Panel: Ethical considerations to shape key actions Ethical considerations VulnerabilityConsider potential medical, social, and economic vulnerabilities of both donor and recipient mother-infant dyad and mechanisms for reducing vulnerabilities. Equity and fairnessConsider which populations carry the risks and burdens of supplying donor human milk; and which receive the benefits of donor human milk. Consider how equity and fairness are addressed through allocation and access to donor milk and develop safeguards to prevent exploitation of women donating and selling milk. Respect for autonomyConsider and respect personal and community decisions regarding donor human milk. Consider the role that sociocultural factors, such as religion and kinship, play in decision-making processes. Human rightsEnsure equitable access to donor human milk, without discrimination, for infants in need. Call on governments to meet their commitments to women and children through existing conventions and human rights mechanisms,* which call for maternity protection, gender equality, and rights of women and children to adequate food, nutrition, health, and informed choice.

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Background. Transplant therapy is considered the best and often the only available treatment for thousands of patients with organ failure that results from communicable and noncommunicable diseases. The number of annual organ transplants is insufficient for the worldwide need. Methods. We elaborate the proceedings of the workshop entitled “The Role of Science in the Development of International Standards of Organ Donation and Transplantation,” organized by the Pontifical Academy of Sciences and cosponsored by the World Health Organization in June 2021. Results. We detail the urgency and importance of achieving national self-sufficiency in organ transplantation as a public health priority and an important contributor to reaching relevant targets of the United Nations Agenda for Sustainable Development. It details the elements of a global action framework intended for countries at every level of economic development to facilitate either the establishment or enhancement of transplant activity. It sets forth a proposed plan, by addressing the technical considerations for developing and optimizing organ transplantation from both deceased and living organ donors and the regulatory oversight of practices. Conclusions. This document can be used in governmental and policy circles as a call to action and as a checklist for actions needed to enable organ transplantation as treatment for organ failure.