Since the mid-1990s, the People’s Republic of China has been a leading driver of human trafficking for the purpose of organ extraction, which mainly involves taking organs from political prisoners and religious minorities, including Muslim Uyghurs, Falun Gong practitioners, and Christians. 

Although there are no official estimates, Smith said as many as 70,000 people each year in China are murdered for their organs to be given or sold to patients on transplant lists, both in China and abroad. 

Demand for organs for transplant significantly outpaces supply worldwide, with multiyear waits for kidney, heart, lung, and liver transplants in almost every Western country. Investigative reports, however, have found that transplant list wait times in China are significantly shorter, sometimes only a matter of days for Chinese Communist Party members.

But Smith said there is emerging evidence of a significantly broader international market for illicit organ trafficking and human trafficking for organ extraction.

In particular, Smith said organs extracted from Muslim Uyghur prisoners are frequently sold to Middle Eastern buyers, who put a premium on organs from patients who practiced the Islamic dietary practice of halal. 

“This is a global phenomena,” Smith said. “It’s going on all over the world: the Philippines, the Middle East, other places where they buy and sell. And it’s not just China.”

Smith’s bill, the Stop Forced Organ Harvesting Act of 2025, which passed nearly unanimously last year in the House, is meant to punish not only Chinese Communist Party actors engaging in organ trafficking but also the United States and other entities involved in the international network. But the bill has not yet been taken up by the Senate Foreign Relations Committee. 

In March, Sen. Ted Cruz (R-TX) introduced a competing bill zeroing in on holding China accountable for human rights atrocities called the Falun Gong and Victims of Forced Organ Harvesting Protection Act. Since then, legislation has been stalled.

Targeting US involvement in international organ harvesting 

Smith contends that all countries, to some degree, including the U.S., are complicit in international illicit organ trafficking. 

“The whole world has some complicity in this, especially when it comes to brokers, governments looking the other way or looking askance,” Smith said. “So we have, I think, a moral duty, an obligation to say we need to stand with the victim and with the oppressed, not the oppressor, and stop it.”

Only two U.S. medical societies, the Transplantation Society and the Association of American Physicians and Surgeons, have voiced opposition to forced organ harvesting in China and other countries.

The most recent policy from the American Medical Association, for example, says it encourages the People’s Republic of China to be in “compliance with internationally recognized standards” and condemns organ retrieval “without the informed consent of the donor,” but stops short of calling out alleged forced harvesting.

Smith juxtaposed the U.S. medical establishment’s toleration of CCP human rights abuses with the lack of tolerance given to the U.S.S.R. during the Cold War. The Soviet Union, according to Smith, was largely excluded from the Western scientific community during the Cold War, and he believes the same should happen today for China.

The Stop Forced Organ Harvesting Act creates penalties to hold bad actors accountable for complicity in aiding the CCP’s forced organ harvesting, including imposing sanctions or revoking travel documents from foreign nationals involved in the international network.

But the bill also establishes a civil penalty of up to $250,000 in damages and criminal punishment of up to 20 years in prison and $1 million in fines for participating or enabling forced organ harvesting, applicable to U.S. nationals and foreigners on U.S. soil.

For example, criminal or civil charges could be applied to U.S. physicians or healthcare providers who actively encourage their patients to go to China for an organ transplant, knowing that they will likely receive an organ from a victim rather than a consenting donor.

“It’s a real problem. It’s global,” Smith told the Washington Examiner. “It needs a really aggressive approach, and this bill does it.”

Cruz hones in on China’s human rights abuses

Cruz’s legislation is narrower by comparison, solely focusing on the CCP’s orchestration of forced organ harvesting for political prisoners and religious minorities.

The senator’s bill only allows the State Department to revoke passports or travel documents for those suspected of the practice in China and the president to impose sanctions on Chinese officials.

Cruz’s bill also does not create criminal or civil penalties for those on U.S. soil who are convicted of participating in forced organ harvesting schemes. 

Further, instead of creating a mandate for an annual report on international forced organ harvesting, Cruz’s legislation requires the State Department and the Department of Health and Human Services to jointly produce a singular report on the scope of the problem in China within the year the bill is signed into law. 

Smith told the Washington Examiner Cruz’s legislation does not go far enough.

“China is the most egregious violator of it, but it is a huge problem everywhere,” Smith said.

A spokesperson for HHS told the Washington Examiner that the department does not comment on pending legislation. The State Department did not respond to the Washington Examiner’s request for comment on its preferences between Smith and Cruz’s bills.

A spokesperson for Smith told the Washington Examiner that his office is working on scheduling a meeting with Cruz and his team to reach a compromise. Cruz’s office declined to offer comment.

Smith said he recently met with Sen. Jim Risch (R-ID), the chairman of the Senate Foreign Relations Committee, to discuss advancing the legislation, which will likely require compromise with Cruz and confirmation from the White House that the bill will be signed by the president.

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Risch told the Washington Examiner in a statement that he is “committed to working with Representative Smith on this very important issue” and advancing legislation to “put an end to the horrible practice of organ harvesting.”

“We’ve asked the Senate to bring it up,” Smith said. “Delay is denial if you’re a victim.”