Dr Kunal Saha, contracted by the World Bank as a member of the team for review of World Bank aided health programmes, including the National AIDS Control Programme Phase II, during the period 1999 to 2006 has been making accusations regarding the use of substandard kits in the National AIDS Control Programme in India. This has been reported by some newspapers also. The National AIDS Control Organisation (NACO) strongly refutes these allegations, as the conclusions drawn by him are not based on scientific facts.
The HIV rapid test kits were not used in any blood bank as mentioned by him. He has cited 10 instances as being erroneous where the first test proved positive. However, neither the second or third test provided a positive result. He has alleged that the kit used for the second test is not of quality. However, NACO confirms that the kit used for the second test in question is a pre-qualified World Health Organisation (WHO) kit. The obvious interpretation of the results is that the algorithm worked properly in eliminating false positives.
The documents cited by Dr Saha have been reviewed by Dr Robert Martin, associate Director, Coordinating Centre for Health and Information Services, Centres for Disease Control and Prevention, USA who is also of the view that there is no evidence of use of poor quality HIV test kits in India and his allegations have no basis.
Integrated Counselling and Testing Centres (ICTCs) have been established under the National AIDS Control Programme to provide relevant information and test individuals for HIV infection. There are at present more than 4310 ICTCs in the country in medical colleges, district hospitals and community health centres. The number of individuals tested has increased from 1.8 million in 2004 to over 5.5 million 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 testing is in accordance with international guidelines of the WHO and UNAIDS.
Blood banks normally use Eliza kits, except in exceptional cases when rapid test kits are used. The blood is discarded if the first test is positive. The concerned individual is also advised to visit the ICTC for counselling and testing.
The kits for the first test are procured by National AIDS Control Organisation and kits for the confirmatory tests by the concerned State AIDS Control Societies. The procurement is done following the laid down government guidelines. Dr. Saha has no credible evidence to support his accusation of use of sub-standard kits in India.