Maharashtra AIDS project indicted for fraud

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Maharashtra Aids project indicted for fraud

Vineeta Pandey, Monday, January 21, 2008 03:06 IST

World Bank review shows that a big chunk of the NACP-2 funds went

for bribes, faulty kits led to wrong diagnosis

NEW DELHI: The World Bank has sharply criticised the implementation

of India's Second National Aids Control Project (NACP-2) for high

levels of corruption, misappropriation and financial irregularities.

Mumbai and Maharashtra share the lion's share of the blame for the

fraud and mismanagement in NACP-2, which ran from September 1999 to

March 2006.

The bank's detailed implementation review (DIR) suggests that bribes

of 10-40% had to be paid by non-governmental organisations (NGOs)

for the release of funds, NGOs were poorly monitored and some were

non-existent, and, worse, the poor quality of testing kits supplied

may have exaggerated the number of people testing HIV-positive.

Faulty kits showed people as HIV-positive when they were not,

ruining people's lives and forcing them to live with stigma and

psychological stress when they had no need to. The bank's review

found that a large number of false HIV/Aids- positive cases were

detected due to faulty diagnostic kits supplied by Monozyme India

Ltd, Span Diagnostics Ltd and Zhongshan Biotech Company Ltd of

China.

Interestingly, despite having problems in their contracts, the

Maharashtra State Aids Control Society (MSACS) and the Mumbai

District Aids Control Society (MDACS) continued to award contracts

to these companies even when there were 21 other companies who could

have supplied the same kits.

These contracts were awarded without checking the authenticity,

credentials and credibility of the suppliers. In one case, the

review team found Chinese restaurant Golden Dragon at the address

given by Zhongshan's local distributor in Mumbai, Spectra Pharma and

Health Products.

While the review has raised questions about the legitimacy of the

supplier, the report also hints at the connivance of MDACS officials

who did not even bother to verify the credentials of the supplier

before awarding such an important contract.

The World Bank noted several indicators of fraud and corruption in

procurement procedures for testing kits, including long delays in

opening bids and awarding contracts, apparent avoidance of the World

Bank's prior review threshold and unusual pricing patterns.

What followed was a disaster for many patients. Summarising the

results of cross-checking HIV test results at Mumbai's KEM Hospital

VCTC, the World Bank found that more than half the number of people

declared HIV positive using Monozyme kits (2,640 out of 4,620)

actually tested negative when rescreened. In fact, only 1,980

finally tested positive after two supplementary screenings. In other

words, from the original list of 19,331 people tested, the faulty

tests showed 23.9% as HIV-positive when the real figure should have

been 10.49%. A huge 13.66% of people were wrongly declared as HIV-

positive when they were in sound health.

At GT Hospital, 28 out of the 4,920 people tested with Monozyme kits

showed a false positive. At JJ Hospital, 17 out of 873 results were

discordant. The overall discordance rate at JJ Hospital was 12.23%.

These and several other hospitals in Maharashtra had complained

about the faulty testing kits, indicating the extent of the problem.

The substandard quality of test kits used yielded invalid and

unusually high false positive results, or discordant results. Some

test kits were distributed near their expiry dates. At blood banks,

false negative results carry the risk of infected blood being given

through transfusions; a false positive test means blood that can be

used for those who need it is actually wasted.

All this continued despite regular complaints from blood banks like

Indian Red Cross Society and Tata Memorial Hospital in Mumbai, and

Rajawadi Hospital. MDACS actually reported the matter to the

National Aids Control Organisation (Naco) in 2006 only after the

latter's pressure for a feedback.

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