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Journalism of Courage
The Aids programme, one of the five health programmes in which the World Bank found serious fraud and corruption, is set for a few major changes. The first step is to give a plan of action to the World Bank in the next few weeks.
National Aids Control Programme NACP was one of the Bank-funded projects examined in the Detailed Implementation Review DIR, which was found riddled with three serious flaws8212;the way NGOs were selected to carry out targeted intervention; a corrupt procurement of kits and equipment; and use of substandard testing kits.
The one on substandard testing kits is bothering the Government the most. It essentially means that the test to determine whether a person is HIV positive or not is faulty, questioning the credibility of the entire programme.
National Aids Control Organisation NACO director Sujatha Rao admits that the report has found systemic lapses but says that some of the allegations, particularly the one on the substandard kits, is 8220;baseless and don8217;t stand to reason8221;. 8220;If this were true, it would be a serious indictment of the programme,8221; she added.
Nearly 5.5 million were tested in 2007. The testing is done by using rapid test kits of high sensitivity and specificity. If a positive test is detected, the serum sample is tested again with two other kits using different principles to rule out false positive results. A positive report is given only if all three tests are positive.
The World Bank review alleges that a particular brand of test kits frequently gives 8220;false negative8221; readings, meaning that HIV-contaminated blood will appear to be 8216;clean8217; and suitable for distribution. This rate of failure was higher than what was prescribed by NACO guidelines.
8220;The testing is in accordance with international guidelines of the WHO and UNAIDS. We have not erred in buying substandard kits. However, I do admit that we have to go a long way in reaching testing standards in countries like Thailand,8221; she said.
Following the report, an expert from Australia is here to guide NACO through to better testing standards and protocol.
The report had found unqualified NGOs pulling strings, Government officials getting cuts to award contracts and politicians acting as middlemen in the entire targeted interventions.
8220;I am happy that the report will spur action on problems that we were already aware of,8221; said Rao, admitting that these were things that the Government was familiar with and was trying to grapple with.
Remedial measures are now on a fast-track. NACO8217;s teams will fan out in the first week of February to review work done by 800 NGOs in the next phase NACP. The contracts would only be renewed after the team8217;s site visit and a detailed review of their work. NACO will also train 2,000 master-trainers who will work with these NGOs on a regular basis.
On the procurement front, since World Bank is involved at every step, Rao believes that it just points to systemic failures. The ball is in the Bank8217;s court on this one.
