AIDS imperils Orissa: Deliberate Delay in Reaching at Remedy: Is Payola the Purpose?

Subhas Chandra Pattanayak

I ask the question directly to Chief Minister Naveen Patnaik, because it is his Government that has put Orissa in the quagmire of AIDS by not implementing the High Court orders that had suggested the remedy more than four years ago on 28.7.2011.

The question is: Behind this deliberate delay and dilly-dallying, is collection of payola the purpose?

He should seek answer to this question from records of the Government.

A three year old boy had fallen victims to AIDS by taking blood from a Bhubaneswar based Blood Bank and the High Court of Orissa on conducting in-depth study on why the child whose parents had no AIDS was affected by the deadly syndrome after taking blood from the blood bank that claimed to have screened the blood with ELISA. The Court came to the conclusion that if a donor has been infected with HIV, that causes AIDS, hiss blood shall not show the infection within six months, which is known as ‘window period’. ELISA may not detects the virus if blood is collected from the donor during this ‘window period’. The virus can be directed in the ‘window period’ only through NAT PCR technology, the Court determined on deep analysis. So, in its judgement dated 28. 7. 2011 it directed the Government of Orissa, which was a party to the case, to establish NAT facility in all the official blood banks of the State so that patients in dire need of blood can get safe blood.

As the Government had ignored the High Court directive and blood donations were rising in numbers, so also threat of AIDS, I exposed the matter in ORISSA MATTERS on 8.7.2012. By then, one year had elapsed. We even tried to wake up the High Court to government’s negligence to its just order in our provocative article captioned ‘The issue is AIDS: Let the verdicts be not mere wordy acrobatics’ . It was published on 21.7.2012. We exposed how a coterie of officers in the health department were using tricks of subterfuge against the High Court order. it was published on 28.8.2012.

On 1.9.2012, inspired by the ORISSA MATTERS postings, Congress Leader Prasad Harichandan raised the issue in the Legislative Assembly. In replying him, health minister Dr. Damodar Raut assured the House that the High Court orders will be implemented and the NAT technology would be adopted in phased manner. In the first phage the blood banks attached to the three government medical college hospitals as well as to the capital hospital shall be equipped with this method with immediate effect. But mandarines in his heath department did not proceed in the matter till Dr. Raut was divested of this department. He had openly alleged that the Departmental Secretary was not paying any heed to his directions.

We, as a committed sentinel of Orissa, continued to expose the tormenting dilly-dally resorted to by bureaucracy, when unsuspecting patients were being infected with AIDS and other severe TTIs by taking blood from blood banks, which, in view of the analysis done by the High Court in its 2011 judgement, nobody can say for sure to be safe.

Finally, the Health Department resolved to adopt NAT technology as assured by the Health Minister in the Assembly and after 15 months of the Minister’s assurance, the matter was placed before the Expenditure Finance Committee, which was approved by the same Committee on 13.12.2013. The EFC had advised the Health Department to apprise the Law department of the decision taken to adopt NAT technology, as the High Court had issued orders for use of NAT in blood screening.

Long four months passed by to call for ‘Request for Proposal’ (RFP) .The State Blood Transfusion Council (SBTC) was authorized to call for RFP, which it dis in March 2014.

Two companies responses.

A high power Committee comprising experts from outside the State selected one of the companies in June 2014 as its offer was acceptable as per the terms and conditions laid down by the Government.

Surprisingly, instead of putting orders to the selected Company, on 29.9.2014, a meeting was held on Technology , Tender process, and Cost break-up of service charges to be paid towards NAT testing facility of blood units in the blood bank. It unanimously accepted the proposal to adopt NAT and decided to charge 1/4th of the NAT testing cost of Rs.790/- from patients settling the chargeable rate to approximately Rs.200/-.

The matter should have ended there. But, another dilatory tactics was adopted. A fresh meeting was held on 17.10.2014 to  workout the cost towards service charge. In this meeting it was put on records that when ELISA testing shows Negative result, NAT shows Positive in one out of 500 tests. Yet, confusing notes were made in item 4 of the minutes.

In File 64/14 part 1 the Law department was moved on 14.11.2014 as per EFC, dated 13.12.13, to say if the decision to adopt NAT was as per the High Court Orders. The Law Department expressed shock over the inordinate delay in implementing the High Court Order and in its opinion sent on on 15.11.2014, it observed that the scheme should be implemented immediately.

File was put on 22.12.2014 and gathered dust there till 29.1.2015. And since then, has been pending with the Secretary, Health and Family Welfare.

In the meeting taken on 17. 10.2014 by the departmental Secretary “to prepare a road map for the implementation” of the NAT scheme, it was held that:
(a) NAT technology is the foremost and latest technology in the
transfusion field as per WHO issued guidelines.
(b) From various study papers it is revealed that NAT is helpful in reducing the window period.
(c) NAT can detect Hepatitis B & C much earlier than the traditional ELISA method.
(d) Till date the NAT is known as “Gold Standard Procedure” to provide the safe blood to the public.
(e) From the reports it reveals that, NAT yield (ELISA Negative & NAT positives) is around 500: 1. (Resolution No.1)

This means, the Secretary is convinced that when viruses causing AIDS escape ELISA screening, NAT is catching at least one in every 500 tests.

In Orissa, about 3,50000 units of blood are transfused per year to patients in critical conditions where transfusion is not avoidable. This means, per day transfusion is around 1000. If the AIDS causing HIV virus is escaping detection in one in every 500 units of blood, then it indicates that every day the State Government is inserting the dreaded disease to two unsuspecting patients.

This alarming reality does not find consideration in the corridors of power.

I had discussed the shocking phenomenon in my last posting captioned ‘Orissa in Quagmire of AIDS: High Court Ruling sand Minister’s order rot under Red Tapes, published on 20.10.2014. The Government does not bother. Because of the dilly-dallying mandarines, the funds allocated for implementation of the NAT scheme in the last supplementary budget could not be spent.

How long the mandarines in health department shall keep the High Court order and the Minister’s declaration inconsequential?

Is incompetency of bureaucracy or the mandarines’ super competency in cultivating a climate for payola responsible for this massive delay in implementing the High Court order?

Let the Chief Minister say, because, as per official confession mentioned supra, his government has been infesting two persons with AIDS and other TTIs per day by not adopting the NAT technology.