Introduction: This study attempts to determine a picture of the legislative landscapes in Low- and Middle-Income Countries (LMICs) in Africa as defined by the world bank, with specific focus on organ donation, organ trafficking and organ trade. This would include laws that define any prerequisites for organ-related healthcare. The aim is to establish what these LMICs have regarding organ donation and procurement laws, if any.
Method: A mixed-method approach was used to get the legislative frameworks of different African countries.
1. Legal and medical contacts residing in these countries were emailed.
2. Primarily one international legislation database was consulted via the University of Cape Town (UCT) African legislation resources. This database was consulted in addition to other country specific legislation databases, found either online or via the UCT African legislation resources.
https://www.legis-palop.org/
https://governo.gov.ao/ao/
https://www.lexadin.nl/wlg/legis/nofr/oeur/lxweang.htm
https://www.lexlink.eu/

3. African law databases
4. Government websites for any countries that had them available
5. Internet searches using PUBMED and Google for any health-related legislation in these countries
After reading the available documentation, countries were classified into 3 categories:
1. Countries with no healthcare legislation available
2. Countries with some healthcare legislation available (such as a health act), but where there is no detail around transplantation, organ donation, organ trafficking or organ commercialization. Also, countries where there are secondary sources referring to legislative resources or where research on the legislative landscape has been done, but no primary sources (legislation) have been found.
3. Countries with legislation resources which mention transplantation, organ donation, organ trafficking or organ commercialization.
Results

Conclusion: The majority of LMIC’s do not have any health legislation available online. Some countries have legislation on health-related matters, but often the only sources are primarily health-policy-orientated or secondary sources. Very few LMIC’s have legislation available that specifically pertains to transplantation, organ donation, organ trafficking or organ commercialization. Some of these countries also have a language barrier, meaning that the primary sources are written in languages other than English.
Driving deceased donation in countries with no legislative framework is impossible. Furthermore, African countries are at risk for organ trafficking and organ commercialization because of legislative barriers.