September 28, 2007
HIV/AIDS specialist Kunal Saha, who was commissioned by the World Bank earlier this year to investigate an HIV-prevention program in India, is calling on the bank to address evidence that some hospitals and blood banks allegedly were using faulty diagnostic test kits to screen for HIV, the Washington Post reports.
Saha, a professor at Ohio State University, traveled to India as a bank consultant on a team investigating potential problems with the $230 million AIDS control project funded by the World Bank between 1999 and 2006, according to the Post. Saha and two India-based medical specialists in March and April visited hospitals and blood banks in major cities, gathering lab documents that Saha said indicate the facilities were using defective diagnostic testing kits. He cited 2004 and 2005 test results from two Indian hospitals in which blood samples that were known to be HIV-positive tested negative during a second, confirmatory test performed with defective kits, according to the Post. Saha said he found a document suggesting that questionable kits were available for use as late as April despite public statements from Indian health workers and World Bank officials in the country that defective test kits were no longer available.
The bank has not released a draft report from the visit by Saha and the other two doctors, according to the Post. According to a copy of an April 26 e-mail, the draft notes that there were significant quality issues with HIV tests at blood banks and testing centers between 2003 and 2006. Saha said he discussed the matter with former World Bank President Paul Wolfowitz before he left the bank and in August briefed staff members at the bank about his concerns. This year, bank officials approved an additional $250 million to a new HIV program in association with India's National AIDS Control Organization after regarding the previous program as "satisfactory," the Post reports.
"If people are getting HIV because of defective test kits, it's horrendous, it's unthinkable," Saha said in a telephone interview.
Kees Kostermans, the World Bank's lead public health specialist in South Asia, on Thursday said the bank's report on the issue will not be released for at least two months; however, he said the bank has no specific evidence that faulty diagnostic tests had led to the spread of HIV in the country. Kostermans added that NACO officials said defective kits had been removed from health facilities and none remained in use. Kostermans said, "It is in nobody's interest to have poor-quality test kits."
Beatrice Edwards, who monitors World Bank operations for the Government Accountability Project and is assisting Saha, called for stricter monitoring and a rapid public accounting of the problems. "If there's any project in the portfolio that needs to be monitored and where the equipment needs to be safeguarded, this is it," Edwards said (Johnson, Washington Post, 9/28).
Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2007 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.