. My birth parents fled from 
North Korea from communism. I heard so many stories, but this 
is really getting worse. The U.S. Congress must use every tool 
to find evidence of organ harvesting and prevent it from 
happening. So many political prisoners, including Falun Gong 
practitioners, are suffering at the hands of the CCP--actually, 
other communist countries are following that. I see that with 
Vietnam and other communist countries.
    So we must stop this. I have met with several survivors of 
the CCP's internment camps that torture and enslave minorities, 
including the Uyghurs, and have heard firsthand about the 
horrors experienced at the hands of the CCP. In June, I sent a 
letter to U.S. Secretary of State Antony Blinken, calling for 
immediate action to prevent those who participate in the CCP's 
forced organ harvesting industry from earning immigration 
status in the United States. We must do whatever we can to 
prevent the organ harvesting industry.
    I look forward to learning more today about the steps that 
we should be taking to prevent these human rights atrocities 
from continuing. Thank you for coming, witnesses, and Mr. 
Chairman, thank you for holding this hearing. It is very, very 
important that the whole world know exactly what the CCP has 
been doing to these minority communities. So thank you.
    Chair Smith. Commissioner Steel, thank you so very much for 
your statement and for your leadership on this Commission. It 
is greatly appreciated.
    I'd now like to yield to our good friend and colleague, the 
co-chair of the China Commission, Senator Merkley.

STATEMENT OF JEFF MERKLEY, A SENATOR FROM OREGON AND CO-CHAIR, 
          CONGRESSIONAL-EXECUTIVE COMMISSION ON CHINA

    Co-chair Merkley. Well, thank you very much, Mr. Chairman. 
This is an important hearing. Welcome, everyone.
    The history of human rights abuse in the organ transplant 
system has been a long-standing concern of this Commission. For 
example, back in 2006 the Commission reported that ``executed 
prisoners likely are the source of the majority of organs used 
in transplant operations in China, according to reported 
statements from Chinese officials and reports from U.S. human 
rights organizations.'' The notion that prisoners, including 
prisoners of conscience, might be executed so their organs can 
be transplanted into other people, is horrific.
    This is an area where we can say that international 
pressure appears to have produced some results. In 2014, China 
pledged to stop obtaining organs from executed prisoners and to 
``ensure the voluntary donation from citizens as the sole legal 
source of human organs.'' But have they done what they 
promised? Many experts have cast doubt about whether China has 
adhered to its pledges and abided by international standards, 
and that's what we're here today to explore.
    A Congressional Research Service report notes that 
``Researchers on organ harvesting in China have relied largely 
on circumstantial evidence, logical inferences, and interviews 
to support their arguments.'' In part, this problem can be 
blamed on the Chinese authorities, who make it extremely 
difficult to get accurate and trustworthy data. The system is 
not transparent. The Chinese government has refused to grant 
independent or international investigations into its organ 
transplant practices. The Chinese government has provided 
information that refutes the allegations of human rights 
violations.
    We need facts to make assessments and formulate policy. We 
must continue to demand that the Chinese government provide 
more transparency so we can assess whether they are meeting 
international standards, and we must take care not to let our 
policy responses be based on circumstantial or outdated 
evidence. Two years ago, the Tom Lantos Human Rights Commission 
in a hearing chaired by today's chairman, Representative Smith, 
addressed this topic with two of the witnesses here today. I 
look forward to any new information that they have uncovered 
since.
    Chairman Smith is also author of the Stop Forced Organ 
Harvesting Act, which passed the House a year ago. I'm a co-
sponsor of the Senate version, and I hope we can soon move it 
on our side. Last, I observe that one clear action that the 
Chinese government can take to provide assurances that its 
institutions are not harvesting organs from executed prisoners 
is to stop executing prisoners. I urge China to ratify the 
second optional protocol to the International Covenant on Civil 
and Political Rights aimed at the abolition of the death 
penalty. I should note that for different but significant 
reasons, the U.S. should do so as well. Thank you for being 
here today for this important discussion, and I look forward to 
your testimony.
    Chair Smith. Thank you, Chairman Merkley.
    I'd now like to introduce our distinguished witnesses. Our 
first two witnesses are researchers who doggedly pursued the 
subject of forced organ harvesting and are well known to this 
Commission. They have both produced some of the most compelling 
evidence available on forced organ harvesting in the PRC. For 
that, we owe them a huge debt of gratitude. They have both 
testified at hearings that I've chaired on this issue over the 
years, and, Ethan, stretching back over a decade now. Both are 
engaged in important research, and more of that will be 
forthcoming in the coming weeks and months.
    Ethan Gutmann is a China Studies Research Fellow at the 
Victims of Communism Memorial Foundation, cofounder of the 
International Coalition to End Transplant Abuse in China, and 
author of the seminal 2014 book ``The Slaughter: Mass Killings, 
Organ Harvesting, and China's Secret Solution to Its Dissident 
Problem.'' He is also coauthor of the influential 2016 
investigative report ``Bloody Harvest/The Slaughter: An 
Update,'' with David Matas and David Kilgour. He is currently 
working on a new book based on his personal interviews with 
Uyghur and Kazakh refugees throughout Central Asia, entitled 
``The Xinjiang Procedure.''
    Matthew Robertson, who will be joining us by way of Zoom 
from Australia, is a Chinese studies research fellow in data 
sciences at the Victims of Communism Memorial Foundation, a 
Ph.D. candidate in political science at the Australian National 
University, and an incoming postdoctoral fellow at the 
University of Mannheim in Germany. Matthew is a leading expert 
in organ trafficking harvesting in China and regularly gives 
lectures and presentations at academic conferences, briefs 
government officials, and has provided expert testimony to the 
U.S. Congress and the China Tribunal. His work has been 
published in peer-reviewed journals, including his 
groundbreaking 2022 article, ``Execution by Organ Procurement: 
Breaching the Dead Donor Rule in China.'' American Journal of 
Transplantation carried that, which showed that surgeons were 
being used as executioners in China.
    Our third and fourth witnesses will talk about how medical 
research institutions, corporations, and U.S. state 
legislatures are grappling with the legal and ethical 
implications of forced organ harvesting and organ tourism, 
which often fuels the illegal trafficking of organs.
    Dr. Maya Mitalipova is the director of the Human Stem Cell 
Laboratory at the Whitehead Institute for Biomedical Research, 
MIT. She was born in Kazakhstan and was trained in genetics and 
embryology at the Moscow Human Genetics Institute. Her 
scientific achievements are world renowned and include animal 
cloning at the University of Wisconsin in Madison and stem cell 
therapy. Since joining MIT, Dr. Mitalipova has focused on the 
study of Alzheimer's and Parkinson's disease. She has also 
applied her expertise to the study of DNA collection and mass 
DNA sequencing in China and its implications. She has 
previously contributed written testimony to the Commission with 
regard to complicity with China's human rights abuses, a topic 
that she will elaborate on today.
    Finally, Dr. Tom Oliverson is a practicing anesthesiologist 
representing Texas's 130th State house district in northwest 
Harris County, including the communities of Tomball, Cypress, 
Waller, and Hockley. Dr. Oliverson serves as the chair of the 
House Committee on Insurance and is a member of the Public 
Health and House Select Committees on Health Care Reform. 
Nationally, he's president of the National Council of Insurance 
Legislators. He is widely regarded as an expert on health care 
policy solutions, having authored multiple groundbreaking laws 
that have established Texas as a national leader in health care 
reform, including a bi-
partisan law restricting state insurance payments for Texans 
seeking organ transplantation in China, which is a national 
model for other states to follow. And I hope my state of New 
Jersey follows your lead, Doctor. I deeply appreciate that 
leadership. Congratulations on that, and we look forward to 
your testimony as well.
    Ethan Gutmann, the floor is yours.

  STATEMENT OF ETHAN GUTMANN, CHINA STUDIES RESEARCH FELLOW, 
  VICTIMS OF COMMUNISM MEMORIAL FOUNDATION AND AUTHOR OF THE 
                           SLAUGHTER

    Mr. Gutmann. I'll focus on recent developments today, 
specifically the CCP systematic harvesting of Uyghurs and other 
Turkic groups. Just as the rise of China's transplant system 
was built on the persecution of Falun Gong, harvesting is now 
bound to the Xinjiang camp system constructed from 2016 to 
2018. Now I want to also use this as an opportunity to respond 
to the CRS casting a little shade on witness statements. So, 
Congressman Smith, please forgive the repetition with previous 
testimony in this case, but I will go through estimates of 
annual camp disappearances, particularly taking into account 
the strengths and the weaknesses of refugee testimony. I will 
move to a case study in Aksu, and I will conclude by describing 
a shift in Western transplant surgeons' attitudes over the last 
2 years, and the implications for U.S. policy.
    Now let's begin with the Kazakh doctor Sayragul Sauytbay. 
I'm not good with the pronunciation here. She was employed as a 
Chinese language teacher and made herself useful throughout her 
camp. Following a camp-wide health check--that's what they call 
them--including comprehensive blood tests--Sayragul was asked 
to sort out the camp's medical files. She noticed a colored 
checkmark on certain files in the 23- to 35-year-old age range 
based on tissue typing. From Sayragul's perspective, she only 
lacked the external list of individuals who would receive the 
organs. She was certain on this point.
    Now several camp survivors noticed that following the blood 
test results some prisoners were forced to wear colored 
bracelets or vests. There was no apparent logic to the color 
grouping, only that these people were in their late twenties 
and they were healthy. Witness testimony is far from perfect. 
Personal bias, trauma, and partisanship can influence the 
results. But I don't believe these elements are distorting the 
testimony here.
    Let me explain why. First, every refugee was from a 
different camp. There was no collusion.
    Second, outside of the rape room, all 20 camps had 
installed cameras and listening devices. Other than saying 
something like ``pass the plunger,'' speech did not exist. In 
an environment of suppressed social contact and omnipresent and 
arbitrary interrogation or sexual abuse, humans compensate. 
Like starving animals, hearing becomes acute. Vision sharpens. 
Minute changes in their environment are keenly observed.
    Third, most camp refugees I interviewed in Central Asia 
were Kazakhs. With a relatively porous border and a nation-
state that occasionally lobbies China on their behalf, the 
Kazakhs view themselves as accidental prisoners. They don't 
like their Chinese overlords, but most Kazakhs are not loyal to 
the Uyghur cause. They had no motive to manipulate numbers to 
reach a particular result or to please me.
    Fourth, the interviews were purposely broad. Most witnesses 
had no idea that I was forming numerical estimates, and the 
majority were only dimly aware of organ harvesting in the first 
place.
    I wish to avoid false precision here. Even my most 
analytical witness, Ovalbek Turdakun, who recently escaped from 
Kyrgyzstan, could never determine the exact number of detainees 
in his camp. What emerged from their testimony is that there 
are two kinds of people who leave the camp early. The first 
group is about 18 years old on average. The announcement that 
they are going to work at a factory or perhaps in a bingtuan, a 
military-run cotton farm, is usually made during lunch. Light 
applause is often encouraged.
    Now, the second group is between 25 and 35. The average is 
usually 28--this was very explicit from witness to witness--the 
age the Chinese medical establishment prefers for organ 
sourcing. They are removed in the middle of the night. There is 
no applause. They are not to be mentioned again. There were a 
couple of outlier witnesses, but 90 percent of the witnesses 
were fairly consistent. 2.5 percent to 5 percent of the camp go 
missing exactly this way every year.
    Now I don't have a plausible alternate explanation for 
this, and assuming there are one million in the camps, I 
estimate 25,000 to 50,000 Uyghurs are harvested annually. Let's 
go with the lower range. The Kilgour-Matas-Gutmann report of 
2016 that Congressman Smith mentioned estimated China's annual 
transplant volume at 60,000 to 100,000. Using the minimum 
estimate, let's assume that Uyghurs and Kazakhs can be 
harvested for at least two organs. That translates into a 
minimum of 50,000 organ transplants. That's the lion's share of 
China's annual transplant volume, and it's supplied by 25,000 
dead people.
    Now on the assumption that the Gulf states organ tourists 
prefer Muslim donors who don't eat pork, the CCP has tried to 
capitalize on the switch from Falun Gong to Uyghur sources. At 
least one Chinese transplant hospital blatantly displays a 
Muslim prayer room and halal canteen on the web. Yet the 
logistical challenge of shifting away from the coastal area of 
China to Xinjiang, 4,000 kilometers away from the hospitals 
that foreign organ tourists prefer, required profusion methods 
and Western technology. I'd welcome a question on that.
    It also required a streamlined infrastructure, and there's 
one example of that, and it's a very good one. Picture a 
reeducation camp for 16,000 people. Picture a hospital, Aksu 
Infection Hospital, that performs organ transplants. Picture a 
second camp for 33,000 people constructed around that hospital. 
And picture a large crematorium. And the fact is, in Aksu all 
these structures are less than a kilometer away from each 
other. Radio Free Asia reporter Gulchehra Hoja first noticed 
this anomaly and witnesses can confirm it.
    A Uyghur convict explained that the Aksu Infection Hospital 
was originally for SARS patients. In 2013, it was repurposed as 
a reeducation hospital for extreme Muslim dissidents. The 
crematorium has a prominent Chinese sign. The air smells like 
burnt bones. A second Uyghur male confirmed that the local 
workers constantly complained about the stench. Now, it's a 20-
minute drive to Aksu airport's human organ transplant transport 
channel--that's an export-only fast lane to move human organs 
east. That's its only function.
    First Hospital Zhejiang Province is near Shanghai--not too 
far from Shanghai. And it's a designated big brother to Aksu 
Infection Hospital. They report that their liver transplants 
increased by 90 percent in 2017, while kidney transplants 
increased by 200 percent. On March 1st, 2020, First Hospital 
performed the world's first 
double lung transplant on a COVID patient. This was an 
advertisement to foreign organ tourists that China was still 
open for business.
    I'll conclude. I'm over time, and I'll conclude with 
policy. Beginning in 2012, the Western transplant consensus was 
not to investigate China but to engage with and lead the 
Chinese transplant industry to a soft reform. This consensus, 
however ineffective, acted as a brake on unified congressional 
action. In 2022, the International Society of Heart and Lung 
Transplantation, ISHLT, decided to impose an academic boycott 
of China. The next year, the ISHLT asked me to present my 
research and the research of Robertson, Lavee, Matas, and 
Kilgour at their annual conference. And I did that.
    Now, no transplant group has followed the ISHLT's lead at 
this time, but Congress has a responsibility, I believe, to act 
on an ongoing human rights catastrophe. But they must also 
respond to ISHLT's courageous act. Realistically, the 
infrastructure of harvesting may be too robust to save Uyghur 
and Kazakh lives in the near term. Yet Congress can stop 
Beijing's ongoing attempts to normalize medical deviance to 
spread this practice. And the passage of the Stop Organ 
Harvesting Act could galvanize the international transplant 
community to stop seeing research and investigation into 
Chinese harvesting as inflammatory or a deal breaker, but 
instead as a quest for justice on behalf of those young men and 
women whose only crime was that they were healthy.
    That concludes my remarks. Thank you.
    Chair Smith. Mr. Gutmann, thank you very much for that very 
extensive testimony. It really does inform us, motivates us, 
and I want to thank you so deeply for it.
    I'd now like to ask Matthew Robertson if he could join us 
from Australia.

STATEMENT OF MATTHEW ROBERTSON, DOCTORAL CANDIDATE, AUSTRALIAN 
NATIONAL UNIVERSITY (CANBERRA) AND CO-AUTHOR OF ``EXECUTION BY 
 ORGAN PROCUREMENT: BREACHING THE DEAD DONOR RULE IN CHINA,'' 
              AMERICAN JOURNAL OF TRANSPLANTATION

    Mr. Robertson. Hello. Thank you, Mr. Chairman and ranking 
members, for inviting me to testify at this important hearing, 
and thank you to the Victims of Communism Memorial Foundation, 
which has supported my research on this issue for many years.
    The atrocity of forced organ harvesting in China has been 
occurring for decades on a large scale, and it's claimed tens 
if not hundreds of thousands of lives. It's a state-sponsored 
program that has targeted political prisoners and members of 
dissident groups that Beijing sees as a threat. We know this 
based on evidence from China's own documents and medical 
papers, on which rigorous scholarly analysis has been published 
in leading academic journals, including the American Journal of 
Transplantation. Anyone who doubts the evidence can consult the 
work of the China Tribunal, chaired by renowned former war 
crimes prosecutor Sir Geoffrey Nice. I refer to this in my 
written testimony.
    Beijing says it has reformed its organ transplant industry 
into a purely voluntary system since 2015. But the official 
data supporting this claim has been demonstrated to be 
falsified. My coauthors and I published this analysis--a 
forensic statistical analysis in a leading academic journal, 
BMC Medical Ethics, in 2019. Given Beijing's well-documented 
practices of propaganda and information control, especially 
around what it deems to be sensitive issues, we have every 
reason to believe that the atrocity continues today. This means 
that anyone who traveled to China for a transplant organ could 
unwittingly cause the murder of an innocent human being and at 
the same time provide financial gain to an illicit industry 
that advances Beijing's goals of eliminating its political 
enemies, real or perceived.
    Any institution worldwide that collaborates with this 
industry would be indirectly supporting this activity, 
including hospitals providing training to Chinese transplant 
surgeons, universities facilitating transplant research and 
knowledge transfer, and businesses supplying transplant 
products and technologies. While Beijing's main target of organ 
harvesting has been death row prisoners and practitioners of 
Falun Gong, millions of Uyghurs are now also vulnerable to this 
abuse, as you've already heard. Beijing has conducted mass 
blood typing and DNA testing on vast swaths of its Uyghur 
population under the banner of health checkups. There is no 
institutional constraint on this data being put to predatory 
uses, such as organ matching.
    Today, for the first time, I can tell you about some new 
evidence of these practices from internal Chinese police files. 
A computational analysis of personnel records contained in the 
Xinjiang police files--this is a cache of thousands of files 
hacked from police computers in China by an anonymous third 
party and passed exclusively to my institution, VOC. It shows 
that over 200,000 of more than 500,000 persons in two counties 
in Xinjiang have had their blood samples taken. There are also 
numerous references throughout the file to DNA collection. As 
the files end in 2018, we can assume that since then, many more 
Uyghurs have been blood typed and entered into such databases.
    On their own, these findings obviously cannot prove that 
Uyghurs are being harvested for their organs, but blood type is 
a necessary precondition to organ matching, and DNA data allows 
for better organ matches. Given the PRC's history here of 
killing prisoners for their organs, its collection of this 
information amid this mass internment campaign should be highly 
concerning. And we've heard the same evidence from two 
different angles today.
    So what can policymakers and lawmakers do about this? I 
have a few recommendations here. I elaborate on some of them in 
greater detail in my written testimony, and I'm happy to expand 
on it in the Q&A. The U.S.-based consultancy Global Rights 
Compliance has also published a useful legal advisory, Do No 
Harm, that has detailed recommendations about cutting ties with 
PRC entities engaged in this abuse. However, before even 
cutting ties, there's a lot we don't know about the extent of 
the complicity and the involvement of U.S. institutions in 
supporting this activity in China.
    To begin with, Congress could ask the National Science 
Foundation and the National Institutes of Health to audit their 
grant making over the past two decades to uncover any funding 
that's been provided to PRC medical entities that have been 
involved in the transplant industry. Before 2015, almost all 
transplants in China were exclusively from prisoners. This is 
even admitted to by Chinese medical leaders, so that there are 
thousands--at least hundreds--of hospitals involved here. Any 
of them that have failed to uphold human subject protections 
should not be receiving Federal funds.
    Congress could exercise its oversight powers another way. 
It could call U.S. hospitals and medical centers that have 
trained Chinese transplant surgeons to account. They could 
gather data from those institutions and then that would build a 
record of which surgeons have been trained and what they have 
received training in. Then we could match that with VOC's 
databases about activity in China to understand what knowledge 
transfer from the United States has facilitated organ 
trafficking in China.
    Finally, and more aggressively, the U.S. Government could 
freeze the assets of and deny visas to any PRC individuals who 
have engaged in organ trafficking. We have lists of thousands 
of surgeons and hundreds of hospitals from Chinese medical 
databases, and these could be used to build dossiers on 
perpetrators and to identify them for visa denials and asset 
seizures. I'll be pleased to share this work with the 
Commission upon request and correspond further. Thank you.
    Chair Smith. Thank you so very much, and I do hope, God 
willing, when we get this bill into law, that you would share 
all of that with the U.S. Department of State and other 
agencies of the U.S. Government, so that we really draw a very 
focused scrutiny on this. So thank you so very much.
    I'd now like to ask Dr. Mitalipova to present her 
testimony.

    STATEMENT OF MAYA MITALIPOVA, DIRECTOR, HUMAN STEM CELL 
  LABORATORY, WHITEHEAD INSTITUTE FOR BIOMEDICAL RESEARCH, MIT

    Ms. Mitalipova. Thank you for giving me the opportunity to 
testify today in front of you.
    The Chinese government is building the world's largest DNA 
database by acquiring DNA sequencing data from companies within 
China and across the globe, including from the USA. A number of 
biotech companies are assisting the Chinese police in building 
this database. They include U.S.-based Thermo Fisher Scientific 
and the Chinese company BGI, Beijing Genomics Institute. BGI in 
particular is very dangerous because it collects DNA from 
Americans and uses it for research with the Chinese military.
    Chinese authorities are enrolling in genome surveillance 
tens of millions of people in Tibet and in Xinjiang, a.k.a. 
East Turkistan. Those individuals have no control over how 
their samples are collected, stored, and used, and neither do 
they know of the potential implications of the DNA collection 
for them and for their extended families. In 2016, a biometric 
data collection program was launched in Xinjiang, where data 
from an estimated 15 million Uyghurs has been collected under 
the guise of free annual physical exams. Note, the Han Chinese 
population of the region was exempt from this program.
    Despite it being a free exam, no results were returned to 
these residents. Mass DNA sequencing is a costly project. The 
least expensive sequencing of a small portion of DNA today can 
cost $100 per sample. The sequencing of 15 million samples can 
cost at least 1 to 2 billion dollars. To maintain this database 
for tens of millions of samples, you need a substantial number 
of professional bioinformatics specialists, specialized 
computers and software, and expensive sequencing machines.
    Why is the Chinese government investing billions of dollars 
to sequence the DNA of the entire population of Xinjiang and 
Tibet? What can DNA sequencing data be used for? DNA sequencing 
can be used in basic biological research, disease discovery, 
finding novel treatments, forensics, ancestry research, and in 
organ transplantation. Now, let's see which of these uses can 
be applied to Uyghur people in Xinjiang.
    Finding disease mutation and ancestry research in the 
region where the Chinese government is conducting genocide 
against Uyghurs? The answer is no. The forensic investigation 
on the rest of the population of Uyghurs who are not yet 
detained, on people who are tightly monitored--on the margin it 
can add to the cost of DNA sequencing by tightening 
surveillance capacity. But the answer is no.
    The only reason left for DNA use is for organ 
transplantation. And yes, its use for forced organ harvesting 
and transplantation can absolutely justify the enormous cost of 
mass DNA sequencing. According to witnesses, authorities in 
Xinjiang on a mandatory basis withdraw not only blood for DNA 
but also perform ultrasound checks of all internal organs, 
including an iris scan. Again, patients never receive the 
results of these health checks.
    China's organ transplantation industry accounts for a 
minimum of 60,000 organ transplants per year. The least 
expensive kidney transplant can cost around $70,000 U.S. And 
some other organs can cost up to a half million dollars. In 
free countries like the USA and Europe, organ donor recipients 
are on a wait list for months, and some for years, for matching 
donor organs, while in China, the matching donors can be found 
in a few weeks. According to research conducted by Ethan 
Gutmann, an estimated minimum of 25,000 Uyghurs are subjected 
to forced organ harvesting per year.
    For successful organ transplantation, doctors rely on 
several important criteria, including three main blood tests, 
cell surface tests, and limited DNA tests to determine if a 
patient and a potential donor are a match. Current genetic 
tests detect differences in DNA sequences at just a few 
specific locations in the genome of the transplant recipient 
and their organ donor. The fewer the differences are, the 
better the chance for long-term acceptance of the new organ. A 
whole genome sequencing data for a large number of genes would 
give a better match of donor and recipient organ, which in turn 
will result in no rejection, and long-term survival of the 
transplanted organs.
    When a patient requests an organ in China, his or her DNA 
sequence data will be blasted against millions of DNA databases 
stored in computers. Within a few minutes, a perfect match will 
be found. If a potential donor of the organs is not in a prison 
or camp, then Chinese authorities can easily find a reason to 
detain a match to be killed for their organs on demand.
    This is one and maybe the main reason why the Chinese 
government invested billions of dollars in DNA sequencing of 
the entire population of Xinjiang and Tibet, because it will 
make exponentially many more billions of dollars per year in 
return. Thermo Fisher's involvement in forced organ harvesting 
in Xinjiang is undeniable. But while it has vowed to stop 
selling sequencing machines to the region and to stop providing 
technical support to maintain them, the company is very 
successfully selling HLA kits and other custom-made DNA 
profiling products for organ transplantation, as high as in the 
10 million range.
    The continued sale of DNA profiling products and 
technologies by Thermo Fisher to China has to be stopped by 
Congress. It's time for the U.S. Congress to pass the bill 
introduced by Senator Hagerty and Senator Peters, the 
Prohibiting Foreign Access to American Genetic Information Act 
of 2024. This legislation will help to protect sensitive genome 
data of Americans from being used by foreign governments like 
China, whose business practices threaten U.S. national 
security.
    There is also growing evidence that academic research 
universities and publishers across the globe, and in particular 
the U.S., are complicit in aiding in the use of genetic 
technologies to surveil minority groups--Uyghurs and Tibetans 
in China. Professor Moreau and his colleagues warned scientific 
publisher PLOS, based in San Francisco, of 96 published 
research papers--that these papers hold sensitive genome data 
of minority ethnic groups. Only 12 of the 96 flagged papers 
have been retracted so far.
    Ethical concerns go beyond scientific publication. Data 
collection from these publications is commonly deposited into 
genetic databases, which are a resource not only for medical 
researchers and population geneticists, but in some cases, law 
enforcement agencies. I ask Congress to take action to restrict 
U.S. academic research universities and scientific publishers 
from sharing any technologies with Chinese companies and the 
Chinese government, like BGI.
    I urge Congress to question and, if necessary, to sanction 
Thermo Fisher for aiding China in the genocide of innocent 
Uyghur and Tibetan people and prisoners of conscience 
throughout mainland China. Thank you so much.
    Chair Smith. Doctor, thank you very much for your 
testimony. A number of very important recommendations for us 
that we will follow up on. I thank you for that.
    And it is now my privilege to introduce Dr. Tom Oliverson 
from Texas.

 STATEMENT OF TOM OLIVERSON, M.D., TEXAS STATE REPRESENTATIVE 
 AND CHAIR, INSURANCE COMMITTEE, TEXAS HOUSE OF REPRESENTATIVES

    Dr. Oliverson. Good morning, Chair Smith, Chair Merkley, 
and members of the Commission. My name is Tom Oliverson, and 
I'm a board-certified anesthesiologist and Texas state 
representative, where I chair the House Committee on Insurance. 
Thank you for allowing me the honor to speak with you today 
about what Texas has done to combat the horrific practice of 
forced organ harvesting.
    I first became aware of the horrors of forced organ 
harvesting through the advocacy efforts of the Southern USA 
Falun Dafa Association. Through the examples and eyewitness 
testimony that they provided, I became aware of the horrific 
persecution faced by Falun Gong practitioners in China. Around 
the same time, I met with members of the Chinese Uyghur 
community through the advocacy work of the Minaret Foundation. 
A pattern of religious persecution, incarceration, and 
execution for government profit became clear.
    With the help of these organizations and the Victims of 
Communism Memorial Foundation, my colleagues and I have worked 
for several years to honor the victims of communism and 
advocate for justice for the victims of forced organ 
harvesting. In 2021, I joint-authored a resolution condemning 
China for their forced organ harvesting practices, and through 
separate legislation created the Victims of Communism Memorial 
Day in Texas. This past year, we approved the creation of a 
victims of communism monument at the Texas Capitol, the first 
of its kind at a state capitol, and had our most significant 
achievement to date, the passage of Senate Bill 1040.
    Senate Bill 1040, by Senator Lois Kolkhorst and myself, is 
an attempt to choke off the demand for stolen organs, since in 
Texas, obviously, we can't affect the supply. We're attacking 
the demand by prohibiting health benefit plan issuers in Texas 
from providing coverage for medical and surgical treatments 
associated with organ transplants performed in China, or in 
another country known to participate in forced organ 
harvesting. While Texas's jurisdiction may be limited, Senate 
Bill 1040 works precisely because solid organ transplantation 
surgery and the medical aftercare associated with it is so 
prohibitively expensive that most Texans could not afford such 
care without insurance coverage and if you ask any insurer, 
they will likely tell you that this group of medical and 
surgical costs are the most expensive of all care subsets that 
they cover.
    As Senate Bill 1040 was working its way through the 
legislative process, we were able to hold a press conference to 
allow those impacted by forced organ harvesting to share their 
stories. I believe these firsthand accounts were the reason 
that we were able to pass this bill with the overwhelming 
bipartisan majority that we did. We had several survivors of 
Chinese detention camps share their powerful stories with us. 
They told us about the daily horrors of being a religious and 
political prisoner, and about those in the camps who would 
suddenly disappear, never to be seen again. They spoke of 
undergoing a series of medical tests, not for their benefit but 
rather to assess their overall health and tissue type. They 
shared that, because of their healthy lifestyles and abstinence 
from alcohol, Falun Gong practitioners and Uyghurs were the 
most often targeted groups.
    Bills modeled after Senate Bill 1040 have already been 
heard in the Arizona House and the Utah Senate, where they have 
successfully passed the committee stage. A similar bill in the 
Missouri House recently received a hearing, and Idaho and 
Illinois are in the process of passing similar legislation. 
Senate Bill 1040 sets a crucial precedent, but it has 
limitations. In my home state of Texas, only about 15 percent 
of all issued health plans are subject to state regulation. The 
rest are federally preempted and regulated by ERISA.
    This, I hope and pray, is where Members of Congress like 
yourselves come in. Passage of legislation, like Senate Bill 
1040, at the Federal level would massively expand the number of 
health plans subject to this bipartisan human rights protection 
and strike a huge blow to the inhumane practice of organ 
harvesting. I'm immensely proud that the work that we started 
in Texas is being modeled in other states. I'm so thankful for 
the work that is being done by this Commission to force the 
conversation at a national level.
    I firmly believe that passing this sort of legislation at 
the Federal level will ensure a future free from the scourge of 
forced organ harvesting. Thank you for your time today.
    Chair Smith. Dr. Oliverson, thank you for your leadership, 
for getting a bill that has become the prototype and the 
pioneering law for all of us to follow. Thank you for that 
leadership. It's extra-
ordinary. Also, since you are, on the national level, the head 
of the insurance initiative for lawmakers, others will pick it 
up. I include my own state of New Jersey in that.
    Chair Merkley does have to return to the Senate. He was 
coming in late because they had a vote and has to go back. I 
really appreciate him coming across to the House side. I yield 
to him such time as he would like.
    Co-chair Merkley. Thank you very much, Mr. Chairman, and 
thank you all.
    Mr. Gutmann, the implication of your testimony is that the 
individuals, the Falun Gong or Uyghurs who are disappearing, 
are not returning. Is that my correct reading of your 
testimony, that your assumption is that they are being 
executed?
    Mr. Gutmann. The assumption is with the Uyghurs, at least, 
that they're being transported in some state, sort of suspended 
animation, to the east coast for harvesting.
    Co-chair Merkley. In the New York Times this last week, 
there was an article regarding Afghanistan and people in dire 
conditions selling their organs, but they were basically 
selling one kidney. I'm not sure if they were also selling 
their livers or not, but the kidneys were highlighted. In that 
case, there are lots of folks who can be interviewed who sold 
an organ, but we're not seeing that in China? We're not seeing 
people--was it reinforcing the sense that people are being 
executed; you don't see people who have sold an organ?
    Mr. Gutmann. Well, I think that certainly--a lot of things 
are possible in China. There's all kinds of business that takes 
place, especially in the kind of gray market--not black market, 
but kind of gray market in between the white market and the 
black market. I would say this: what we've seen is a massive 
growth--I think certainly my colleague Matthew Robertson would 
have something to say on this as well--hearts and lungs, 
particularly lungs. There's a very dramatic growth, so China 
has surpassed the kidney stage on this, quite a while ago 
actually, and they are the leader in heart transplant 
operations in the world today, certainly.
    Co-chair Merkley. And the assumption in Afghanistan is that 
the organs are supplying a market, perhaps in Herat. It did 
raise in my mind the question, and I'll ask this of anyone on 
the panel who has insight on this, as to whether China is also 
supplementing the organ supply by flying in organs from other 
countries. Does anyone have any insight on that?
    Mr. Gutmann. I have never seen good, solid evidence that 
they are flying organs out from China. It is perfectly possible 
from the site I mentioned, from Aksu, you can get a medium-
range airplane to fly to Saudi Arabia, for example. That would 
be possible, but I've never seen the evidence. I've also heard 
of the military supplying the Japanese off the coast, and 
submarines, and so forth, but there's absolutely no critical 
evidence on that, not a witness, not anything we found.
    Co-chair Merkley. The weight of the evidence is the organs 
are all coming internally? The vast majority?
    Mr. Gutmann. Yes.
    Co-chair Merkley. Well, thank you all very much for your 
testimony, and what a profoundly troubling situation that 
people are being executed--identified by their DNA, by their 
blood type, systematically accounting for that, being matched 
and supplied--kind of executed on demand--to both folks 
internal to China and tourists coming in for the organ tourist 
business. Thank you all for this very powerful testimony.
    Chair Smith. Thank you, Senator.
    I'd like to, Mr. Gutmann, thank you again for your 
leadership, which informs this Commission and, I think, the 
whole world on this issue. You did point out that on the 
assumption that the Gulf states organ tourists prefer Muslim 
donors who don't eat pork, the CCP has tried to capitalize on 
the switch from Falun Gong to Uyghur sources. At least one 
Chinese transplant hospital blatantly displays its Muslim 
prayer room on the web. Yet the logistical challenge of 
shifting from the coastal area to Xinjiang, 4,000 kilometers 
away from the hospitals that organ tourists prefer, requires 
profusion methods and Western technology.
    Could you maybe elaborate on that? Because that is really--
I mean, we've been trying to figure out why Falun Gong--I mean, 
they're still murdering thousands of Falun Gong practitioners 
and stealing their organs. Part of our thought was, Well, maybe 
they're running out of 28-year-olds, and that's, you know----
    Mr. Gutmann. Running out of what?
    Chair Smith. Twenty-eight-year-old victims; they're looking 
for others. But this adds another dimension to it, that they're 
looking to kill other Muslims in order to procure their organs.
    Mr. Gutmann. The evidence is that in 2013 they started 
running out of Falun Gong organs. The reason we know that is 
because they started to visit Falun Gong in their homes, in 
fact, to do a DNA cheek swab--it was a primitive DNA test--and 
blood tests in their homes. These were people who were not 
incarcerated. This was very unusual, and it happened in, I 
believe, six provinces simultaneously. Now, in 2014, that's 
when the mass health checks of the Uyghurs began, so it seems 
to me that they were looking for another source at that point.
    To really--and I'll make this very quick--what happened was 
that Dr. Ko Wen-je in Taiwan had pioneered a new method of live 
organ harvesting that would preserve organs very well, and he 
was doing this in a kind of gray area legal zone in Taiwan. He 
then went on to push it. He became a salesman for Medtronic, 
which is an American company. I think you guys are familiar 
with that. Medtronic makes ECMO, this oxygenation system, and 
there was a second off-label use that had been identified about 
2008, when he gave a major talk at a conference in China, and 
that was on organ preservation. You could increase organ 
viability from, say, 4 hours to 16.
    The Medtronic device--ECMO device--is too large. It's a big 
machine. They needed a mobile machine. There was a German 
company--there's still a German company--named Hemovent--I'm 
not sure I'm pronouncing that correctly, but they made a 
miniaturized, portable version of an ECMO machine. Beginning in 
2017, Hemovent auctioned their devices to China on a mass 
scale. Now, we've looked at the actual auction records and 50 
percent of those hospitals are the transplant hospitals that we 
identified in our 2016 report as very likely organ harvesting 
centers.
    In June 2019--here's another clue for you all--sales of 
ECMO machines stop and they're replaced by ventilators. Now 
that may have been an early outbreak of COVID. On its own, it's 
just one piece of data, but I think the important point is 
that--what is not speculative here is that Hemovent was sold to 
the Chinese company MicroPort in October 2021 for 123 million 
euros, so this is obviously a very valuable technology. I'm 
sure the Chinese have reverse-engineered it by now. But you can 
see how Western technology moved into this gap in China and 
helped to make the harvesting of Uyghurs profitable.
    Chair Smith. Do you want to speak to that, Dr. Mitalipova?
    Ms. Mitalipova. Yes. I just want to add that the 
technologies are developing day by day and month by month, and 
those technologies can be applied to evil practices like forced 
organ harvesting. Internal transfer of the organs right now I 
think is not an issue because if you oxygenate the organs you 
can transfer them not only within China but maybe to a 
neighboring country, where they actually train the medical 
doctors and surgeons. And now I think they started training 
them in Central Asia, like in Kazakhstan and Uzbekistan, so 
it's kind of a warning sign when China starts training medical 
personnel on this particular technology.
    Chair Smith. Can I ask you, does anybody know when a victim 
is brought into the hospital to have their organs stolen and 
then die, are they aware of it? How much pain--we know the 
psychological pain could be beyond words, but do they 
experience physical pain? The doctor that testified at our last 
hearing said his victim wasn't even anesthetized correctly and 
was in shock and was awakened as this gruesome Josef Mengele-
like process was occurring. I'm wondering if, as an 
anesthesiologist, Dr. Oliverson, you might want to speak to 
this as well. How do they get them--do they drug them as soon 
as they take them away from the camp, that up to 5 percent, as 
you mentioned, Mr. Gutmann? Do they know where they're going?
    Mr. Gutmann. I think there's a lot of very sketchy evidence 
on this, but it is true that initially Falun Gong practitioners 
who were coming in from the camps made this claim that they 
were using low anesthesia to save money--to make it even more 
profitable. There is at least some, as I say, sketchy evidence, 
because some of the stories that come out are kind of 
outrageous and are seemingly told backwards, in other words, 
the way witnesses sometimes tell stories. Having said that, 
Enver Tohti, the doctor who performed live organ harvesting on 
a living human being, made the point that if you don't use 
enough anesthesia it is like, he said, you cannot cut a rabbit 
up even if you have four men holding the rabbit down. So he 
feels this is impossible. So I think it's mixed on that.
    I would imagine that what we're looking at is a very 
sophisticated operation today in Xinjiang, East Turkistan. And 
basically, you are looking at an entire people being moved. 
Now, normally ECMO saves lives in the West precisely because 
you can move a very sick person from place to place. It is very 
useful for organ harvesting because you can remove one organ, 
one kidney, one liver, and then still go back home. After 6 
hours everybody can take a break and then come back to it. As 
long as that heart is still beating, the organs are oxygenated. 
Now, this is very valuable.
    In the Chinese context, it's very sinister. It means, 
basically, that the PSB, the Public Security Bureau of China, 
does not want to take living people or people who are not in 
some sort of state of suspended animation. I don't know how 
else to describe it because I'm not a doctor, but to put them 
on a plane, and in the hold, and move them. Now, this has been 
verified by at least one doctor in Taiwan who works on the 
mainland on a continuous basis, that that is pretty much how he 
thinks it is done, though he believes it's possible to move 
individual organs in a kind of oxygenated form as well.
    Chair Smith. Dr. Oliverson, what about at the Federal 
level? Obviously we've got Medicare, we've got other kinds of 
insurance, Obamacare. Is there a place for us to be doing 
something vis-a-vis Federal insurance policies, health 
policies?
    Dr. Oliverson. Yes, Mr. Chairman. I think that any type of 
insurance product, reimbursement system, that would allow a 
patient to engage in medical tourism--to be clear, not all 
medical tourism is bad, per se. But any situation where a 
person could go overseas to China and receive organ 
transplantation and care thereafter and be reimbursed for that 
or have that bill paid, that's what we shut off in the state of 
Texas. And so I'm not familiar enough with CMS rules, if it 
would cover a procedure performed on a Federal health insurance 
product overseas, but assuming that it would, and it could, 
then yes, sir, I think that should obviously be included.
    Chair Smith. That would also include those reimbursable 
through tax credit policy that we have in abundance here as 
well, so we will follow up on that. Again, your law is 
inspiring not just other states, but a Federal look that's 
going to bear fruit, I believe.
    You know, one other question to Ethan Gutmann, and then 
I'll go to my good friend and colleague. You pointed out that 
in 2022 the International Society of Heart and Lung 
Transplantation imposed an academic boycott. What are the other 
groups, if you are aware of them, that have not, and what does 
that actually mean? Is it robust? Is it, you know, they just 
don't deal with them, or are they bringing some light and 
scrutiny to this ongoing, terrible abuse?
    Mr. Gutmann. I'm sorry. I didn't really fully understand 
the question.
    Chair Smith. The Society of Heart and Lung Transplantation 
boycott, the academic boycott.
    Mr. Gutmann. Oh, I see. Yes.
    Chair Smith. Exactly what does that really mean? Also, some 
of the others that should be doing this, who are they and why 
aren't they?
    Mr. Gutmann. What it means? I mean, it's actually pretty 
important, because it basically means they cannot publish in 
our journals or in the journal of the International Society for 
Heart and Lung Transplantation, which is probably the most 
important transplant journal in the world today, arguably. So 
that's significant. It means that they won't attend conferences 
in China. In fact, when I spoke in Denver last year, two 
Chinese surgeons had slipped into a crowd of 3,600 surgeons. 
They hired a bodyguard in case, I guess, they were going to 
take a blow dart and fire it at me or something. Instead, they 
just stormed out in the middle of my speech, which is sort of 
standard behavior.
    But the point is that I think it's very significant. 
There's a huge loss of--look, part of this is about hitting 
China in the purse, and obviously we've all been talking about 
that and I think that's very important--but part of this is 
about face and the International Society for Heart and Lung 
Transplantation has withdrawn any possibility of the Chinese--
you know, they've said: Look, if you can give us evidence, if 
we can go on the ground and verify it, we'll do that, we'll 
pull the academic boycott, but until then, it remains in 
effect. They've held to that this year, as I understand it. 
They're having a big meeting in Prague, I think, right now. I 
think that's significant.
    The other groups have not joined them. There are a lot of 
different transplant groups, but certainly, of course, the 
Transplantation Society, you're very familiar with because 
you've talked to the main guy, one of the presidents there. 
What we've gotten from them is silence--ever since the Uyghur 
business began. They used to carry Beijing's water--give us 
Beijing talking points. They don't do that anymore, and so it's 
an interesting effect. We don't know.
    Jacob Lavee, the Israeli doctor who changed Israel's 
policy, particularly on insurance--HMO insurance to go to China 
for transplants--he's on the ethics committee of ISHLT and he 
really pushed this through. It really comes down to him. He's a 
hero for doing that, but as he says, right now, the ISHLT is in 
a state of ``brilliant isolation,'' so that is where we stand. 
That's why I tried to make a point of looking to the political 
system here to kind of stand with them at this time, because I 
think that's such a significant change in the medical 
community.
    Chair Smith. Mr. Robertson, did you want to weigh in on 
that?
    Mr. Robertson. Yes. There's something to say about, for 
instance, the Transplantation Society. It has had a very 
different perspective from ISHLT for these many years and so 
the current president of the TTS, I mean, he has personally 
worked with Chinese surgeons who have been among the most 
egregious in their abuses, and some of them have circulated 
through institutions that he was at, like the Cleveland Clinic 
in the United States, so they basically believe that China has 
reformed its transplant system, and they seem to think that 
whatever abuses may have happened in the past, number one, 
they're not that curious about what the nature of them was. 
Number two, they think they've all been cleaned up.
    And the TTS is the global professional body for 
transplantation, not just heart or a particular subfield, so 
the leadership there influences the views of the larger 
international body of transplant professionals, and even the 
wider medical groups. So that's why ISHLT's stand here is so 
much more impressive, because they've looked at the evidence 
very closely and made a determination, and hopefully those 
other groups will come along.
    Part of my recommendations about looking into what 
institutions in the United States have trained Chinese surgeons 
and getting accountability over that, and investigating the 
funding, is--it's part of a deterrent effect to kind of join 
the more isolationist camp and put some teeth into these 
policies. Because otherwise, there's no social cost for these 
surgeons, because they don't get negative attention from the 
media or the major human rights groups. They don't have a cost 
to this and they've been friends with these Chinese surgeons 
engaged in these activities for a long time, so they just don't 
have an incentive to change their policy at the moment.
    Chair Smith. Thank you very much. You know, the End Organ 
Harvesting Act will help not only sanction those who are 
committing these horrific crimes, but it'll also empower the 
State Department to do robust reporting in a way that will be 
very similar to what we do on human trafficking, religious 
freedom. So it will make a difference and people will no longer 
be able to say, Oh, I didn't know.
    Michelle Steel, our commissioner from California.
    Representative Steel. Thank you so much, Chairman. This is 
very, very important. It's not just in the United States. We 
are making sure that our citizens are aware of what the CCP's 
been doing in China, especially when you're hearing the CCP 
saying that organ harvesting is a voluntary system. That's just 
totally nonsense and we all know it.
    I think the whole world has to know that what's going on 
inside of China, that's going to open up other communist 
countries such as Vietnam and other areas, because they're so 
closed. We don't even know what's going on in those prisons and 
what these people are doing. I sent a letter out to 17 of the 
Olympic corporate sponsors before the Beijing Olympics, and I 
asked them, since they were spending billions and billions of 
dollars on advertising, can we spare some of the money to let 
people in the world know what the CCP has been doing, not just 
organ harvesting but other stuff too. But you know what? 
Seventeen companies, I never even got one answer.
    So for them, profit is more important than human rights. 
It's really sad to see that we are not going in the right 
direction. How can government and nongovernmental medical 
organizations work together to raise awareness? What tools are 
needed to stop this in the world and what do we have to do? 
Because we must work together. Not just the United States but 
the whole world has to work together. So if any witnesses would 
like to answer these questions----
    Ms. Mitalipova. I would say the universities that develop 
the technologies. There's such a different range of 
technologies that can be used for the practice of organ 
transplantation in the medical field, and so many technologies 
are shared.
    I would say programs at the universities like Confucius 
Institutes, or the Thousand Talents program that they have 
launched to specifically fund the professors. And it's in any 
field, and especially in the field of science, like chemists, 
and biologists, and so on. They have done it by giving grants 
to these professors and training their scientists. Science is 
international, and you can't really discriminate against a 
Chinese scientist. I work with Chinese scientists. They're 
great, my colleagues, you know, and I know they want to do 
science for humanity and it probably doesn't even cross their 
mind to do something else. But their government, you know, 
censors them, and I don't know if they are even aware of those 
professors in the United States who are working on the Thousand 
Talents program, and been funded. You know how it goes, that 
you have access to internal university services, and where the 
IP is, where the intellectual property office is.
    And when you are beyond the firewall of the university, 
it's stealing those technologies, and those technologies that 
have been developed with the tax money of the American people. 
We, as scientists are developing these technologies. But the 
U.S. Government has to look into--we closed quite a lot of 
Confucius Institutes, created under the guise that there would 
be a cultural exchange and so on and so on. But those were 
propaganda--CCP propaganda institutes.
    Representative Steel. I'll reclaim my time.
    Ms. Mitalipova. Oh, sure.
    Representative Steel. Thank you very much. I'm on the Ways 
and Means Committee and I'm on the Education Committee. My 
Deterrent Act just passed. The Chinese government actually 
pours money, over $200 million, into UC Berkeley in California, 
my state. And UC Berkeley never reported. They brought Chinese 
officials and researchers to their really sensitive research 
center, and they did a tour and they received the money. My 
Deterrent Act passed, so anything they received from China, 
Iran, or those countries of concern--even coffee--they have to 
report to the department what they're receiving, because it's 
getting really dangerous. It's not just for China, but all 
these pro-Hamas, and terrorists too. Qatar was putting in a lot 
of money. We see that, and we are looking into those 
universities, so I totally agree with you.
    Second, the question that you were talking about--we have 
to stop involuntary collection of medical and DNA information 
in American companies. You're talking about the CCP stealing 
our data to send to BGI and use those data, for what? And how 
can we stop here? Is it going to be helpful to stop organ 
harvesting?
    Ms. Mitalipova. The BGI is run by the CCP. I don't think 
there's any question about that, but the Beijing Genomic 
Institute, by itself, really hasn't developed any technologists 
in DNA sequencing. What they have been doing, the Chinese 
government pays money to acquire a lot of companies, small or 
big. They couldn't acquire Illumina, as far as I know, but 
there are lots of small companies in the United States they 
acquired--they bought--literally bought it.
    Once they buy these companies, like 23andMe, and we 
submitted--a lot of Americans submitted their DNA information, 
and how it can be used in the future when the technologies will 
develop--we don't know what technologies--and the technologies 
are developing. You know, what can they be used for? We call 
the 21st century the century of biotechnology. The medical 
fields have developed, and that's how we have improved human 
health, and the average lifespan has increased, especially in 
Western countries, because those technologies have been 
developed.
    When it comes to the CCP, when they hold that genetic 
information of Americans, that is private information. Of 
course, they might not create some bioweapon, per se; they tell 
me probably it's impossible at this moment. But what they can 
do is jeopardize somebody's private information about carrying 
a mutation. Let's say somebody in Congress had submitted to 
23andMe to find out some of their mutations or something, or 
even where their ancestors come from. That information right 
now is in the hands of the CCP, literally, if BGI had acquired 
this.
    How can this be used? They can actually, just knowing about 
some disease mutation that somebody in power in the United 
States or a decisionmaker in Congress might have--that 
information could be used by the Chinese government to 
jeopardize that person, perhaps with information. Maybe in an 
election. Or let's say, like, you know, they had a child 
outside of marriage. You know, they could blackmail them--this 
information is so private and sensitive.
    I can't believe that companies like 23andMe, or any other 
DNA companies, can actually sell all our personal data. It's 
almost like my passport or my credit card was sold to China and 
they now know everything about me, including my home address, 
and everything--even my kids and grandchildren wouldn't be safe 
because I share my DNA with them.
    Representative Steel. Thank you so much. My time is up. Mr. 
Chairman, I yield back.
    Ms. Mitalipova. I think it is so important that the 
government take care of this.
    Chair Smith. Commissioner Nunn is recognized.
    Representative Nunn. Well, thank you very much, 
Commissioner. I want to compliment Commissioner Steel. Ma'am, 
do you have any follow-up that you wanted to take on that? I 
didn't want to cut into your time, if you've got a follow-on.
    Representative Steel. I have actually so many questions 
regarding this. And, you know what, I'm so very interested in 
this. Organ harvesting is an awful thing. This should just 
stop. And not just in our Commission do we have to do it, but 
we have to do it all over the world. We have to stop the CCP--
you know, these are innocent people's organs--we really have to 
stop it. I am just so frustrated. We've known about this issue 
for the last 30 years and we really have to do something more 
than just the hearing here. The whole world has to work 
together to stop these horrific things. Thank you very much for 
giving me a little more time.
    Representative Nunn. Thanks, Commissioner Steel.
    Well, I first want to begin by thanking the panel. I want 
to thank Chairman Smith for leading what is absolutely a 
difficult conversation to have, but it's also an important 
conversation to have with the American people, one that too 
often we see in this bipartisan, bicameral committee really 
examining the autocracy that is happening within the Chinese 
Communist Party today. For years, the U.S. has heard rumors of 
the nonconsensual transplanting of human organs, otherwise 
known as organ harvesting, happening inside communist China. I 
can think of no act more heinous than taking a political 
prisoner, strapping them to a medical bed, and stealing their 
body parts from the inside out, and then launching those on a 
black market--or, worse, the type of genetic analysis that 
we're talking about today.
    As you can see behind me, though, this is not a sci-fi 
movie. This is not written from a horror book. This is 
happening right now, today, in the most populous country in the 
world. Those who have repeatedly been persecuted, the Uyghurs, 
Falun Gong, and detainees are oftentimes the subject of these 
heinous crimes. But they are not alone. It is expansive and it 
is routine throughout China. In 2006, independent reports 
alleged that tens of thousands of Falun Gong practitioners in 
the reeducation through labor detention facilities in China 
were victims of organ harvesting while they were still alive, 
but which ultimately resulted in their death.
    Independent reports have also shown that nearly 25,000 
Uyghurs were the victims of organ harvesting every single year. 
The madness, the wholesale slaughter of a population, has to 
stop, particularly when it's used under the guise of doing 
science. I applaud Chairman Smith for his leadership on this 
and for the difficult issues that he continues to bring forward 
with this Commission but, most importantly, for those who 
cannot defend themselves.
    With our witnesses today, I'd like to begin with Ethan 
Gutmann. You're a Chinese Studies fellow/researcher. You've 
helped lead at the Victims of Communism Memorial Foundation. 
We'll begin with looking inward. Have Western corporations been 
complicit in the oppression of Uyghurs and Falun Gong members 
here in the United States or been co-opted as agents of 
communist China in their endeavors?
    Mr. Gutmann. I'm going to--I think Maya might have more to 
say on that question than me, so I'd hand it over to her. I 
just mentioned the Medtronic ECMO connection, which I think was 
significant. Let's put it this way: before ECMO--Medtronic-
ECMO, got involved, you could maybe do one or two organs from a 
human being and get away with it, keep them fresh and get them 
to the right places. This is also something Didi Kirsten Tatlow 
from the New York Times looked at very closely, the logistics 
of it.
    After ECMO, it became possible to harvest as many as four 
healthy organs from a single person. Suddenly turning a person 
from $100,000 into half a million dollars or more from foreign 
organ tourists. This is a dramatic difference. It became an 
incentive to harvest Falun Gong. It improved the chances that 
you'd make real money.
    Ms. Mitalipova. I think transplant technologies and medical 
practice has been--really progressed over the years, especially 
in the 1990s and 2000s, in organ transplantation. The organ 
transplant only can develop if the organs are accepted by the 
recipient. This is not just DNA sequencing, but it's a lot of 
blood tests and HLA, as they call it, a specific antigen on the 
surface of the cells and the organs as well, that has to match 
with the donor. Now I think the technology is HLA typing. So 
now the matching donor and recipient are a match, and they can.
    After organ transplant care--immunosuppressant drugs--all 
of those have been developed really well. The first 2 years 
after organ transplant, there was up to a 60 percent rejection 
rate before; right now that's decreasing because of the post-
transplant care that has been developed. The medical field 
has--the scientists worked on it. I think the immunosuppressant 
drugs help. The DNA sequencing comes into that, because the 
more the genes can be sequenced, the less differences between 
the donor and the recipient in the genome, the better the 
outcome that that organ will live not just 10 years. It can 
live in that recipient for 20 to 30. You really prolong the 
transplanted organ life in the recipient by DNA sequencing.
    Representative Nunn. So is it fair to say, Dr. Mitalipova, 
that not only is China working to develop an exploitation and 
long-term facilitation of organs for profit, but that DNA 
sequencing on the front end, making sure that that organ is 
capable to be transferred, is a huge part of the business 
model, if you will, of how this is done?
    I'd like to talk with Matthew Robertson here. I know you're 
coming in from Australia to us. Mr. Robertson, you're working 
on a number of studies, your most recent being ``Execution by 
Organ Procurement.'' We just talked about DNA here. You 
documented through the Australian Strategic Policy Institute in 
2020 that the Chinese authorities have been building a DNA 
database largely of the male population. We have some folks in 
the audience here in Washington who are still looking for 
family members associated with this. Is it fair to say not only 
is this the largest police-run DNA database in the world, but 
that there is a concerted effort to identify and track all men 
in the country in this type of roundup?
    Mr. Robertson. Thank you for your question. The scale of 
that program is very extensive. It was almost not known about 
until an enterprising investigator (not myself) began looking, 
on a large scale, at Chinese media reports. It's unclear what 
the purpose of that was. It does appear to have been a campaign 
to gather DNA data on males across the country. The connection 
with that and the organ trade is unclear. It's not clear that 
there is any connection.
    I want to touch on a point that you made about the 
complicity of Western corporations with this industry in China. 
I think it's fair to say that Western companies and 
institutions--health care, hospitals, medical centers--have 
been instrumental in the rise of China's organ transplantation 
industry. I can just give you a couple of examples. Roche, it's 
a Swiss company. It has a U.S. financial presence. They built 
the first organ registry for the PLA in the early 2000s. Some 
of the other drug companies have been sponsors of the Chinese 
official transplant associations and they've funded research by 
Chinese surgeons during a time when there were no voluntary 
transplants.
    And this is not even to mention extensive training. At 
least hundreds of Chinese surgeons who have engaged in organ 
trafficking have been trained in the United States. The Chinese 
transplant industry simply could not have capitalized on the 
incarcerated population of political prisoners without gaining 
the know-how from the West. This is something that has already 
happened, and we need to study it, investigate it, understand, 
actually, the dimensions of that contact. But there could still 
be ongoing ties, money being made, and things that can be done 
now. So I think the first step is understanding what has 
happened and then stopping it to the extent that it continues.
    Representative Nunn. Mr. Robertson, if such an 
investigation were to be taken, particularly into how the West 
has intentionally or unintentionally emboldened the harvesting 
of organs from China, would you have recommendations for this 
Commission that we could take for both the investigation piece 
and to be able to do that fact-finding mission, as you've done 
on the DNA side?
    Mr. Robertson. Yes. One idea, just a starter, is an audit 
of what the NSF and NIH have funded and whether money has gone, 
as subgrantee, probably not as the principal awardee, but as 
sub-awardee, to any of the many hundreds, nearly 1,000 
hospitals, in China that have engaged in organ trafficking. 
These are some of the biggest hospitals in China, biggest 
health care centers. It would be almost surprising if NIH money 
has not gone to them. So that should be accounted for.
    There's also going to be training at taxpayer-funded 
medical centers across the United States. The Cleveland Clinic 
is certainly one. Now, some of these are going to be private 
and some of them are going to be public, but there may be 
record requests that could be lodged with these institutions. 
Congress could put some muscle behind getting them to look 
through their databases, because they'll have this information 
in an archive somewhere about who has come from China and 
received what training. And so, as part of an investigation 
that can be put together with our data sets of transplant 
surgeons and entities in China, from this data set of medical 
publication and our cache of surgeon biographies.
    So we could put together on the U.S. side--when they came, 
what training they received, and then their activities in 
China--what transplants they participated in prior to 2015, 
let's say. Then you could get a picture of what the complicity 
of U.S. institutions has been, but there's much more. There's 
visa bans. I mean, the most provocative suggestion I've made is 
actually using the SDN list. The same way that Iranian nuclear 
physicists are treated, where there's just no financial ties, 
no U.S. ties at all, no export controls, the works. The blocked 
persons list.
    That would be the most stringent or extreme response that 
the U.S. Government could engage in. But if we're going to buy 
the story that's being told here about the gravity of these 
abuses, that would seem perfectly warranted. I understand that 
would be a huge process, but certainly, I think it'd be worth 
considering. And in principle, there's nothing preventing the 
U.S. Government from doing that if it so wished.
    Representative Nunn. You've laid out a compendium, I think, 
that we should all look at. I'd ask the rest of the panel--I 
mean, things that are immediately concerning are one, that we 
have U.S. taxpayer dollars knowingly going to potentially 
thousands of hospitals inside China that would be harvesting 
these organs. I think, second, it's safe to say that it's not 
just China that is benefiting from this practice. We have seen 
time and time again that others, particularly those in the 
West, are benefiting from this harvesting of organs. And three, 
to your point, that the facilities and the medical 
professionals who have been trained here in the West under the 
aegis of the medical code and Hippocratic Oath, are then being 
used as instruments of either the state or with knowing 
negligence to then harvest their fellow countrymen, is beyond 
the pale.
    I would like to open it up to the panel. Are there other 
recommendations that you would have here, either on the DNA 
mapping program that China is undertaking, or, two, in holding 
the actual institutions accountable within China who are doing 
this harvesting? What can we do on this side of the Pacific?
    Mr. Gutmann. I'm going to make a very quick suggestion on 
this. One thing I wanted to mention, just very quickly, was 
that Matthew talked about Roche, and, you know, it's 
interesting that Roche was testing its immunosuppressive drugs 
in China. It was using China as a very cheap place to do that 
kind of testing. Got a big population of people who received an 
organ, but those organs were from Falun Gong, in some cases, 
undoubtedly, especially at that time when Roche was doing this 
in the early 2000s. It is also true that Pfizer got involved in 
that as well. Pfizer did testing in China. They seemed to 
truncate their testing program, or at least try to do it as 
quickly as possible, because it was a controversial idea at 
that time, since 2007, something like that. But I think it's 
really worth looking at the immunosuppressive industry because 
this is--people were killed to allow other people to test in 
China. I think that's a really unethical idea.
    I'd mention one other thing. I don't know how this falls 
into a category of how American policy could affect it, but 
that's for you guys to figure out, to some extent. A real 
problem of the spillover from China--and I get this from David 
Matas--he says, in Busan, Korea at a symposium in November 
2022, the first Asian Organ Donor Donation International 
Symposium--this was Korea, China, and Japan. I've looked at the 
records for that, and a couple of the speakers talk about 
replicating the Euro transplant system. That is to say, a 
cross-border allocation of organ donations. The speakers showed 
absolutely no awareness that such a system would mean the 
allocation to Japan and Korea of organs sourced from prisoners 
of conscience in China, killed for their organs.
    This is a classic case of, as I say, the normalization of 
deviance. It's exactly what China wants. Their system of 
reform, that they have always touted, has really been about 
that. It's about--it's not about reforming themselves--it's 
about putting these systems in so that other people are doing 
them too so the Chinese will feel okay about it. Or whatever. 
The evidence is going that way, and that is, it seems to me, 
one of the most important boils to lance here. I'm not quite 
sure how to do it, but I know the ISHLT thing is very helpful 
on that. But obviously, maybe just even some explicit language 
from the U.S. Government on this would help a lot.
    Representative Nunn. Dr. Oliverson, did you have a follow-
up on that?
    Dr. Oliverson. Yes, Commissioner. You know, we're in the 
Natural Resources hearing room, as I understand it, and I think 
the simplest answer to your question, which is the approach we 
took in Texas, is you're not going to stop the supply. I think 
it's important to understand that in its clearest form, a 
communist government--whether it's China or another 
government--looks at a human being not as an individual with 
inalienable rights but as a natural resource. If that can be 
monetized for the benefit of the collective good, you're never 
going to stop that unless you can choke off the demand. That's 
the approach that we took in Texas and that's what I'm here 
today urging you to do--aggressively stop the flow of dollars 
from Americans to China and other countries paying for these 
procedures. If nobody wants the organs, then they'll stop 
taking them.
    Representative Nunn. I think that is probably one of the 
most salient recommendations that we can have is that holding 
folks accountable outside of China, as well as identifying the 
threat coming from inside China, is a two-tier approach that we 
need to take comprehensively.
    Mr. Chairman, what I'd like to do going forward as well is 
to come up with a list of recommendations that could be 
actioned by committees of jurisdiction to be able to address 
this, both holding China accountable on the international 
scene--particularly those doing business with those thousand-
plus medical institutions operating in China--but then equally, 
holding ourselves and our allies accountable for the export 
market that has proven so lucrative for the destruction of 
human life inside China. With that, I yield back the remainder 
of my time. And I thank the Commission.
    Chair Smith. Commissioner Nunn, thank you. As always, thank 
you for your very well-informed and incisive questioning, but 
also your recommendations. We will work with you on all of 
that. Thank you so very much.
    Mr. Gutmann, the first time I heard you talk about the 
ideal age for harvesting being 28 years of age, we know that 
when somebody gives their heart in a voluntary fashion, or one 
of their loved ones does it, it's the result of a car accident 
that has been catastrophic or something. It is not, you know, a 
government official saying, Let's look at the 28-year-olds and 
cull those out of the herd in order to destroy them to steal 
their organs. About 25 years ago I read a book about Unit 731, 
that Imperial Japan had operated inside of China, where 
vivisection was performed on POWs, many, many Chinese, without 
anesthesia--Dr. Oliverson, as you know.
    They also did some organ harvesting there, not for 
transplant, as far as we can tell, but for other reasons. They 
tested all kinds of things like anthrax and other things on 
them. Horrible, horrible stuff. And the Chinese, rightfully, 
are outraged by what had been done at Unit 731. Well, this is 
their Unit 731 in China today, taking these wonderful young men 
and women. I think, Ethan, you had said previously that it's 
pretty much equally divided between males and females. So we've 
got a lot of young women and a lot of young men in the prime of 
their lives being taken by a dictatorship to steal their 
organs.
    And one of the things--and maybe you might want to speak to 
this--that we've been hearing about more and more is that there 
are also dedicated wings or hospitals where, from Xi Jinping on 
down, in the Chinese Communist Party, if they need a liver or 
they need some other organ, you know, a very young and vibrant 
and healthy 28-year-old will be involuntarily providing that to 
them. So it's their way toward longevity at the cost of 
committing murder in order to get there. Plus, there's also the 
financial incentive as well, that they make money on this. If 
any of you wanted to respond to that. But when I read that 
book, and when I first heard through Harry Wu about organ 
harvesting, the first thing I thought of was Unit 731, having 
read that book as a newer Member of Congress way back when.
    The designated hospitals, would any of you want to speak to 
that? Or, you know, I thought you made a very good point, 
Ethan, about the hospital in Aksu. That was very enlightening. 
And if you wanted to elaborate on that at all . . . and then 
your final comment that Congress can stop Beijing's ongoing 
attempts to normalize medical deviance. And that the passage of 
the Stop Organ Harvesting Act could galvanize the international 
transplant community to stop seeing research and investigation 
into the Chinese harvesting as inflammatory, but rather as a 
quest for justice on behalf of those young men and women whose 
only crime was that they were healthy. What a profound ending 
to your testimony.
    Mr. Gutmann. Thank you. I have nothing to add.
    Chair Smith. Anybody else like to add before we close the 
hearing? Thank you so much. You've given us so much to act 
upon, so many insights, as you do on a regular basis but now in 
an open hearing. I deeply appreciate it. The hearing is 
adjourned.
    [Whereupon, at 11:46 a.m., the hearing was concluded.]

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                            A P P E N D I X

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                          Prepared Statements

                                ------                                


                  Prepared Statement of Ethan Gutmann

    I'll focus on recent developments today, specifically the CCP's 
systematic harvesting of Uyghurs and other Turkic groups. Just as the 
rise of China's transplant system was built on the persecution of Falun 
Gong, harvesting is now bound to the ``Xinjiang Camp System'' 
constructed from 2016 to 2018.
    I'll go through estimates of annual camp disappearances, taking 
into account the strengths and weaknesses of camp refugee testimony, 
move to a case study in Aksu, and conclude by describing a shift in 
Western transplant surgeons' attitudes over the last 2 years--and the 
implications for U.S. policy.
    Let's begin with the Kazakh doctor, Sayragul Suaytbay. ``Employed'' 
as a Chinese language teacher, Sayragul made herself useful throughout 
her camp. Following a camp-wide ``health check'' including 
comprehensive blood tests, Sayragul was asked to sort out the camp's 
medical files. She noticed a colored check mark on certain files in the 
23- to 35-year-old age range based on tissue typing. From Sayragul's 
perspective, she only lacked the external list of individuals who would 
receive the organs.
    Several camp survivors noticed that following the blood test 
results, some prisoners were forced to wear colored bracelets or vests. 
There was no apparent logic to the color grouping, only that they were 
in their late twenties and ``they were healthy.''
    Witness testimony is far from perfect. Personal bias, trauma, and 
partisanship can influence the results. Yet I don't believe those 
elements are distorting the testimony here.
    First, every refugee was from a different camp.
    Second, outside of the rape room, all 20 camps had installed 
cameras and listening devices, talking was not allowed. Other than 
saying something like ``pass the plunger,'' speech did not exist. In an 
environment of suppressed social contact and omnipresent and arbitrary 
interrogation or sexual abuse, humans compensate. Like starving 
animals, hearing becomes acute. Vision sharpens. Minute changes are 
keenly observed.
    Third, most camp refugees whom I interviewed in Central Asia were 
Kazakhs. With a relatively porous border and a nation-state that 
occasionally lobbies China on their behalf, the Kazakhs view themselves 
as ``accidental prisoners.'' They don't like their Chinese overlords, 
but most Kazakhs are not loyal to the Uyghur cause. They had no motive 
to manipulate numbers to reach a particular result or to please me.
    Fourth, the interviews were purposely broad. Most witnesses had no 
idea I was forming numerical estimates, and the majority were only 
dimly aware of organ harvesting.
    I wish to avoid false precision here. Even my most analytical 
witness--Ovalbek Turdakun, who escaped from Kyrgyzstan--could never 
determine the exact number of detainees in his camp.
    What emerged is that there are two kinds of people who leave the 
camp early: The first group is about 18 years old on average. The 
announcement that they are going to work at a factory, or perhaps in a 
bingtuan--a military-run cotton farm--is usually made during lunch. 
Light applause is encouraged.
    The second group is aged between 25 to 35. The average is usually 
28--the age that the Chinese medical establishment prefers for organ 
sourcing. They are removed in the middle of the night--no applause, not 
to be mentioned again. There were a couple of outlier witnesses, but 90 
percent of the witnesses were fairly consistent: 2.5 percent to 5 
percent of the camp go missing exactly this way every year.
    I don't have a plausible alternate explanation. Assuming there are 
one million in the camps, I estimate 25,000 to 50,000 Uyghurs are 
harvested annually.
    Let's go with the lower range. The Kilgour-Matas-Gutmann report of 
2016 estimated China's annual transplant volume at 60,000 to 100,000. 
Using the minimum estimate, let's assume that Uyghurs and Kazakhs can 
be harvested for at least two organs. That translates into a minimum of 
50,000 organ transplants--the lion's share of China's annual transplant 
volume--supplied by 25,000 people.
    On the assumption that Gulf states' organ tourists prefer Muslim 
``donors'' who don't eat pork, the CCP has tried to capitalize on the 
switch from Falun Gong to Uyghur sources. At least one Chinese 
transplant hospital blatantly displays its Muslim prayer room and halal 
canteen on the web. Yet the logistical challenge of shifting from the 
coastal area to Xinjiang--4,000 kilometers away from the hospitals 
which organ tourists prefer--required perfusion methods and Western 
technology. It also required a streamlined infrastructure. One example:

      Picture a ``re-education camp'' for 16,000 people.
      A hospital--``Aksu Infection''--that performs organ 
transplants.
      A second camp for 33,000 people, constructed around the 
hospital.
      And a large crematorium.

    In Aksu, all these structures are less than a kilometer away from 
one another. RFA reporter Gulchehra Hoja first noticed this anomaly, 
and witnesses can confirm it. A Uyghur convict explained that the Aksu 
Infection Hospital was originally for SARS patients. In 2013, it was 
repurposed as a re-education hospital for ``extreme Muslim'' 
dissidents. The crematorium has a prominent Chinese sign, and ``the air 
smells like burnt bones.'' A second Uyghur male confirmed that local 
workers constantly complained about the stench.
    It's a twenty-minute drive to Aksu Airport's ``Human Organ 
Transport Channel''--an export-only fast lane to move human organs 
east. ``First Hospital Zhejiang Province'' as a designated ``big 
brother'' to Aksu Infection Hospital reports its liver transplants 
increasing by 90 percent in 2017, while kidney transplants increased by 
200 percent. On March 1, 2020, First Hospital performed the world's 
first double lung transplant on a Covid patient--an advertisement to 
foreign organ tourists that China was still open for business.
    I'll conclude with policy. Beginning in 2012, the Western 
transplant consensus was not to investigate China, but to engage with 
and lead the Chinese transplant industry to a ``soft reform.'' This 
consensus, however ineffective, acted as a brake on unified 
congressional action.
    In 2022, the International Society of Heart and Lung 
Transplantation (ISHLT) decided to impose an academic boycott of China. 
The next year, the ISHLT asked me to present my research--and the 
research of Robertson, Lavee, Matas and Kilgour--at their annual 
conference. No transplant group has followed the ISHLT's lead at this 
time. Congress has a responsibility to act on an ongoing human rights 
catastrophe but must also respond to the ISHLT's courageous act.
    Realistically, the infrastructure of harvesting may be too robust 
to save Uyghur and Kazakh lives in the near term. Yet Congress can stop 
Beijing's ongoing attempts to normalize medical deviance, and the 
passage of the Stop Organ Harvesting Act could galvanize the 
international transplant community to stop seeing research and 
investigation into Chinese harvesting as inflammatory, but rather, as a 
quest for justice on behalf of those young men and women whose only 
crime was ``they were healthy.''
    That concludes my remarks.
      Organ Trafficking in China: Background and Current Concerns

                            by Matthew Robertson

                           Table of Contents

1. Background....................................................    34

  1.1 Methods....................................................    35

2. Six key factual claims........................................    35

  2.1 GThe PRC state has sponsored a marketplace in human organs 
  for many years.................................................    35
  2.2 GPrisoners have been blood tested, held captive, and then 
  killed on demand for their organs..............................    35
  2.3 GState agents have engaged in human trafficking and 
  extrajudicial killing to secure organs.........................    36
  2.4 GChina's organ transplantation system appears to have begun 
  as a means of health care for the elite........................    37
  2.5 GSurgeons and health care workers have personally engaged 
  in killing by heart removal....................................    37
  2.6 GThe PRC state has falsified its organ transplant data.....    38

3. Current concerns..............................................    39

  3.1 GLack of accountability means there are no incentives for 
  the cessation of the abuse.....................................    39
  3.2 GUyghurs are highly vulnerable to this abuse...............    39

4. Recommendations...............................................    40

  4.1 GInvestigate federal funding...............................    40
  4.2 GIncreased congressional oversight.........................    40
  4.3 GIndividual sanctions......................................    40
  4.4 GDiplomatic pressure.......................................    41
  4.5 GEntity sanctions..........................................    41
1.  Background

    In the world of organ transplantation, the People's Republic of 
China (PRC) is an outlier. With few exceptions, organs always come from 
voluntary donors. Yet until 2015 the PRC's organ transplantation sector 
was effectively a state-sponsored system of human trafficking and 
killing on demand, with organs sourced almost entirely from death row 
prisoners and, after 1999, political prisoners. After 2015, it became 
more difficult to assess--though as I explain below there are still 
major concerns.
    This organ procurement method seemingly originated as a means of 
providing healthcare for the elite. Surgeons and healthcare workers 
appear to have personally participated in medicalized executions to 
extract vital organs such as hearts and lungs.
    Since the inception of organ transplantation in China, the practice 
has been closely tied to the state judicial and security systems, which 
supplied nonconsenting organ donors to transplant hospitals. That is, 
organ procurement in China has gone hand-in-hand with abuses against 
criminal prisoners and political enemies. The earliest reported 
instance of such abuse occurred in 1970, with the reported live organ 
harvesting of an 18-year-old former Red Guard commander sentenced to 
death for political heresy. The most well-known early case took place 
in 1978, when a young political prisoner reportedly had her kidneys 
extracted on the execution ground while she was still alive.
    With China's economic reforms, the organ transplantation system 
also became subject to market forces. Beginning in 2000, China's organ 
transplantation sector exploded in activity. Thousands of transplant 
surgeons were trained, and hundreds of hospitals began offering 
transplants as a routine therapy. The military-medical complex became 
heavily involved in transplant activity and research. Transplant 
waiting times went from many months to just weeks, days, and sometimes 
hours. Organ transplantation went from a specialized therapy catering 
primarily to Party cadres to a routine treatment available country-
wide. Hospitals began posting organ availability and price lists on 
websites, and transplant tourists from around the world flew to China 
to receive organs on designated dates (meaning the timing of the 
execution of the donor must have been planned in advance.)
    Chinese-language sources reveal that the two key shifts in China's 
transplant sector beginning in 2000 were volume and waiting times: tens 
of thousands of transplants were performed annually, many on an on-
demand basis, coinciding with a gradual and then sudden drop in 
judicial executions. The use of political prisoners as an organ source, 
particularly Falun Gong adherents incarcerated en masse from July 1999, 
is the only plausible explanation for this outcome.
    In 2015, facing international scrutiny, China's medical 
administrators announced a transition from using prisoners to voluntary 
donors. Chinese officials reported extraordinary success in these 
reforms, but China's standards for public transplant data provision 
differ significantly from international norms, with official registries 
remaining inaccessible.
    Regrettably, the PRC seems to have fabricated its voluntary organ 
donation data. Analysis of the available data casts grave doubts on the 
veracity of China's assertions, with official statistics exhibiting an 
implausibly smooth growth rate, discrepancies across datasets, and the 
misclassification of nonconsenting donors as voluntary. Although some 
genuine voluntary reform is taking place, the systematic manipulation 
of data obscures its actual scope. This data falsification can be 
understood as a strategic act by the state to project an image of 
reform while maintaining opacity and control over the organ 
transplantation system.
    Much of the above relates to events in the past. There are at least 
two grounds for ongoing concern.
    First, there has been almost no accountability for this multi-
decade program of large-scale human trafficking and extrajudicial 
killing. PRC surgeons involved in this campaign still travel freely to 
international medical conferences. They are enabled by many people in 
the international medical community who ignore the topic.
    Second, just as during the repression of Falun Gong in 1999, the 
large-scale internment of Uyghurs in Xinjiang has been accompanied by 
large-scale blood testing. Approximately one third of the individuals 
identified in the Xinjiang Police Files, a cache of internal documents 
hacked from public security computer systems in two counties of 
Xinjiang, have had their blood samples taken. That is, in many of the 
files the ID and name of an internee is listed alongside the blood 
type. There are several thousand cases of explicitly labeled DNA 
collection from internees, and thousands of files through the corpus 
discuss DNA collection from Uyghurs.
    While this alone does not prove Uyghurs are being harvested for 
organs, blood type is a necessary precondition for organ matching, and 
DNA data can improve matches. Given China's history of killing 
prisoners for organs, the mass collection of such data from 
extrajudicially detained Uyghurs is disturbing.

1.1  Methods

    I am a social scientist with expertise in computational and 
quantitative methods, professional fluency in Chinese, and a strong 
interest in the scientific study of political violence and genocide. I 
have studied China's organ transplantation system for many years. My 
primary method of work is to write code to scrape data from a wide 
variety of sources, then to construct large-scale datasets and 
searchable databases from these documents. I analyze the data using 
both statistical models and close, qualitative reading. I situate my 
work in the public choice tradition--where I am interested in 
understanding the private incentives of state actors.
    Below, I have tried to summarize the most important parts of my 
findings in six factual arguments.

2.  Six key factual claims

2.1  The PRC state has sponsored a marketplace in human organs for many 
years

    This assertion is supported by admissions from Chinese medical 
authorities, media reports, and the listing of organ transplant prices 
on hospital websites. Chinese medical officials have acknowledged that 
executed prisoners were the primary source of organs, a fact reported 
in both domestic and international media, as well as in official 
statements and medical papers.
    Dr. Huang Jiefu, formerly China's vice minister of health and for 
decades the leader of the transplant sector, has admitted in interviews 
with Beijing-friendly Chinese media that China's organ transplantation 
system was characterized by complex entanglements and vested interests, 
leading to a ``filthy'' and murky trade. In an interview, he stated: 
``There are definitely all kinds of intricate entanglements, interests, 
and chains of interests involved, which makes it filthy. It becomes 
filthy, becomes unclear and inexplicable, and turns into a particularly 
sensitive and complex area, a forbidden zone.'' \1\
    Hospital websites have openly listed prices for various organ 
transplant operations. For example, the China International Organ 
Transplant Center website displayed prices ranging from tens of 
thousands to over $100,000US for foreign patients, while domestic 
prices were significantly lower, in the range of tens of thousands RMB. 
The Zhongshan Hospital at Xiamen University provided an Excel file on 
their website detailing prices for a wide range of transplant 
therapies.\2\
    In addition, the First Affiliated Hospital of Inner Mongolia 
Medical University, a regional-level heart and lung transplant center, 
published a list of service charges for various transplant surgeries. 
These prices, ranging from 600 to 5,000 RMB, appeared to cover only the 
transplant surgery and excluded organ and procurement costs.\3\ A large 
portion of the payments for surgery in China also takes place in cash 
transactions.
    Similarly, the Fujian Provincial Hospital, a regional-level kidney 
transplant center, listed prices on its website for an extensive number 
of organ transplants, despite only being certified for kidney 
transplants. The prices ranged from 3,000 RMB for keratoplasty to 
33,000 RMB for heart-lung transplantation, with the organ cost not 
included.\4\
    These examples illustrate a state-sponsored marketplace for human 
organs in China, with prices openly advertised on hospital websites and 
substantial price disparities between foreign and domestic patients.\5\ 
The state's role in enabling and profiting from this market suggests a 
strategic exploitation of prisoner populations for financial gain.

2.2  Prisoners have been blood tested, held captive, and then killed on 

demand for their organs

    Substantial evidence indicates that prisoners in China have been 
subjected to blood tests, held in captivity, and killed on demand for 
their organs. This assertion is corroborated by evidence and admissions 
from high-level Chinese officials, medical professionals, and official 
publications. Prisoners here are treated as a resource--a captive pool 
of organ supply to be exploited as needed.
    Dr. Huang, a prominent liver transplant surgeon, has been 
intimately involved in the organ transplantation system in China. In 
2005, he traveled to Xinjiang to perform a complex autologous liver 
transplantation on a local Communist Party official. As a backup, Huang 
ordered two extra livers from hospitals in Chongqing and Guangzhou, 
which were delivered the next morning.\6\ This event demonstrates the 
extraordinary ability to procure organs on demand, which is effectively 
impossible to do reliably and at scale in systems relying on voluntary 
donations. Given Huang's high-ranking position and expertise, his 
actions suggest knowledge of the methods used to source organs from 
prisoners.
    Prior to the allegations of organ harvesting from Falun Gong 
practitioners in 2006, Chinese hospitals openly advertised organ 
transplants on short waiting times, ranging from weeks to months. They 
also scheduled foreign tourists for heart transplants on specific 
dates.\7\ The China Liver Transplant Registry in 2005 and 2006 revealed 
that a significant portion of liver transplants were conducted on an 
``emergency'' basis, defined as within 24 to 72 hours of a patient's 
presentation at the hospital.\8\ The only plausible explanation for 
this phenomenon is the existence of a pool of pre-blood-typed, healthy 
donors who could be killed on demand for their organs.
    Medical papers and anecdotes from Chinese surgeons further support 
the claim of organ sourcing from prisoners on demand. In one instance, 
doctors flew a donor to Tibet for a liver extraction, ensuring the 
simultaneous removal of the recipient's liver to maintain the viability 
of the transplanted organ.\9\ This constitutes an admission of human 
trafficking for killing and organ removal, given that they expressly 
flew a living forced donor to a different location, only to then 
conduct the execution and organ procurement. Chinese media also 
documented cases of rapid re-transplantation after rejection, with 
hospitals guaranteeing re-transplantation within a week in case of 
failure.\10\ Surgeons expressed enthusiasm for performing a high volume 
of transplants, with one stating that his team was ``militarized'' and 
ready to procure organs at any time.\11\
    These pieces of evidence, along with the disconnect between the 
volume of transplants and the number of executed prisoners, strongly 
suggest that prisoners in China have been blood tested, held captive, 
and killed on demand for their organs. The involvement of high-ranking 
officials, the short waiting times, and the ability to procure organs 
rapidly all point to a state-sanctioned system of organ harvesting from 
prisoners, likely including prisoners of conscience.

2.3  State agents have engaged in human trafficking and extrajudicial 
killing to secure organs

    Evidence of human trafficking is apparent from the above 
anecdotes--that is, if a prisoner is moved from one location to another 
for the purposes of their being killed and having their organs 
trafficked, this constitutes human trafficking for the purpose of organ 
removal.\12\
    To conclude that the PRC has also engaged in extrajudicial killing 
in the process of organ trafficking requires different evidence, and 
inference on that evidence.
    The main reason to believe that the PRC has engaged in this 
practice is that it is the only plausible explanation that accounts for 
the observations.
    First, there are numerous reports of prisoners, particularly Falun 
Gong detainees, being subjected to unusual blood tests and physical 
examinations focused on assessing organ health.\13\ These tests, which 
include blood typing, are a necessary precursor to organ matching and 
transplantation. Falun Gong refugees have reported that buses would 
arrive at labor camps, and only Falun Gong practitioners would be 
called out for examinations and blood tests. In the following months, 
many of those tested would disappear.\14\
    Second, investigators making calls to Chinese hospitals and posing 
as potential transplant recipients have elicited admissions from 
doctors and nurses that organs are available on demand, with some of 
them stating explicitly that the organs come from Falun Gong 
prisoners.\15\ The short waiting times promised, often just weeks or 
even days, further suggest a large pool of pre-screened, living donors 
who can be executed as needed.
    Third, as noted above, a significant portion of transplants in 
China were being performed on an emergency basis, with recipients 
receiving a matching organ within 24 to 72 hours of presenting with 
liver failure. In 2005 and 2006, 26-29 percent of reported liver 
transplants fell into this ``emergency'' category.\16\ This suggests a 
bank of living donors who can be killed on demand. This phenomenon only 
began in the PRC following the anti-Falun Gong campaign.
    Fourth, the official explanation that China's transplant boom was 
driven by death-row prisoners is inadequate. Executions in China have 
been in steady decline since 2000, with a particularly sharp drop after 
2007 due to legal reforms requiring Supreme Court review of all death 
sentences.\17\ However, transplant activity continued to grow during 
this period, with hospitals expanding their transplant centers and bed 
capacity.\18\
    Finally, there is no evidence of a major shift in transplantation 
technology or practices around 1999-2000 that could explain China's 
sudden growth in transplant volume. While other countries saw steady 
increases in transplants per capita from 1989 onward, China's numbers 
jumped dramatically after 1999, suggesting a fundamental difference in 
organ sourcing--not technology that allows greater yield from the same 
population of donors.\19\ The surge in transplants also took place 
immediately after the onset of the persecution of Falun Gong.
    In summary, the transplant activity observed in China, particularly 
in the post-2000 period, cannot be adequately explained by voluntary 
donations or death-row prisoners. The most plausible explanation, based 
on the available evidence, is that the Chinese state has been 
systematically killing prisoners of conscience, primarily Falun Gong 
practitioners, to obtain organs for transplantation. This would be 
consistent with blood and physical tests indicating organ harvesting, 
on-demand transplant availability, and a captive population that can be 
executed without consequence. There is no other known source of organs 
able to explain the outcome we observe.
    While some have made an isolated demand for rigor about these 
claims--that only incontrovertible proof is acceptable before speaking 
about it or taking action--standards of evidence and burdens of proof 
are inherently political. The social scientist can only argue about 
which explanation is best able to account for the observations. This is 
why I believe we should adopt this explanation as adequate until a 
better one presents itself, or we come to uncover new, contradictory 
facts about this period of organ transplantation system development in 
the PRC.
    This line of argumentation--inference to best explanation--is 
particularly relevant when considering the large scale blood testing of 
Uyghur detainees discussed below.

2.4  China's organ transplantation system appears to have begun as a 
means of health care for the elite

    The Chinese Communist Party (CCP) has long provided confidential, 
high-quality health-care exclusively for its top leaders. The CCP 
established a secret healthcare system for state leaders as far back as 
the 1940's, which included special hospitals, clinics, and physicians 
dedicated to treating the elite.\20\ This system, known as the Central 
Commission Healthcare Committee, operates under the direct control of 
the CCP Central Committee's General Office. It coordinates with 
hospitals run by the Ministry of Health and the military to provide 
comprehensive medical care for the Party's upper echelons. The 
Healthcare Committee uses this system as a tool of political control--
leaders in good standing receive a high level of treatment, while those 
who have erred politically may be deprived of care.
    This system has been tightly bound up with organ transplantation 
expertise. Key personnel involved in both the early development of this 
elite healthcare system, as well as its modern incarnation, have had 
deep transplant expertise which they presumably used in the care of 
Party leaders. These figures include Wu Jieping, a renowned urologist 
and confidant to Zhou Enlai, and Li Yantang, another leading kidney 
transplant surgeon.\21\ In 1964, when Mao Zedong shut down the 
Healthcare Committee, Wu was appointed by Zhou to lead a small team 
that continued to provide exclusive care for the Politburo Standing 
Committee. Wu went on to become a trusted physician to many top 
leaders. Li Yantang also cultivated close relationships with the Party 
leadership through his role providing them healthcare. He served as the 
personal physician to Deng Xiaoping and other revolutionary leaders for 
over 20 years.\22\
    This elite Party-controlled medical network appears to have served 
as an incubator for China's organ transplantation system. The same top 
hospitals and expert doctors that were charged with treating the 
leadership also took the lead in developing and performing transplant 
surgeries, including the China--Japan Friendship Hospital, the 301 and 
305 military hospitals, and others.
    There are many ongoing connections between leading transplant 
physicians and the CCP's secret healthcare systems. As noted above, 
Huang Jiefu was for many years a vice chair on the Healthcare 
Committee.\23\ Similarly, the prolific liver surgeon Shen Zhongyang has 
long been appointed a ``core expert'' for the Committee,\24\ while He 
Xiaoshun, another major figure in the transplant field, has also served 
on the committee.\25\

2.5  Surgeons and health care workers have personally engaged in 
killing by heart removal

    A recent study of which I was a co-author provides strong evidence 
that transplant surgeons in the PRC have participated directly in the 
execution of prisoners by organ procurement.\26\ Our work finds that 
for decades, Chinese surgeons and other health workers played a key 
role in a state-sponsored program of medicalized execution by procuring 
vital organs from prisoners who were not properly declared brain dead. 
This finding challenges fundamental ethical principles of transplant 
medicine and implicates medical professionals in severe human rights 
abuses.
    To reach this conclusion, we examined 2,838 Chinese-language 
transplant publications using computational text analysis. We searched 
for evidence of problematic brain death declarations during organ 
procurement, which would violate the dead donor rule--the ethical norm 
forbidding the procurement of vital organs from living donors. Our 
algorithm identified papers with language similar to text strings 
associated with dead donor rule violations.
    We defined as problematic any declaration of brain death where the 
report stated that the donor was intubated after the declaration of 
brain death, or the donor was intubated immediately before organ 
procurement as part of the procurement operation, or the donor was 
ventilated by face mask only. In such cases, brain death could not have 
been properly diagnosed before organ procurement began, which makes the 
surgical removal of organs the proximate cause of death.
    We identified 71 papers published between 1980 and 2015 containing 
such problematic descriptions. These papers came from 56 hospitals 
nationwide, with 348 medical personnel listed as authors, indicating a 
widespread and systematic practice. We discarded many other papers 
documenting transplant operations because they did not meet our 
stringent criteria.
    Our findings challenge Chinese officials' claims that transplant 
surgeons are never involved in executions. The study documents what 
appears to be a state-sponsored program of medicalized execution in 
which surgeons and other health workers played a crucial role. 
Subsequently, the International Society for Heart and Lung 
Transplantation initiated a policy to reject submissions related to 
human organ transplantation from the PRC.\27\ It is the only 
professional medical society to have enacted such a policy.

2.6  The PRC state has falsified its organ transplant data

    In response to international pressure based on the facts above, 
Chinese officials announced a series of reforms starting in 2010 with 
the stated goal of transitioning to a voluntary organ donation system. 
They reported extraordinary successes, with annual voluntary deceased 
donors increasing from 34 in 2010 to over 6,300 by 2018. This data, 
along with assurances that China was no longer using prisoner organs, 
led international medical organizations to endorse China's organ 
donation reform.
    However, a careful analysis of the available data on China's organ 
transplant system casts serious doubt on the integrity of China's 
reported numbers. In another paper I co-authored with Dr. Jacob Lavee, 
we found that the official figures on voluntary deceased donors 
conformed almost perfectly to a mathematical formula, specifically a 
quadratic equation.\28\ China's data adhered extremely closely to this 
arbitrary formula, different from every other country about which data 
was available. That is, only China's data exhibited this artificial 
smoothness. Subsequently, updated 2017 data--which came out after our 
initial analysis--strengthened the hypothesis that the data was 
manufactured, because it provided even stronger evidence that the data 
had been generated based on a model. Such precise conformity to a 
mathematical model is extremely unlikely to occur organically from a 
complex, geographically dispersed voluntary donation system.
    Further investigation revealed anomalies suggestive of data 
falsification in two other datasets--central-level Red Cross figures 
and provincial Red Cross data. The central-level Red Cross data 
contained multiple instances of implausible transplant rates that were 
``corrected'' in subsequent data points to maintain an arbitrary 
organs-per-donor ratio. Provincial Red Cross data was found to be 
inconsistent with transplant activity reported by hospitals. Attempts 
to verify official transplant numbers were stymied by a lack of 
transparency, with key data either withheld or tightly controlled by 
authorities.
    We conclude in the paper that the patterns identified cannot 
plausibly be explained by real underlying organ donation activity, and 
that the main datasets must have been manufactured and manipulated, 
apparently to create a false impression of the successes of China's 
voluntary donation reform.
    While genuine voluntary donations do appear to be occurring, the 
corruption of official datasets makes it impossible to determine the 
actual scale of China's transplant activity and the extent to which 
organs from nonconsenting prisoners may still be entering the system. 
The deliberate falsification of such important data is a serious breach 
of trust that undermines the credibility of China's claims of reform 
and ethical organ sourcing.
3.  Current concerns

3.1  Lack of accountability means there are no incentives for the 
cessation of the abuse

    The grave human rights abuses and extrajudicial killings associated 
with China's organ transplantation system, as detailed in the preceding 
sections, have been met with little to no domestic accountability 
within China. The Chinese judicial system has not taken action against 
the state agents involved in these abuses, which is unsurprising given 
that they were acting in their official capacities in furtherance of 
Party interests. This lack of internal consequences removes a crucial 
incentive for change and reform.
    On the international stage, the repercussions for China's 
transplant community have also been limited. Despite the evidence of 
their involvement in unethical and abusive practices, top Chinese 
transplant surgeons continue to publish in prestigious medical journals 
(with the notable exception of the International Society for Heart and 
Lung Transplantation's journals) and participate in conferences 
alongside leading Western colleagues. This stands in stark contrast to 
the international isolation and professional ostracization faced by 
Soviet psychiatrists for their complicity in human rights abuses, or 
even the pressure exerted by the World Psychiatric Association on 
Chinese psychiatrists that led to a temporary cessation of psychiatric 
abuse in China. The threat of damaged reputations and stunted careers 
can be a powerful motivator for medical professionals to reject 
unethical practices, but this pressure has not been sufficiently 
brought to bear on China's transplant sector.
    The absence of meaningful accountability, both domestically and 
internationally, sends a signal that reform is optional rather than 
imperative. Without tangible consequences, there is little incentive 
for China to fundamentally alter its organ sourcing practices, as 
evidenced by ongoing reports of suspiciously short waiting times for 
organ transplants in Chinese hospitals. Investigators and documentary 
filmmakers have continued to uncover evidence suggestive of ongoing 
abuses in recent years.
    Given the severity and scale of the abuses that have been credibly 
alleged and documented, the burden of proof should lie with China to 
demonstrably prove that its organ transplantation system is now ethical 
and abuse-free. The only credible mechanism for China to demonstrate 
this would be large-scale accountability for the system of 
extrajudicial killing. In the absence of such accountability efforts 
there are fewer incentives for ceasing the abuses, and it is difficult 
to justify the belief that they have stopped.

3.2  Uyghurs are highly vulnerable to this abuse

    The mass internment of Uyghurs and other Muslim minorities in 
Xinjiang since 2017 has been accompanied by a range of disturbing 
practices that raise concerns about their vulnerability to organ 
harvesting. These include the widespread, coercive collection of DNA 
and blood types, blood tests and physical examinations consistent with 
assessing organ health, deaths in custody and disappearances, the 
secretive transfer of detainees by rail to prisons across China, and 
the continuation of organ trafficking in China post-2017.
    Particularly alarming is the evidence of large-scale blood testing 
and biometric data collection from Uyghurs in detention. A preliminary 
computational review of the Xinjiang Police Files, a cache of internal 
documents hacked from public security computer systems in two counties 
of Xinjiang, reveals that over 200,000 individuals from a pool of over 
500,000 have had their blood samples taken. In many cases, the ID and 
name of an internee is listed alongside their blood type. The files 
also contain several thousand instances of explicitly labeled DNA 
collection from internees, with thousands of files throughout the 
corpus discussing DNA collection from Uyghurs.
    While the collection of blood type and DNA data does not in itself 
prove that Uyghurs are being harvested for their organs, it is a 
necessary precondition for organ matching. Blood type compatibility is 
essential for successful transplantation, and DNA data can be used to 
improve donor-recipient matches and post-transplant outcomes.\1\ In the 
context of China's history of killing prisoners for their organs and 
the ongoing reports of organ trafficking, the mass collection of this 
sensitive biological information from a population subjected to 
extralegal detention is deeply concerning.
    The parallels between the current repression of Uyghurs and the 
earlier persecution of Falun Gong practitioners, which coincided with a 
surge in organ transplants and evidence of forced organ harvesting, are 
striking. Uyghur detainees have reported being subjected to unexplained 
blood tests and medical examinations focused on assessing organ health, 
mirroring the accounts of Falun Gong detainees in the early 2000s.\2\ 
The transfer of Uyghur prisoners by rail to facilities across China,\3\ 
the lack of accountability for deaths in custody, and the continuation 
of organ trafficking in Chinese hospitals \4\ despite claims of reform 
all contribute to an environment in which Uyghurs are highly vulnerable 
to being exploited as an organ source.
    Given the gravity of the allegations and the mounting evidence of 
abusive practices targeting Uyghurs, it is imperative that the 
international community demand transparency and independent 
investigations into China's organ transplant system. The mass 
collection of blood samples and biometric data from Uyghur detainees, 
in light of China's history of organ harvesting from prisoners, should 
be treated as a matter of urgent concern and a potential precursor to 
severe human rights violations.

4.  Recommendations

    My expertise is in the substantial and methodological questions 
associated with researching this and other social scientific 
questions--not in what lawmakers and policymakers ought to do in 
response.
    Organizations like the International Coalition to End Transplant 
Abuse in China, Global Rights Compliance, medical groups like Doctors 
Against Forced Organ Harvesting, and professional associations like the 
International Society for Heart and Lung Transplantation have proposed 
a variety of policies that would isolate Chinese surgeons engaged in 
unethical transplant activity, rejecting their publications or denying 
their participation in conferences.
    With sufficient political will, additional measures could be 
implemented. A high-level menu of action items for the U.S. and other 
governments (in rough escalatory order) might include:

4.1  Investigate federal funding

    The U.S. Government should investigate whether federal funding has 
been provided to Chinese entities involved in unethical organ 
transplantation practices. Through my research, I have compiled several 
large datasets from primary Chinese-language sources, including over 
100,000 medical publications, biographies of surgeons, and transplant 
textbooks. These can be used to identify thousands of surgeons, 
healthcare workers, and hundreds of affiliated hospital institutions 
engaged in these activities. The practices described, such as organ 
trafficking and human trafficking for the purpose of organ removal, are 
not only criminal but also violate human subject research protections 
outlined in the Common Rule and the NIH's policy on human subjects 
protections.\1\
    Some of the hospitals involved are among the largest in China and 
have many international ties. Have they received Federal funding from 
U.S. agencies, such as the National Institutes of Health and the 
National Science Foundation? Congress should write letters to these 
organizations, requesting a review of past and current funding to 
entities that have violated human subject protections and engaged in 
organ trafficking. Grantee institutions should be asked to account for 
their level of oversight of potential subawardees implicated in these 
practices.

4.2  Increased congressional oversight

    Another area that requires further scrutiny is the role of U.S. 
medical schools in training Chinese surgeons who have subsequently 
engaged in unethical transplant practices. My preliminary analysis of a 
cache of surgeon biographies indicates that hundreds of PRC doctors 
received training at U.S. institutions--but the full scope of this 
training remains unclear.
    Congressional oversight could include getting a much more thorough 
understanding of which U.S. hospitals have trained Chinese surgeons, 
specifically which surgeons they have trained, what they have trained 
them in, and when. This data could then be joined with our data on 
doctors and hospitals that have engaged in organ trafficking, in order 
to understand the extent to which U.S. institutions, particularly those 
in receipt of Federal funding, have been complicit in the training of 
PRC surgeons.
    This sort of investigation is relevant even if the training took 
place many years ago. Without congressional oversight, it would be 
difficult to get the records held by these U.S. entities showing the 
full scope of their interaction with and training of PRC surgeons. We 
have a number of leads on the U.S. hospitals in question and we would 
be pleased to share them directly with Congress.

4.3  Individual sanctions

    The United States could freeze any U.S. assets and deny visas of 
all surgeons and health care workers who have participated in organ 
transplant surgeries prior to 2015. I suggest the cutoff as 2015 
because even though data associated with the transplant reforms was 
falsified, there is evidently some level of reform taking place. A 2015 
cutoff gives Chinese health care workers the benefit of the doubt. 
Prior to 2015, however, there was no national voluntary organ 
procurement system, and thus almost all transplants were illicit and 
involved coercion, trafficking, and often extrajudicial killing.
    It is possible that the U.S. could enroll allied governments in 
putting similar pressure on perpetrators. This may make it impossible 
for surgeons to travel to Western-aligned countries. The deterrent and 
shaming effect of measures like this might help to spur further reform 
and help to reduce any ongoing abuses.

4.4  Diplomatic pressure

    The United States could present specific information of criminal or 
unethical transplant activities about named facilities and doctors to 
the Chinese government and pressure the government to investigate and 
prosecute them. As we know, the individuals in question work for the 
state and engaged in human trafficking and extrajudicial killing in 
their capacity as agents of the state--nevertheless, publicly and 
privately drawing attention to this information and demanding that 
action be taken could have some effect.

4.5  Entity sanctions

    This would be the most forceful set of sanctions.
    Some of the hospitals and medical centers that engaged in these 
illegal activities, and apparently still engage in them, are among the 
largest and most well-resourced in China. It may be feasible to craft 
export bans that prevented any transplant-related technology or 
pharmaceuticals from entering China, and/or preventing any U.S.-
connected businesses from transacting in China's transplant sector.
    It may also be possible for the Treasury's Office of Foreign Assets 
Control to add these hospitals to the Specially Designated Nationals 
and Blocked Persons list, which would prevent financial transactions 
with U.S. persons. Gathering the intelligence and conducting the legal 
analysis needed to responsibly make these designations would be a major 
interagency effort, but adding thousands of hospitals and surgeons to 
OFAC's SDN list would send an extremely strong signal about the U.S.'s 
opposition to the PRC's practices of human trafficking, extrajudicial 
killing, and organ harvesting.

[Endnotes appear on the following two pages.]


--------------

[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] 

    Matthew P. Robertson, Victims of Communism Memorial Foundation, 900 
15th St. NW, Washington, DC 20005; Australian National University, 
Research School of Social Sciences, Canberra ACT 2600


         Prepared Statement of Maya (Maisam) Mitalipova, Ph.D.

       Forced Organ Harvesting and Corporate Complicity in China

    The Chinese government is building the world's largest DNA database 
by acquiring DNA sequencing data from companies within China and across 
the globe, including the USA.
    Numerous biotechnology companies are assisting the Chinese police 
in building this database and may find themselves complicit in these 
violations. They include multinational companies such as U.S.-based 
Thermo Fisher Scientific and major Chinese companies like BGI (Beijing 
Genomics Institute), AGCU Scientific, and Microread Genetics. BGI in 
particular is dangerous because it collects genetic data of Americans 
and uses it for research with the Chinese military.
    Chinese authorities are enrolling in genome surveillance tens of 
millions of people in Tibet and Xinjiang (a.k.a. East Turkistan), who 
have no history of serious criminal activity. These individuals have no 
control over how their samples were collected, stored, and used. 
Neither do they know of the potential implications of DNA collection 
for them and for their extended families.
    The indiscriminate collection of biometric data in China was first 
reported by Human Rights Watch. Beginning in 2013, state authorities 
obtained biometric samples from nearly the entire population of Tibet 
(3 million residents) and in 2016, a similar program was launched in 
Xinjiang, where data from the region's estimated 15 million Uyghurs and 
other Turkic people, was collected under the guise of free annual 
physical exams. Note, the Han Chinese population of the region was 
exempt from this program. Despite these being ``free exams,'' no 
results were returned to these residents.
    Mass DNA sequencing is a costly project. The least expensive 
sequencing of a small portion of DNA today costs $100 per sample. To 
sequence 15 million samples in Xinjiang can cost at least $1-2 billion. 
To maintain these databases for tens of millions of samples you need a 
substantial number of professional bioinformatic specialists, 
specialized computers and software, and expensive sequencing machines.
    Why is the Chinese government investing billions of dollars to 
sequence the DNA of the entire population of Xinjiang and Tibet?
    What can DNA sequenced data be used for?
    DNA sequencing can be used in basic biological research, disease 
discovery, finding of novel treatments, forensics, ancestry research 
and in organ transplantation.
    Now let's see which of these uses can be applied to Uyghur people 
in Xinjiang:

      Finding disease mutations and ancestry research? In the 
region where the Chinese government is conducting genocide against the 
Uyghur people by detaining up to 3 million (according to the State 
Department) of them in prisons and camps? The answer is ``NO.''

      For forensic investigation? On the rest of the population 
of Uyghurs who are not yet detained? On people who are tightly 
monitored by extensive surveillance cameras? On people whose passports 
have been confiscated by authorities since 2016? On people whose 
kitchen knives are chained in their homes? They live in an open-air 
prison. They have no way to commit a criminal act even if they wanted 
to. On the margins, forensic investigation might add to the cost of DNA 
sequencing by tightening surveillance capacity. But the answer is 
``NO.''

    The only reason left for DNA use is organ transplantation. And 
``YES,'' its use for forced organ harvesting and transplantation can 
absolutely justify the enormous cost of mass DNA sequencing.
    According to a witnesses, authorities in Xinjiang, on a mandatory 
basis, withdraw not only blood for DNA, but also perform an ultrasound 
check of all internal organs, including iris scans. Again, patients 
never receive results from these health checks.
    China's organ transplantation industry accounts for, at a minimum, 
60,000 organ transplants per year. The least expensive kidney 
transplant costs around $70,000 and some other organs can cost up to 
half a million dollars.
    In free countries like the USA and Europe, organ donor recipients 
are on a waitlist for years for matching donor organs, while in China 
the matching donors can be found in a few weeks. The Chinese government 
favors forced-organ harvesting from prisoners of conscience and this 
has been practiced for decades involving a very large number of Falun 
Gong practitioners and now Uyghurs. According to research conducted by 
Ethan Gutmann, an estimated minimum of 25,000 Uyghurs are subjected to 
forced organ harvesting per year.
    For successful organ transplantation, doctors rely on several 
important criteria including three main blood tests, cell surface tests 
and limited DNA tests to determine if a patient and a potential donor 
are a match. Current genetic tests detect differences in DNA sequences 
at just a few specific locations in the genomes of transplant 
recipients and their organ donor. The fewer differences, the better the 
chance of long-term acceptance of the new organ. Whole genome 
sequencing data for a large number of genes would give a better match 
of donor and recipient organs, which in return will result in no 
rejection and the long-term survival of transplanted organs.
    When a patient requests an organ in China, his/her DNA sequenced 
data will be blasted against millions in the DNA database stored in 
computers. Within a few minutes, a perfect match will be found. If a 
potential donor of the organs is not in prison or a camp, then Chinese 
authorities can easily find a reason to detain a match to be killed for 
their organs on demand.
    This is the main reason why the Chinese government invested 
billions of dollars into DNA sequencing of the entire population of 
Xinjiang and Tibet. Because it will make exponentially many more 
billions of dollars per year in return.
    Thermo Fisher's involvement in forced organ harvesting in Xinjiang 
is undeniable. But while it has vowed to stop selling sequencing 
machines to the region and to stop providing technical support to 
maintain them, the company is very successfully selling HLA kits and 
other custom-made DNA profiling products for organ transplantation as 
high as in the ten-million-dollar range. Thermo Fisher's Huaxia PCR 
amplification kit was developed specifically to identify the genotypes 
of Uyghur, Tibetan and Hui ethnic minorities.
    The continued sale of DNA profiling products and technologies by 
Thermo Fisher to China has to be stopped by Congress! It is time for 
the U.S. Congress to pass the bill introduced by Senators Hagerty and 
Peters, the ``Prohibiting Foreign Access to American Genetic 
Information Act of 2024'' (S. 355). This legislation will help to 
protect sensitive genome data of Americans from being used by foreign 
governments like China, whose business practices threaten U.S. national 
security.
    There is also growing evidence that academic research universities 
and publishers across the globe and in the U.S. are complicit in aiding 
the use of genetic technologies to surveil minority groups like Uyghurs 
and Tibetans in China. Professor Moreau and his colleagues warned 
scientific publisher PLOS, based in San Francisco, of 96 of its 
published research papers--that these papers hold sensitive genome data 
from minority ethnic groups. Only 12 of these 96 flagged papers have 
been retracted so far. Ethical concerns go beyond scientific 
publications. Data collected from these publications is commonly 
deposited into genetic databases, which are resources not only for 
medical researchers and population geneticists but also, in some cases, 
law-enforcement agencies.
    I ask Congress to take action to restrict U.S. academic research 
universities and scientific publishers from sharing any technologies 
with Chinese companies like BGI or the like.
    I urge Congress to question and if necessary, to sanction Thermo 
Fisher for aiding China in the genocide of the innocent Uyghur and 
Tibetan people and prisoners of conscience throughout the Chinese 
mainland!

References

1. https://www.hagerty.senate.gov/press-releases/2024/03/06/hagerty-
peters-applaud-committee-approval-of-bipartisan-legislation-to-protect-
american-genetic-data-from-china-controlled-companies/

2. https://thehill.com/opinion/international/4421537-us-company-must-
stop-
supplying-chinas-regime-with-dna-surveillance-tech/

3. https://www.science.org/content/article/ethics-not-checkbox-
exercise-bioinformatician-yves-moreau-reacts-mass-retraction-papers

4. https://www.nature.com/articles/d41586-024-00170-0

               Prepared Statement of Tom Oliverson, M.D.

    Good afternoon, Chair Smith and Chair Merkley, and members of the 
Commission. My name is Tom Oliverson, and I serve as a state 
representative in Texas, where I chair the Insurance Committee. Thank 
you for allowing me the opportunity to be here today to speak about the 
horrific practice of forced organ harvesting.
    I first became aware of forced organ harvesting through the 
advocacy work of the Southern USA Falun Dafa Association. There is a 
sizable number of Falun Gong practitioners in the Houston area where I 
live and represent, many of whom are political and religious refugees 
of China. Later, I was introduced to the Minaret Foundation and learned 
about their advocacy work on behalf of the Chinese Uyghur population.
    I have worked with both of these groups for several years to honor 
the victims of communism and recognize the horrors of forced organ 
harvesting, but our most significant victory came during the most 
recent Texas legislative session, when we passed SB 1040.
    Senate Bill 1040 is an attempt to prevent Texans from becoming 
unknowingly complicit in the act of forced organ harvesting. Senate 
Bill 1040 prohibits health benefit plan issuers from covering human 
organ transplants that are performed in China or in another country 
known to participate in forced organ harvesting and allows the 
Commissioner of the Texas Department of State Health Services to 
designate additional countries who are known to participate in organ 
harvesting.
    Each bill and resolution that the Texas legislature has passed 
addressing this extreme violation of human rights did so with 
overwhelming bipartisan support. To the extent we faced barriers in 
passing this legislation, they came from unexpected sources. For 
instance, we faced a decent amount of opposition from church groups who 
send missionaries to countries like China. They were fearful that their 
volunteers would need to undergo surgery during their missions and be 
unable to be reimbursed by their insurance companies. We were able to 
overcome this opposition, pass the bill, and send it to Governor 
Abbott.
    As Senate Bill 1040 was working its way through the legislative 
process, we were able to hold a press conference to allow those 
impacted by forced organ harvesting to share their stories. I believe 
these firsthand accounts were the reason we were able to pass this bill 
with the overwhelming majority that we did.
    We had several survivors of Chinese detention camps share their 
powerful stories with us. They told us about the daily horrors of being 
a religious and political prisoner and about how often those in the 
camps would suddenly disappear--never to be seen again. They spoke of 
the horror of knowing what was happening to those that vanished and 
being unable to do anything to stop it. They shared that, because of 
their healthy lifestyles and abstinence from alcohol, Falun Gong 
practitioners and Uyghurs were most often targeted. I am confident that 
their bravery in sharing their stories helped us to pass this bill, 
which has now become a model for other states.
    Bills modeled after Senate Bill 1040 have already been heard in the 
Arizona House and the Utah Senate, where they successfully passed the 
committees. A similar bill in the Missouri House recently received a 
hearing, and Idaho and Illinois are also in the process of passing 
legislation.
    I am proud that the work we started in Texas is being modeled in 
other states, and I am so thankful for the work that is being done by 
the Commission to force this conversation at the national level.
                                 ______
                                 

                 Prepared Statement of Hon. Chris Smith

    This hearing will come to order--and it is an important hearing, 
one which addresses one of the most persistent, horrific human rights 
abuses of our time, but sadly, one which has not received the 
widespread attention and condemnation it deserves.
    Almost 2 years ago, Sir Geoffrey Nice testified before a hearing I 
chaired on forced organ harvesting at the Tom Lantos Human Rights 
Commission.
    For those that do not know, Sir Geoffrey was the lead prosecutor of 
Slobodan Milosevic at the International Criminal Tribunal for the 
former Yugoslavia. He is a serious man who engaged in a serious attempt 
to investigate the evidence of forced organ harvesting as the chair of 
the Independent People's Tribunal into Forced Organ Harvesting from 
Prisoners of Conscience in the People's Republic of China--or, simply, 
the China Tribunal.
    Sir Geoffrey summarized for us that day the final judgment of the 
China Tribunal this way--[The Tribunal] found ``unanimously and sure 
beyond a reasonable doubt--that in China forced organ harvesting from 
prisoners of conscience has been practiced for a substantial period of 
time involving a substantial amount of victims.''
    Among those victims, he said, were most certainly the most 
vulnerable populations--prisoners, Falun Gong practitioners, and 
Uyghurs.
    Forced organ harvesting on an industrial scale in China is an 
atrocity unmatched in its wickedness--one has to go back to the 
horrific crimes committed in the 20th century by Hitler, Stalin, Mao, 
or Pol Pot to find comparably systemic atrocities.
    The numbers of those executed for their organs--some even before 
they are brain dead--is staggering. Thus, the China Tribunal's final 
assessment was that state-sanctioned forced organ harvesting in China 
amounts to ``Crimes Against Humanity.''
    So here we are, to again contemplate an unimaginable and 
unacceptable crime.
    We are here again because the Chinese Communist government is the 
world's largest jailer of political prisoners and responsible for a 
genocide targeting Uyghurs.
    We are here again because there are those who doubt or ignored the 
Tribunal's findings--pointing to the PRC's 2015 promise to only source 
organs from voluntary donors, even though evidence presented by one of 
our witnesses here today, 
Matthew Robertson, demonstrates that this data has been falsified.
    We are here again because nearly one year ago, the House passed the 
Stop Forced Organ Harvesting Act by an overwhelming 412-2 vote, and we 
need the Senate to bring the bill across the finish line.
    That landmark and bipartisan legislation authorizes the Secretary 
of State to deny passports and visas to any individual involved in 
illegal organ trafficking--in China and globally.
    It also mandates annual reporting by the State Department on forced 
organ harvesting globally and authorizes sanctions for individuals and 
entities that facilitate organ harvesting.
    In December 2023 a group of civil society groups, religious freedom 
advocates, trade unions, bar associations, and human rights solidarity 
groups wrote to Senator Ben Cardin and Senator James Risch--the Chair 
and ranking member of the Senate Foreign Relations Committee--urging 
committee consideration.
    They said this bill represented the ``strongest legislation ever 
introduced by any country to combat'' the ``grotesque . . . atrocity'' 
of illegal organ trafficking.
    We await Senate action.
    Since the China Tribunal's final judgment, researchers continue to 
investigate the Chinese Communist government and dive deep into the 
data on organ harvesting. Indeed, we will hear from two of the best, 
Ethan Gutmann and Matthew Robertson.
    We will also look at how medical journals, bar associations, human 
rights groups, the United Nations, corporations, and U.S. state 
legislatures are grappling with the legal, ethical, and human rights 
issues associated with being complicit in forced organ harvesting.
    Dr. Maya Mitalipova from MIT and Dr. Tom Oliverson, a Texas state 
representative, will discuss what has been done and what more needs to 
be done to address the PRC's transplantation abuse--including the issue 
of ``organ tourism,'' which often fuels the illegal organ trafficking 
market.
    For more than two decades, I have tried to shed light on forced 
organ harvesting in China. At one hearing in my subcommittee, a Chinese 
security official testified that he and his other security agents were 
executing prisoners--with doctors, of course, there, and ambulances--to 
harvest their organs for transplantation.
    In the 1990's, Chinese doctors, nurses, and security guards came 
forward to describe the harvesting of organs from prisoners and the 
political economy of organ procurement for the elite members of the 
Chinese Communist Party.
    Today I'm announcing an initiative to seek firsthand witness 
information on forced organ harvesting in China. I will be sending a 
letter to Secretary of State Blinken asking him to offer rewards for 
information from witnesses that will disrupt and deter the forced organ 
harvesting industry in the PRC and bring accountability to those 
engaged in this gruesome practice. The State Department offers rewards 
for information on crimes against humanity and human trafficking.
    I invite any of my colleagues to join me in signing this letter, 
copies of which will be available for your consideration. Silence is 
unacceptable--particularly from medical associations and corporations. 
If they remain silent, they are the most at risk of complicity in a 
crime against humanity.
    We all bear some degree of responsibility to act. This is an 
ongoing fight to demand transparency and justice for the victims of 
forced organ harvesting and other horrific human rights abuses in the 
PRC. If we don't act now, many more lives will be lost.
    Thank you, and I look forward to hearing your compelling testimony.
                                 ______
                                 

                Prepared Statement of Hon. Jeff Merkley

    Thank you, Mr. Chairman, for convening this hearing.
    The issue of human rights abuse in the organ transplant system has 
been a long-standing concern of this Commission. For example, back in 
2006 the Commission reported that ``Executed prisoners likely are the 
source of the majority of organs used in transplant operations in 
China, according to reported statements from Chinese officials and 
reports from U.S. human rights organizations.''
    The notion that prisoners, including prisoners of conscience, might 
be executed so that their organs can be transplanted into other people, 
is horrific.
    This is an area where we can say that international pressure 
appears to have produced some results. In 2014, China pledged to stop 
obtaining organs from executed prisoners and to ``ensure the voluntary 
donation from citizens is the sole legal source of human organs . . .''
    But have they done what they promised? Many experts have cast doubt 
about whether China has adhered to its pledge and abided by 
international standards. That is what we are here to explore.
    A Congressional Research Service report notes that ``researchers on 
organ harvesting in China have relied largely on circumstantial 
evidence, logical inferences, and interviews to support their 
arguments.''
    In part, this problem can be blamed on Chinese authorities, who 
make it so difficult to get accurate and trustworthy data. The system 
is not transparent. The Chinese government has refused to agree to 
independent or international investigations into its organ transplant 
practices or provided information that refutes the allegations of human 
rights violations.
    We need facts to make assessments and formulate policy. We must 
continue to demand that the Chinese government provide more 
transparency so that we can assess whether they are meeting 
international standards. But we must also take care not to let our 
policy responses be based on circumstantial or outdated evidence.
    Two years ago the Tom Lantos Human Rights Commission, in a hearing 
chaired by today's chairman, Representative Smith, addressed this topic 
with two of the witnesses with us today. I look forward to hearing any 
new information that they have uncovered since then.
    Chairman Smith is also the author of the Stop Forced Organ 
Harvesting Act, which passed the House a year ago. I am a co-sponsor of 
the Senate version and hope we can move it soon on our side.
    Last, I observe that one clear action that the Chinese government 
can take to provide assurance that its institutions are not harvesting 
organs from executed prisoners is to stop executing prisoners. I urge 
China to ratify the Second Optional Protocol to the International 
Covenant on Civil and Political Rights aimed at the abolition of the 
death penalty. I should note that for significant but different reasons 
the United States should do so as well.
    I look forward to the testimony of the witnesses. 
    
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                          Witness Biographies

    Ethan Gutmann, China Studies Research Fellow, Victims of Communism 
Memorial Foundation and author of The Slaughter

    Ethan Gutmann is a Senior Research Fellow in China Studies for the 
Victims of Communism Memorial Foundation and co-founder of the 
International Coalition to End Transplant Abuse in China. He has 
written for publications such as The Wall Street Journal Asia, The 
Weekly Standard, National Review, and Investor's Business Daily, and 
has provided briefings for the U.S. Congress, the Central Intelligence 
Agency, the European Parliament, and the United Nations. In 2017, 
Gutmann was nominated for the Nobel Peace Prize. Gutmann's research 
into Chinese surveillance, the laogai system, and the intersection of 
Western business with Chinese security objectives began to receive 
sustained attention following the publication of his first book, Losing 
the New China, in 2004. His next book, The Slaughter: Mass Killings, 
Organ Harvesting, and China's Secret Solution to Its Dissident Problem, 
was released in 2014. He also co-authored the influential 2016 
investigative report ``Bloody Harvest/The Slaughter: An Update.'' He is 
currently working on a new book based on his personal interviews with 
Uyghur and Kazakh refugees throughout Central Asia, titled The Xinjiang 
Procedure.

    Matthew Robertson, doctoral candidate, Australian National 
University (Canberra) and co-author, ``Execution by Organ Procurement: 
Breaching the Dead Donor Rule in China,'' American Journal of 
Transplantation

    Matthew Robertson is a China Studies Research Fellow with the 
Victims of Communism Memorial Foundation. He is concurrently a Ph.D. 
student in political science at the Australian National University in 
Canberra. His research interests include biopolitics, political 
violence, and authoritarian politics. His dissertation, using 
computational methods and process tracing, explores the political logic 
of state control over citizen bodies in the case of China's organ 
transplantation industry. Previously he has worked as a reporter, 
researcher, and translator for several nonprofit organizations, and as 
an interpreter (from Chinese) for financial services firms. His 
research using statistical forensics to demonstrate the falsification 
of Chinese organ donor registry data was published in the leading 
journal of medical ethics, BMC Medical Ethics. Other peer-reviewed 
publications he has co-authored have appeared in BMJ Open and The BMJ.

    Maya (Maisam) Mitalipova, Ph.D., Director of the Human Stem Cell 
Laboratory at the Whitehead Institute for Biomedical Research, MIT

    Dr. Mitalipova is from the Almaty region of Kazakhstan. She has 
advanced degrees in genetics and embryology from the Moscow Human 
Genetics Institute. Her scientific research on animal cloning at the 
University of Wisconsin in Madison and stem cell therapy are world 
renowned. In 2001, working for an Australian biotech company, BresaGen, 
Inc., she led a cell therapy program that established four human 
embryonic stem cell lines from human embryos. These lines were approved 
for Federal funding by the National Institutes of Health by President 
George W. Bush. These four human stem cell lines were distributed 
worldwide for research on various diseases. In August 2005 Maya joined 
the Whitehead Institute for Biomedical Research at MIT, where she 
accepted a position as Director of the Human Stem Cell Laboratory. 
Working with world-renowned stem cell professor Rudolf Jaenisch, she is 
conducting research on neurodegenerative diseases using stem cells. 
Since joining MIT, Maya has isolated more than 20 human embryonic stem 
cell lines and reprogrammed hundreds of induced pluripotent stem (iPS) 
cell lines using a new technology of reprogramming somatic cells to 
stem cells for the study of Alzheimer's and Parkinson's disease.

    Tom Oliverson, M.D., Texas State Representative, Chair of the 
Insurance Committee, Texas House of Representatives

    Dr. Tom Oliverson is a practicing anesthesiologist who represents 
Texas's 130th State House District in northwest Harris County, 
including the communities of Tomball, Cypress, Waller, and Hockley. Dr. 
Oliverson serves as the Chair of the House Committee on Insurance and 
is a member of the Public Health and House Select Committee on 
Healthcare Reform. Nationally, he is the President of the National 
Council of Insurance Legislators (NCOIL), the immediate past National 
Legislative Chair for the National Association of Christian Lawmakers, 
and the Vice Chair of the National Council of Physician Legislators. He 
has been chosen by his
Republican colleagues as ``Best Freshman Legislator'' and has 
also been named to Texas Monthly's ``10 Best Legislators 
List.'' He is widely regarded as an expert on healthcare policy 
solutions, having authored multiple groundbreaking laws that 
have established Texas as a national leader in healthcare 
reform.