At the Crossroads: Where Sexual and Reproductive Health and Rights Meet the Uganda Human Organ Donation and Transplant Act, 2023

Abstract

Uganda’s Human Organ Donation and Transplant Act (UHODTA), 2023, was enacted to address regulatory gaps, prevent organ trafficking, and promote ethical transplantation practices. While the Act represents a progressive step in health governance, its undifferentiated application to sexual and reproductive  organs, tissues, and cells raises significant legal, ethical, and human rights Sexual and concerns. This paper examines the intersection between the UHODTA and reproductive health, sexual and reproductive health and rights (SRHR), focusing on how the Organ transplantation Act’s broad definitional scope and regulatory architecture risk undermining law, Informed consent, reproductive autonomy, informed consent, and gender equality. Drawing on Gender equality, the World Health Organisation’s Guiding Principles on Human Cell, Tissue Bioethics and Organ Transplantation, comparative legal analysis, and SRHR norms, the paper interrogates key provisions relating to consent regimes, authorisation requirements, presumed consent, and the categorisation of reproductive materials. It argues that conflating reproductive gametes and low-risk assisted reproductive technologies with complex solid-organ transplantation results in over-regulation, disproportionate burdens on women, and potential constitutional violations. The paper further highlights regulatory gaps concerning emerging practices such as vascularised composite allografts, including uterine and penile transplantation, which raise distinct psychosocial and ethical considerations inadequately addressed by the Act. It concludes that while the UHODTA aligns with global anti-trafficking and safety standards, its current form risks criminalising routine fertility care and entrenching structural inequities. The paper calls for legislative amendment, subsidiary regulation, or judicial interpretation to exempt reproductive tissues from the Act’s scope and to establish a distinct, rights-based framework grounded in explicit informed consent and SRHR principles.