"PLEASE don't take your organs to heaven," reads the American bumper sticker. "Heaven knows that we need them here on earth." Last year more than 7,000 Americans died while awaiting an organ transplant—almost double the number of American soldiers killed in Iraq since 2003. In Europe, too, thousands of people whose lives could be extended or transformed (by having sight restored, for example) through transplants forfeit the opportunity for want of available organs.
    Research by the World Health Organisation (WHO) has found that only one in ten people in need of a new kidney, the body part most in demand, manages to get one. In the poorest places, of course, a complex transplant—which in the American health system costs $500,000—is unthinkable for most people anyway. But the gap between supply and demand for organs affects the poor too, by creating a market in body parts where abuses are rife.
    In prosperous and middle-income countries, the waiting lists for organ transplants grow ever longer as ageing populations, hypertension and obesity (a big cause of diabetes-driven kidney failure) take their toll. The problem has been exacerbated by a fall in road deaths in rich countries, which—along with strokes and heart attacks—are the main source of organs for transplant. Small wonder that people scour the globe to procure the organs they or their loved ones need; or that unscrupulous intermediaries offer help.
    The latest of many organ-harvesting scandals is now raging in India, one of several poor countries where the sale of organs used to be legal but has now been banned, with the apparent effect of driving the trade underground. A doctor, Amit Kumar, is awaiting trial after reportedly confessing to having performed hundreds of illegal transplants for rich clients from America, Britain, Canada, Saudi Arabia and Greece. He has been accused of luring labourers into his clinics with job offers; victims were then offered up to $2,000, a princely sum, to part with a kidney. Some who refused are said to have had kidneys removed anyway after being drugged.
    Another kidney racket flourished in South Africa between 2001 and 2003. Donors were recruited in Brazil, Israel and Romania with offers of $5,000-20,000 to visit Durban and forfeit a kidney. The 109 recipients, mainly Israelis, each paid up to $120,000 for a "transplant holiday"; they pretended they were relatives of the donors and that no cash changed hands.
    Knowingly or unknowingly, Europeans may have benefited from another racket, operating on their doorstep, in a region where the West claims to be upholding human rights. Carla del Ponte, until recently the chief prosecutor at the war-crimes court for ex-Yugoslavia, claims in a new book that in 1999, guerrillas from Kosovo harvested the organs of 300 captive Serbs at a secret site in Albania. The authorities in Kosovo and Albania have hotly denied the story.  Which of the following affects the poor the most according to the first two paragraphs?