World Bank To Investigate Concerns About HIV Testing Kits In India

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HIV Testing Kits

The World Bankplans to hire two independent consultants to investigate concerns aboutthe reliability of some HIV testing kits in India, Graeme Wheeler, thebank's managing director, and Kees Kostermans, a medical expert whooversees the bank's South Asia public health operations, said lastweek, the Washington Post reports (Johnson, Washington Post, 10/13).

Themove follows allegations from HIV/AIDS specialist Kunal Saha -- who wascommissioned by the bank earlier this year to investigate anHIV-prevention program in India -- that some hospitals and blood banksin the country were using faulty diagnostic test kits to screen forHIV. Saha, a professor at Ohio State University,traveled to India as a bank consultant on a team investigatingpotential problems with the $230 million AIDS control project funded bythe World Bank between 1999 and 2006. Saha and two India-based medicalspecialists in March and April visited hospitals and blood banks inmajor cities, gathering laboratory documents that Saha said indicatethe facilities were using defective diagnostic testing kits. He cited2004 and 2005 test results from two Indian hospitals in which bloodsamples that were known to be HIV-positive tested negative during asecond, confirmatory test performed with defective kits. Saha said hefound a document suggesting that questionable kits were available foruse as late as April despite public statements from Indian healthworkers and World Bank officials in the country that defective testkits were no longer available.

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The bank has not released a draftreport from the visit by Saha and the other two doctors. According to acopy of an April 26 e-mail, the draft notes that there were significantquality issues with HIV tests at blood banks and testing centersbetween 2003 and 2006. Saha said he discussed the matter with formerWorld Bank President Paul Wolfowitz before he left the bank and inAugust briefed staff members at the bank about his concerns. This year,bank officials approved an additional $250 million to a new HIV programin association with India's National AIDS Control Organization after regarding the previous program as "satisfactory" (Kaiser Daily HIV/AIDS Report, 9/28).

Reaction

Saha has criticized World Bank officials for not acting more quickly to regulate NACO, the Postreports. He also has called on the bank and NACO to issue a nationwidepublic health alert about potential problems with the HIV tests. "Whatis the point in assigning new consultants to revisit the same issues?"Saha wrote in an e-mail to Wheeler on Friday, adding, "It isregrettable that in spite of the grave nature of these complaints thatobviously pose serious risk of transmitting HIV to innocent citizens inIndia, NACO has shown little inclination to act expeditiously to solvethis issue."

Kostermans said the agency is working with Indianofficials to ensure the safety of the HIV testing program. He said thebank needs to examine a larger sample of data to identify and avoidfuture problems, the Post reports. Saha is a "medicaldoctor, I am a medical doctor," Kostermans said, adding, "We have thesame concerns." Kostermans said the bank has not determined if theconsultants will interview Saha. He also said that finding people inIndia who might have been exposed to HIV can be a logistical challengebecause of inconsistencies in record-keeping and the time that haspassed since Saha's investigation.

Beatrice Edwards, who monitors World Bank operations for the Government Accountability Projectand is working with Saha, said the bank's response has been inadequate.She added that the "major issue is to protect public health, notprotect the reputation of NACO, which seems to be the priority."Wheeler and Kostermans did not say when the consultants will be hired,the Post reports (Washington Post, 10/13).

Reprinted with permission from kaisernetwork.org. You can view theentire Kaiser DailyHIV/AIDS Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . TheKaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service ofThe Henry J. Kaiser Family Foundation.

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