Non-Oriya Health Secretary Sabotages the Minister: CM Ought to Know, His Party is spreading AIDS

Subhas Chandra Pattanayak

When on July 7, in presence of Panchayati Raj and Law Minister Mr. Arun Kumar Sahoo and Food Supplies and Consumer Welfare, Employment, Technical Education and Training Minister Mr. Sanjay Kumar Das Burma, the Minister of Health and Family Welfare, Information and Public Relations Mr. Atanu Sabyasachi Nayak told me on his own accord, in his Secretariat chamber, that, the issue I had raised has been ordered to be implemented immediately, I was very happy and was sure, Orissa shall be saved from a great disaster.

But I had no idea that his Secretary – a non-Oriya IAS officer – would sabotage him and continue infecting people of Orissa with AIDS through unsafe blood supplied by Red Cross Blood Banks without proper screening.

I had stumbled upon a case of AIDS caused to a 3 year old boy in 2012.

He was a victim of blood transfusion on operation table.

The blood he was given was infected with HIV.

He was a native of a village of Baramba adjoining my birthplace Tigiria. His father had given me the details of how the misfortune engulfed him and had requested me to take such steps that no child should be such a victim of medial mismanagement. His sobs and tears are still alive in my heart.

I investigated into it and found that in 2011 the Orissa High Court, on awarding a cash punishment to the State to the tune of Rs.3 lakhs, had directed that the Orissa Government must immediately adopt NAT method of blood screening as the prevailing method of ELISA was not competent enough to detect HIV in its “window Period”. The Government was sleeping over it.

I exposed the malady repeatedly with updated input. It attracted attention of Sri Prasad Harichandan, then the Opposition Chief Whip, who moved an adjournment motion on the topic. On September 1, 2012, the then health Minister Dr. Damodar Raut answered the motion with an emphatic YES to the NAT method and announced to adopt the method in all Blood Banks “in phased manner”, which would start with four major Blood Banks serving the 3 Government Medical Colleges and the Capital Hospital.

He could not see his announcement implemented because the health secretary and a few mandarins were interested in continuance of the ELISA method.

I continued to expose the apathy of administration in this particular matter, as a big population of transfusion dependent patients were sure to be affected by the dreaded virus. Taking the cue, almost all newspapers of Orissa used their spaces time and again in this mission; but the mandarins did not buzz.

After election 2014, the portfolio of Health came to the hands of the young dynamic Minister Atanu Sabyasach Nayak.

I raised the issue before him, cries of the unfortunate man of Baramba still vibrating in my heart.

He took two days to study the matter and sent the following “Note” (No.23, Dt.19.9.2014) to the Secretary:

“This is regarding implementation of NAT screening method for blood in four centres catering to 6 major blood banks of the State.

The Hon’ble High Court in 2011 on one PIL case filed before it had passed an order for earliest implementation of NAT. The then Hon’ble Minister, Health and F.W., Odisha had assured on the floor of the House for implementation of NAT in phased manner while answering an adjournment motion in the subject on 01,09,2012. A Technical Committee constituted by the Government had visited two States i.e. Karnatak and Uttarpradesh and inspected various centres where NAT was implemented and had given their report.

I am told, the SBTC was directed to go ahead for implementation of the project. The major procedure involving Financial and Technical formalities are also over. The Technical Expert Committee has also given its views on the Request of Proposal received.

It is a matter of concern, why the important decision to implement the direction of Hon’ble High Court has not been operationalized till date.

A detail report in this regard is to be called for at the earliest. A meeting in this regard may also be convened at your level as early as possible to expedite the process.

One year has passed away since then. Implementation is hanging under many pretenses.

This is a classic instance of how incompetent or ill-motivated mandarins in the Secretariat have been playing tricks upon the political Government.

It is an instance of how a non-Oriya IAS officer has continuously kept the Minister in dark, while pushing at least two Oriyas into AIDS everyday by forcing unsafe blood upon them.

Yesterday, the Chief Minister addressed a workshop of his party in matter of Jivan Sindhu, a project of BJD to make the party appear concerned for the people. It transpired from his speech that since commencement of this project six months ago, its collection of blood has reached 37,232 units.

Medico-scientific surveys have established, and the High Level Technical Committee held under the chairmanship of the Health Secretary on 17.10.2014 had held that, “NAT yield (ELISA Negative & NAT positives) is around 500: 1” which means, NAT method detects one case in every 500 units as HIV positive and ELISA detects none.

All the blood units in Orissa are being screened in ELISA method. This prompts us to suspect that out of the 37,232 units of blood collected and supplied by BJD during this six months under the banner of Jivan Sindhu under guidance of the Chief Minister, AIDS causing viruses have been pumped into at least 76 unsuspecting patients.

This is a very serious situation.

Jivan Sindhu is a political program of the ruling party aimed at appearing pro-people as it is increasingly being viewed as a server of avaricious industries at the cost of indigenous population. The CM wants that, before the next election, its blood collection should exceed 5 lakh units.Vote bank politics can go to any extent.

If NAT is not immediately implemented, the said 5 lakh units would be forcing at least 1,000 Oriyas into AIDS by way of blood transfusion.

Health Minister Atanu babu should immediately wake up as the concerned Minister and foil the foul game of the non-Oriya IAS officer, who, as Commissioner-cum-Secretary has been presiding over the horrific delay in implementation of the already approved program, is playing; or if he is unable to administer his Secretary, the attention of this Chief Minister should immediately be drawn into this malicious conduct of the mandarins.

Human life is more precious than the lady IAS officer, whose negligence and incompetency is pushing unsuspecting Oriya patients into the pernicious grip of HIV.

Any further delay must not be allowed.

Nothing could be more Incongruous than Biju Janata Dal’s Blood Plan

Subhas Chandra Pattanayak

Orissa Chief Minister Naveen Patnaik has announced today that his party – Biju Janata Dal – would conduct blood collection camps all over the State with effect from March 5.

Nothing could be more incongruous than this, when his government has been spreading AIDS by keeping the blood banks bereft of necessary facilities to supply safe blood to patients.

If the BJD blood plan is not meretricious and nasty political ploy, it would be better for its members to educate their chief minister Naveen Patnaik to act honestly and to immediately implement the NAT decision for safe screening of blood, without waiting for bribe.

The following links may be studied by them to reach the crux and to educate their party chief -cum-chief minister on necessity of proper screening of blood, to stop spread of AIDS in absence of appropriate technology.

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.

Orissa in Quagmire of AIDS; High Court Ruling and Minister’s Order Rot under Red Tapes!

Subhas Chandra Pattanayak
aids iconOrissa is in Quagmire of AIDS. The Government has not yet studied to what extent it has spread in the State. But the figure must be alarmingly high as the State has failed to stop supply of infected blood through the Blood Banks, despite specific direction of the High Court of Orissa, that had even punished the State Government with Rs.3 lakhs to be paid as compensation in a case where it was established beyond doubts that a boy of only 17 months of age had been infected with this dreaded disease consequent upon receiving transfusion of infected blood supplied by Government Blood Bank, BMC Hospital, Bhubaneswar, on an operation table. The Blood Bank had supplied screened blood; but the virus had escaped detection, as the ELISA method used for screening is not advanced enough to detect HIV in the grey zone or window period.

On elaborate study and research, the High Court of Orissa had ruled in W.P.(C) No.13441 of 2009 on 28 July 2011 that PCR NAT method be used in all the Blood Banks to stop supply of contaminated blood to patients, as had happened to the child in the instant case. Mandarins of Health Department, instead of implementing this Order, have kept this judgment subjected to their own judgment!
The following three articles, out of a lot earlier published in these pages, would be of help in understanding the sad phenomenon and to see how the Government of Orissa has criminally neglected the most calling cause of health in the State and how its Health Minister’s assurance to the Assembly to implement the remedial method – NAT, as directed by the High Court, has been rotting under the red tapes of bureaucracy.

The articles are:

1. Shocking Reality: AIDS Being Aided by Government of Orissa,
2. AIDS: A Coterie of Officers use Tricks of Subterfuge against the High Court Order and,
3. ORISSA MATTERS Exposed a Malady that reached a Remedy, thanks to Prasad Harichandan

On relying upon the Minister’s announcement in the Assembly, people had believed that they would soon be saved from threat of Transfusion Transmitted Infections like AIDS. But the Minister’s announcement stayed inconsequential because of political timidity.

Political Timidity

Prasad Harichandan of the Congress party was the mover of the adjournment motion, in reply to which Health Minister Dr. Damodar Raut had announced to adopt NAT for blood screening. Had the announcement been executed, the credit for its implementation might have also gone to the mover of the motion Mr. Harichandan. So it was abandoned. Health Minister Dr. Raut, who had given the assurance to the Assembly to implement the High Court order in phased manner, till his last day in the department, did not give the necessary thrust to implementation of his own announcement on NAT in the Assembly.

New Health Minister’s query

After Election-2014, a new Minister in Mr. Atanu Sabyasachi Nayak took over the charge of Health. A young, energetic, workaholic person, he immediately addressed himself to pending tasks. And, thus he located how the department has slept over the High Court Judgment as well as the assurance given by the Government to the Assembly for adoption of NAT to stop infected blood flowing into unsuspecting patients.

He sent the following “Note” to the Secretary.

ASNayak to S.H.Note Sheet
Date 19.9.2014
This is regarding implementation of NAT screening method for blood in four centres catering to 6 major blood banks of the State.
The Hon’ble High Court in 2011 in one PIL case filed before it, had passed an order for earliest implementation of NAT. The then Hon’ble Minister, Health and Family Welfare, Odisha had assured on the floor of the house for implementation of NAT in phased manner while answering an adjournment motion on the subject on 01.09.2012. A technical committee constituted by the Government had visited two States i.e. Karnataka & Uttar Pradesh and inspected various centers where NAT was implemented and had given their report.
I am told that SBTC was directed to go ahead for implementation of the project. The major procedure involving financial & technical formalities are also over. The technical expert committee has also given its views on the request of proposals received.
It is a matter of concern why this important decision to implement the direction of Hon’ble High Court has not been operationalized till date.
A detail report in this regard is to be called for at the earliest. A meeting in this regard may also be convened at your level as early as possible to expedite the process.
Minister of State (Ind), Health & F.W, I&PR, Odisha

In response to the Minister’s note, the Health Secretary informed him on 20 September 2014 that, “A meeting in this connection was scheduled to 15.09.2014 which could not be held due to sudden demise of the mother of the Director, State Blood Transfusion Council. The meeting has been rescheduled for 29.09.2014”.

Secretary acts a judge over the judgment

What happened on September 29? The meeting was held under chairmanship of the Secretary of Health. But it was nothing but an exercise of equivocations, and attempts to stymie the implementation. And, more intriguingly, it was a game of subjecting the judgment of the High Court to judgment of the Secretary. The Minister should take serious note of it.

Secretary doesn’t bother about Minister’s query

As would be seen from the Minister’s note sheet, he had asked, “Why this important decision to implement the direction of Hon’ble High Court has not been operationalized till date” And, he had called for “a detail report” on the delay and had directed to convey a meeting “as early as possible to expedite the process”.

But, instead of complying with the absolutely appropriate orders of the Minister, the mandarins invented tricks to delay the process.
I quote from the minutes:
After thorough discussion, the following decisions were taken:
i. The fact sheet on NAT needs be prepared and submitted;
ii. The letter may be issued to NAT technology user States to get feedback on NAT technology after implementation of NAT, such as performance of NAT system, transport logistics, review mechanism along with grievance redress mechanism during failure of equipment.

Playing over judicial wisdom

The “fact sheet on NAT” is already with the department, as otherwise, the decision could not have been taken to adopt NAT and call for Tenders. Why then this decision at Para- i? Moreover, the High Court has analyzed the essential necessity of NAT to stop supplying HIV infected blood to unsuspecting patients. The government has only one option; i.e. implementation of the High Court Order.

Where from the mandarins get the mandate to sit in judgment over the judgment of the High Court?

When the bureaucratic decision quoted above in Para- i is nothing but playing over the judicial wisdom of the High Court, the decision at Para- ii is indicative of how casually the mandarins are treating the issue of AIDS that they generate by supplying contaminated blood to the patients on operation tables or for serious diseases that require regular and frequent blood transfusion like Thalassemia, Sickle Cell etcetera.

Luxury of equivocations

The quoted decision at Para-ii above says, “Letter may be issued to NAT technology user States to get feedback on NAT technology after implementation of NAT”. They shall send letters to other States to get feedback on NAT! What a great design to waste time!

After the High Court judgment, the Secretary of the Health Department had deputed a high-level committee of experts to collect physical feedback from States where NAT is in use and the Expert Committee’s report, strongly recommending adoption of this advanced technology to ensure supply of safe blood, is very much in the records of the department. This has also been reflected in the Minister’s note quoted supra. So, why again the decision to send letters to the same States for feedback? Does replacement of a Secretary with a new incumbent renders earlier obtained feedback useless?

Moreover, why this, when the only option left to the Secretary is implementation of the ruling of the High Court in the 2009 case? And the only duty of the Secretary is to tell the Minister as to why the High Court Ruling has not been implemented.

The minutes of the September 29 meeting is more indicative of confusion the bureaucracy is creating. As for example, item b under Para iii wants the firm to give “Tax Details”. The tender notice issued by the department, to which firms have responded, itself has stipulated in its ‘Format’ that the “rate quoted should include all applicable taxes except Odisha VAT, which would be paid as applicable”.

When the respondents to this notice are bound by the ‘Format’ beyond which they cannot go, why this confusion is created in matter of ‘Tax details’? Obviously, the Secretary does not want implementation of the High Court Order and therefore, unnecessary hurdles are created in provision of funds for the scheme in supplementary budget.

To escape blame, a decision has been noted under Para-v, which states, “To roll out the NAT facility in whole State, the tentative budget requirement will be around Rs.23.7 crores. But as per decision, in first phase total budget, requirement was projected at Rs.9.48 crores (as per EFC decision). Thus provision in supplementary budget will have to be made based on requirements”.

This note, juxtaposed with Para-iv that says, “Policy decision should be chalked out”, read with the mischief as discussed in context of Paras- i, ii and iii above, makes it clear that either the bureaucracy is infested with elements that need greasing of palms to make the matter move or the Secretary is too stubborn to yield to orders of the High Court and the Minister. Be it whatever, it is clear that the mandarins in Health Department are not paying attention to the urgency of stopping supply of AIDS generating contaminated blood from Blood Banks in the State.

Health Secretary makes a farce of EFC

The situation is horrific when the meetings taken by the Health Secretary do not bother about soundness of the minutes of the Expenditure Finance Committee (EFC) held as far back as on 13 December 2013.

“After going through the relevant documents of the Indian Council of Medical research (ICMR) Studies and other related studies papers & documents”, this authoritative body, in its decision No.1 had “approved” the “proposal submitted by the Health and Family welfare Department for implementation of NAT PCR testing method in Blood Banks in the State”. Further “It is decided to be implemented in the three Medical Colleges and Hospitals of the State”, said its 2nd resolution. The Health department has made a farce of this approval of the EFC.

Manners of the mandarins

The following events may help us understand how hazardous to human health are the manners of the mandarins in the Department of Health in Orissa –
1. The High Court of Orissa, shocked to see a 17 month old boy in AIDS by taking blood on the operation table supplied by a Blood Bank of Bhubaneswar, had issued mandatory direction on 28 July 2011 to the State Government to immediately adopt NAT method for blood screening, so as to eliminate every chance for HIV virus escaping detection within window period.

2. The Minister of Health, in replying an adjournment motion on 1 September 2012 on the issue of non-implementation of the High Court ruling, declared in the House that the Government would implement the Order in phased manner with utmost quickness.

3. Following the Minister’s announcement, an expert committee was sent to various States that use NAT method for field study and feedback and the said Committee submitted its report recommending NAT as the most efficient method for ensuring safe blood to the patients that led the Health Department to arrive at a decision to adopt NAT.

4. The Finance Department accorded necessary approval vide the EFC resolution on 13 December 2013.

5. Request of Proposal was issued through ads on 20 February 2014 and offers obtained and firms selected under stipulations laid down by the department.

6. Despite this when the High Court order of 28 July 2011 and the Minister’s announcement of 1 September 2013 were not implemented, despite EFC approval on 13 December 2013 till 15 September 2014, the new Health Minister, in his notes dated 16 September 2014 wanted to know from the Secretary the reasons thereof and asked the Secretary to call a meeting to ascertain who caused the delay and “as early as possible to expedite the process”.

But, instead of honoring the Minister, the Secretary has taken all steps to delay the process!

This is when the State is in the quagmire of AIDS.


State in whirlpool of TTIs; Young Orissa stresses on implementation of Minister words to Assembly for safe blood from Blood Banks

YO Press meet

Orissa is in serious debacle due to spread of transmission transferable infections with deadly viruses like HIV/HBV/HCV escaping notice as outdated methods in vogue are not capable of perfect screening of blood in the blood banks, alleged Young Orissa in a Press conference on July 12 at Bhubaneswar.

Secretary of the organization, Debi Prasad Nayak presented various documents in support of his apprehension that the State of Orissa, due to nonchalance of administration, has fallen in a whirlpool of transfusion transmitted infections (TTIs). Three out of 1528 units of blood carry life killing viruses like HIV, HBV, HCV etc as the existing system of blood screening escape detection in blood banks, he said.

“According to ICMR, these viruses escape in 3 average cases of screening in1528 donated units of blood. Orissa is having 3,41,000 units of blood donations per annum in the average. This indicates that at least 669 unsuspecting patients are accepting infected blood transfusion in Orissa per year”, alleged Nayak.

Citing official statistics, he said, “there are 12,000 thalassemia patients in Orissa who thrive on blood transfusion taken at least once or twice every month. They use about 25% of the total blood received through donations. So, at least 167 thalassemia patients are suspected to be receiving blood infected with HIV/HBV/HCV viruses without them knowing of the danger. This is more serious a syndrome when there is possibility of three fold more infections as an unit of blood is now being separated into three component like platelet, plasma and pack-cell under NACO guidelines for better, larger and specific use of the life-saver. This is stark treachery against the unsuspecting patients’ he said.

Narrating how an unsuspecting patient of only 3 years, who for surgery had accepted transfusion of blood obtained from BMC hospital Blood Bank, was found infected with HIV”, he informed that the “Orissa High Court considering his complaint, had directed the State Government to pay him Rs 3 lakhs as compensation with a further directive to adopt NAT method for dependable screening of blood as the Government is basically responsible to supply safe blood to patients”.

This judicial direction was given in W.P.( C ) No.13441 of 2009 disposed of on 28.07.2011. But the State Government, as is its wont, did not pay any heed to the High Court directive.

Worried over the administrative negligence to such a serious hazard, the Opposition Chief Whip Sri Prasad Harichandan moved an adjournment motion on the issue on September 01, 2012. Nayak said, “Honʼble Minister of Health Dr. Damodar Raut, in his reply announced that the Govt. will use NAT method in all Blood Banks in phased manner and will start Nat Screening with immediate effect in the four most major Blood Banks in the three Medical College Hospitals and Capital Hospital. But, we regret to note, the Ministerʼs announcement has gone barren and resultantly AIDS is rising along with other TTIs in Orissa” cried the Young Orissa Secretary while informing that a “recent case of HIV infection located in the capital city is caused by unsafe blood transfusion”.

“We demand immediate implementation of the Ministerʼs announcement in the Assembly on September 01, 2012 by replacing the ELISA screening with NAT PCR Screening in the Blood Banks attached to Capital Hospital and the Hospitals of the three Government Medical Colleges at Berhampur, Cuttack and Burla and adoption of the said method in all the Blood Banks of Orissa without monetary pressure on the patients” , said Sri Nayak.

Young Orissa office bearers, Priya Pritam Mohanty, Pranab Kumar Bal, and Arobinda Mishra were present in the conference along with Nayak.

Attempts to foil Health Minister’s assurance; only the rich to get safe blood!

Subhas Chandra Pattanayak

In reply to an adjournment motion moved by Opposition Chief Whip Prasad Harichandan on 1st September 2012, Health Minister Dr. Damodar Raut had assured that Orissa would adopt NAT PCR system to ensure appropriate screening of blood to avoid AIDS from transfusion.

A boy of only 17 months was found infected with AIDS by accepting transfusion of blood obtained from Muncipal Hospital Blood Bank, Bhubaneswar. The news was broke by in 8 July 2012 and Sri Harichndan had very ably brought the matter to the attention of the Assembly.

Dr. Raut in his reply noted that people of Orissa have made monumental mark in blood donation and from 126076 units in 2000; blood collection has reached 307022 units in 2011. People’s eagerness to donate blood to save the lives of fellow citizens needs be equally honored by the government’s readiness to supply safe blood to needing patients through proper screening. Therefore, Dr. Raut said, in a meeting on 22 August 2012 the Government had consulted all the Blood Bank Directors and Officers in a conference and had taken a decision to jettison the rapid test method of screening and adopt ELISA method to screen out AIDS virus in the Blood Banks.

As Harichandan pointed out that ELISA is not the latest technology to screen AIDS virus, but NAT PCR is, the Minister had appreciated the position and had assured to adopt the latest method; for nothing is more valuable than human life and moreover, as patients’ confidence in blood banks would diminish if AIDS virus escapes the deficient screening. He however had declared that the method being costly, the State would start with four major blood banks: one each attached to the three Government Medical Colleges and the Capital Hospital Blood Bank. The facility would be extended to all the Blood Banks of Orissa in course of time, he had assured the Assembly.

The Budget of Health department placed in and awaiting approval of the Assembly has made a token provision for replacement of ELISA with NAT PCR in the aforesaid four Blood Banks.

But, the Finance department has planted a rider that the cost of NAT PCR screening should be collected from the patients. If the rider is not dropped, only the rich will benefit; because the poor patients cannot afford the screening cost.

The present Finance Minister was the Minister of Health when deficient screening through old method of ELISA had infested the seventeen months old child with AIDS and the Orissa High Court had punished the state Government with cash penalty of Rs.3 lakhs for supply of HIV infested blood to the boy without perfect screening. When he is the Finance minister, his department is asking the Health department to impose such a heavy cost on poor patients on accounts of NAT PCR that it will never be possible for them to get pure blood through perfect screening!

Should the poor people have no right to safe blood? Should the latest and the safest NAT PCR screening for which the government in the Health department has put budgetary provisions on the anvil of the Assembly be available only to the rich?

Should the Finance department be allowed to foil the most welcome welfare proposal of the Health department?

Should the Assembly allow its own anxiety for safe blood to patients be steered into benefit of the moneyed men alone?

ORISSA MATTERS Exposed a Malady that reached a Remedy, thanks to Prasad Harichandan and the new Health Minister

Subhas Chandra Pattanayak

ORISSA MATTERS had exposed a malady in Orissa’s health care sector, which, thanks to Opposition Chief Whip Prasad Harichandan and a number of alert MLAs and a considerate minister-in-charge has reached a remedy on September 1.

While investigating into how far welfare verdicts are being honored by the Government, ORISSA MATTERS had stumbled upon a milestone judgment delivered by the Orissa High Court a year ago on 28 July 2011 in the matter of compensation claimed by the father of a small kid of 17 months, infected with AIDS because of transfusion of unsafe blood supplied to him by a government blood bank in course of his operation.

In response to the case, the blood bank as well as the State Government had claimed that “safe blood”, determined to be so by screening in ELISA method, was supplied to the kid.

But the kid’s advocate Mrs. Sujata Jena had put up a tremendous argument. She had established that ELISA method was not efficient beyond doubt to detect HIV in its “window period” which comprise about three months from the day of infection.

If blood is drawn from a HIV infected person within the first three months of infection, the virus may escape detection through ELISA screening and may appear to be “safe” even though HIV positive. This had happened to the kid, Jena had argued.

Accepting her well researched argument, the High Court had come to the conclusion that the disaster could not have befallen the kid had the blood given to him on an operation table could have been screened through the “latest technology” called Nucleic Acid Testing (NAT) in Polymer Chain Reaction (PCR) method.

And, thus determining, the High Court had awarded a compensation of Rs. 3,00,000/- to the child including cost of his further treatment to be borne by the State, and had issued a mandamus that “the Government must ensure that in all Blood Banks, the PCR method is available to identify the virus of HIV during window period”.

But as is its wont, the government run by Naveen Patnaik did not welcome the mandamus.

Therefore, despite a bureaucratically constituted committee comprising eminent serologists and Professors of microbiology in all the Government Medical Colleges of Orissa having “unanimously” resolved on 25 Feb.2012 that the NAT PCR technology, being “the latest and foremost technology available in India”, “need to be introduced for screening of the blood units to reduce the gray zone period of Transfusion Transmissible Infections like HIV-I, HIV-II, Hepatitis-B and HCV”, the political Government ignored the same.

We exposed this malady in these pages on 8 July 2012 as it came to our attention while investigating into non-implementation of welfare verdicts.

It was a cue for other newspapers in Orissa to stress on the necessity of blood screening in NAT PCR method.

But to our shock, the Government wanted another committee to undo the 25th February “unanimous” recommendation of the committee aforesaid.

The new committee, wherefrom the experts of the previous committee were kept out, rejected the recommendation for NAT PCR method and resolved on 24 July 2012 to challenge the High Court order dated 28 July 2011 through a review petition.

Harichandan turned it turtle

As we again exposed this mischief, it attracted the attention of Sri Harichandan, the well erudite Opposition stalwart. With the Assembly in session, he headed an adjournment notice that came up for discussion on September 1. Government got the jolt.

In initiating the debate, Sri Harichandan completely razed down the 24 July decision of the Government in Health department that had tried to justify non-implementation of the High Court order for adoption of NAT PCR method for blood screening.

He cited National Blood Policy and many other referral documents including the 1996 Supreme Court verdict in Common Cause case to demolish the government stance reflected in July 24 resolution and castigated the government for the contempt shown to the High Court order and for discernible lack of concern for human life as is seen in its reluctance to equip blood banks with the latest technology to ensure that the bloods collected and supplied by them do not carry latent viruses of HIV-I, HIV-II, or other Transfusion Transmissible Infections like Hepatitis-B and HCV as happens in the “window period”.

If HIV and other killer viruses continue to spread from the blood supplied by blood banks, patients would fear to take blood transfusion and all the blood banks will collapse, causing thereby serious dislocation in health care in the State, he warned. Though the Red Cross is tagged to Blood Banks, it cannot bear the cost of NAT and hence the State must provide necessary fund for adoption of the method, he said.

Besides the fire his speech usually emits, he was so much his persuasive best in this matter of immense public importance, that, despite the 24 July resolution to challenge the High Court verdict, the Minister of Health announced that the Government will adopt the NAT technology to obtain safe blood for transfusion.

Stop all avoidable luxurious spending by ministers and bureaucrats and give primacy to blood screening by NAT PCR method instead of avoiding it under the plea of financial constraints, said Pratap Sarangi. Dr. Prafulla Majhi supported the demand for adoption of NAT technology in place of ELISA even as Dr. Nrusingh Sahu cited the cost factor in support of continuance of ELISA method. Dr. Ramesh Chandra Chyau Pattanayak and Alekh Jena contributed their input to the debate.

In reply to the debate, Minister of Health Dr. Damodar Raut pointed out that the departmental reluctance to adopt NAT PCR method was driven by, cost factor besides, lack of direction in NACO and NBTC guidelines.

But, he confessed, howsoever marginal be the failure in detection of HIV through ELISA, it is most unfortunate that a kid of only 17 months was infected by AIDS, which is being attributed to unsafe blood transfusion.

He announced to introduce blood screening through NAT method in the four most busy blood banks in the State, to begin with.

So bureaucratic bungling may no more stymie the latest technology and NAT should soon be in use in the blood banks operating in each of the three Medical Colleges and the Capital Hospital, Bhubaneswar.

For us in ORISSA MATTERS, it was a day of victory, as the malady we had exposed got remedied.