The Islamabad placenta scandal exposed more than a crime. It exposed a governance failure Pakistan can no longer ignore.
By Dr Quaid Saeed Akhunzada
When a woman gives birth in a Pakistani hospital, she is rarely asked what should happen next to the placenta. That organ, which nourished a life for nine months, is quietly removed, labelled as medical waste and disposed of. It has always been this way. Until, apparently, it was not.
A few days ago, Islamabad authorities arrested individuals allegedly involved in the organised collection, processing and export of human placentas collected from hospital maternity wards. The accused had turned something deeply personal and biological into a commercial supply chain without the knowledge or consent of the mothers involved. The scandal has already faded from the headlines. It should not have.
This is not simply a story about bad actors in a broken system. It is a story about what happens when science outpaces law, when commerce enters spaces where ethics should prevail, and when the bodies of women become resources that no one thought to protect because no one thought to ask.
The new value of old waste
Not long ago, the placenta was considered worthless once its job was done. Today, it occupies a unique place in both medicine and commerce. Researchers around the world are studying placental tissue for wound healing, regenerative therapies and immunological treatments. Some clinical applications are already in use. Others remain experimental, although the scientific potential is considerable.
At the same time, the placenta has entered commercial markets in ways that raise serious questions. Placenta-based cosmetics, creams, serums and hair treatments are sold across Asia, Europe and the Americas. Dietary supplements derived from placental extracts are marketed with bold health claims. The line between emerging science and commercial exploitation is often invisible to consumers.
This dual character, combining medical promise with commercial demand, created the conditions for what happened in Islamabad. When something once considered worthless acquires value, those positioned to supply it will find ways to do so. The real question is whether governance can keep pace.
How did it leave the hospital?
The most disturbing aspect of the Islamabad case is not that someone wanted to buy placentas. It is that someone was able to take them.
Hospitals operate under strict biological waste protocols. Tissue removed during medical procedures must be catalogued, handled safely and disposed of properly. These are not aspirational guidelines. They are legal obligations designed to protect public health. If placentas were diverted from maternity wards on a large scale, as investigators allege, then something failed somewhere in the system.
Were hospital staff complicit? Was there negligence in record-keeping? Were the quantities too small to trigger audits? We do not yet have complete answers. But the questions themselves should concern every health administrator and regulator in Pakistan. Biological material left a controlled environment and entered an unregulated one. That should never have been possible.
The mothers whose placentas were allegedly taken deserve particular consideration. They were not consulted. They were not informed. They did not consent. In a country where maternal healthcare remains under-resourced and women’s bodily autonomy is often undervalued, this case represents an extreme, though not entirely surprising, extension of a broader pattern. Women’s bodies were treated as resources to be exploited.
Law in a grey zone
Pakistan’s legal framework is simply not designed for a case like this. The Transplantation of Human Organs and Tissues Act, 2010, the closest relevant law, was enacted to combat organ trafficking. It does not adequately address placental tissue, its ownership, the conditions under which it may be collected or the standards required before any commercial use.
This legal silence has real consequences. Without classification, there is no ownership. Without ownership, there is no consent framework. Without consent, there is no accountability. The placenta currently exists in a legal grey zone. In that ambiguity, exploitation finds room to flourish.
Several fundamental questions remain unanswered. Who owns the placenta after childbirth, the mother, the hospital or the state? Under what circumstances can it be used for research or commercial purposes? What constitutes meaningful informed consent in a maternity ward, where women may be exhausted, vulnerable and unlikely to scrutinise paperwork? And how should exports, apparently the destination in this case, be regulated?
None of these questions have legislative answers today. That must change.
Faith, culture and the body
Law is not the only lens through which this issue should be viewed. In Pakistan, as in many societies, the human body is not merely biological. It is also a source of dignity, meaning and spiritual obligation. Islam, the faith of the overwhelming majority of Pakistanis, does not prescribe specific rules for placental disposal, but it does emphasise respect for the human body, cleanliness and the prohibition of exploitation.
In many Pakistani families, particularly in rural areas, there is a tradition of burying the placenta. The practice reflects a belief in honouring what nourished a new life. It is neither legally required nor formally regulated, but it reflects a cultural understanding that the placenta is not simply waste to be packaged and sold.
Any regulatory framework emerging from this scandal must respect these sensitivities. Mothers should have the right to make culturally and religiously informed decisions about what happens to placental tissue. That right cannot exist without first ensuring informed consent.
What the world has learned
Pakistan is not the first country to confront these questions, and international experience offers both useful models and important warnings.
The United Kingdom classifies placental tissue under its Human Tissue Act, which requires consent for storage and use and imposes criminal penalties for violations. The European Union similarly emphasises traceability, donor rights and quality standards for human biological materials. Neither system is perfect. Both, however, begin with the principle that human tissue is not an ordinary commodity.
Malaysia offers a particularly relevant example. As a majority-Muslim country with a strong healthcare system, it allows families to retrieve placental tissue for traditional or religious purposes while prohibiting its commercialisation. Scientific use is permitted under strict ethical oversight. The balance is not perfect, but it is deliberate. It demonstrates that cultural values and scientific progress need not be in conflict when supported by thoughtful regulation.
The United States, by contrast, illustrates the risks of fragmented regulation. Some placenta-derived products fall under the authority of the Food and Drug Administration, while others slip between regulatory agencies. The result has been the growth of a commercial market for placenta-based therapies with questionable evidence, often targeting vulnerable consumers. Pakistan should avoid repeating that experience.
What must happen now
The arrests made in Islamabad were necessary, but they are not enough. Those responsible should be held criminally accountable. However, prosecutions alone will not close the regulatory gap that allowed this to happen, nor will they prevent future exploitation.
Pakistan urgently needs a comprehensive legal framework governing human biological materials. Such legislation should recognise the mother as the legal owner of placental tissue and require informed written consent before it can be retained for any purpose other than disposal. Hospitals must implement traceable and auditable systems for managing biological waste, with strict penalties for diversion. Any export of human biological material should require licensing by a competent health authority.
Beyond these basic safeguards, Pakistan should establish a clear pathway for legitimate scientific research. Placental tissue has genuine medical potential, and banning research altogether would be an overreaction. However, research must be governed by ethics committees, conducted transparently and kept completely separate from commercial supply chains. Scientific research conducted with integrity can coexist with commercial interests, provided appropriate safeguards exist.
Regulatory reform is rarely headline-grabbing. Yet the absence of such reform is precisely what made the Islamabad placenta scandal possible and what will make similar incidents inevitable if nothing changes.
At its heart, this story is about values, not biology. It asks what kind of society Pakistan wants to be in a world where the human body increasingly carries commercial value. The answer cannot be left to traffickers or to gaps in the law.
Women who give birth in Pakistani hospitals deserve to know that their bodies, and the biological material that sustained new life, are protected by law, respected by society and never treated as commodities for sale.
The placenta scandal was a warning. Pakistan must heed it and act before the next crisis exposes even deeper failures.
(The views expressed are those of the author, Dr Quaid Saeed Akhunzada, former Chief Executive Officer of the Islamabad Healthcare Regulatory Authority)