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.

http://orissamatters.com/2015/02/19/aids-imperils-orissa-deliberate-delay-in-reaching-at-remedy-is-payola-the-purpose/

http://orissamatters.com/2014/10/20/orissa-in-quagmire-of-aids-high-court-ruling-and-ministers-order-rot-under-red-tapes/

http://orissamatters.com/2012/08/28/aids-a-coterie-of-officers-use-tricks-of-subterfuge-against-the-high-court-order/

http://orissamatters.com/2012/07/08/shocking-reality-aids-being-aided-by-government-of-orissa/

http://orissamatters.com/2012/09/02/orissa-matters-exposed-a-malady-that-reached-a-remedy-thanks-to-prasad-harichandan-and-the-new-health-minister/

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.

AIDS: A Coterie of Officers use Tricks of Subterfuge against the High Court Order

Subhas Chandra Pattanayak

The National Blood Policy makes it a must for the State “ to provide safe and adequate quantity of blood, blood components and blood products” (Objective 1) and “to make latest technology available” (Objective 3) to the blood banks for correct screening so that patients needing urgent transfusion would get safe blood.

But the State government run by Naveen Patnaik has failed to adopt “latest technology” as a result of which AIDS is spreading through blood transfusion in Orissa. Dependents on frequent transfusion such as thalassemia patients are more vulnerable to Virus 1 (HIV-!), Hepatitis C Virus (HCV) and Hepatitis B Virus (HBV).

After we exposed this phenomenon in these pages, various news media organizations have been harping on about the urgency of adoption of latest technology in screening of blood.

In a case of a 17 month old child who is infected with AIDS after taking blood transfusion, the Orissa High Court, a year ago, had not only awarded a cash compensation worth Rs. 3 lakhs to the infected boy, but also had made it a “must” for the Government to adopt advance technology, i.e. NAT PCR method in “all the Blood Banks” for blood screening, in order to ensure supply of “safe blood” to patients. Its mandate is in these words: “Therefore, the Government must ensure that in all blood Banks the Polymer Chain Reaction (PCR) method is available to identify the virus of HIV during window period”.

Steps to Implement the Court Order

This judgment had forced the State government to review its blood screening scenario in a high level committee constituted for the purpose under the chairmanship of Dr. Pramod Meherda, IAS, M.D., NRHM & Project Director, Orissa State AIDS Control Society.

The Professors & Heads of Departments of Microbiology in VSS Medical College, Burla Dr. Sudhir Kumar Ghosh, the Professors & Heads of Departments of Microbiology in MKCG Medical College, Berhampur Dr. Binojini Parida, the Associate Professors in Microbiology department of MKCG Medical College, Berhampur, the Associate Professors in Microbiology department of SCB Medical College, Cuttack Dr. Bimoch Prajna Pati, the Drug Controller of Orissa, Ex-Director of SBTC Dr. L.N.Hati, Dr. Mangala Pr. Mohanty, Hon. Secretary, IRCS-OSB, Director of Central Red Cross Blood Bank at Cuttack Dr. Benudhar Satpathy and seven other top functionaries were members in this committee.

Unanimous Recommendation for NAT

The Committee met on 25 Feb.2012 at the Conference hall of OSCAS. Its minutes disclose, “After thorough discussion on NAT PCR technology, the Committee unanimously recommended that the NAT PCR technology which is the latest testing facility 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, as it is the latest and foremost technology available in India”.

The Sleeping State

Despite this “unanimous” recommendation submitted “after thorough discussion” by all the above noted illustrious microbiologists, serologists and other specialists in the Committee, the State Government did not wake up to the occasion.TTI continued to affect lives in Orissa.

We had to expose this monstrous negligence of the state to the most urgent need of the moment in these pages on 8 July 2012.

Shocking Mischief

Thereafter, on 24 July 2012, the Secretary of Health P.K.Mohapatra took a “meeting on implementation of NAT PCR in Blood Banks”.

To our surprise and shock, we found that all the super-specialists, serologists and microbiology Professors who, “after thorough discussion” in the previous meeting of 25 February 2012 had “unanimously” recommended that “the NAT PCR technology which is the latest testing facility need to be introduced for screening of the blood units to reduce the gray zone period of Transfusion Transmissible Infections” were kept out of this meeting and a Director of Medical Education and Training (DMET) having no role under the rules of business in the concerned matter, who was to retire from service the same month, was encouraged to lobby for the old ELISA method and to raise a bogus allegation that the High Court had delivered its verdict directing for adoption of NAT PCR for blood screening without being “apprised properly on the issue under reference”. And, it seems, such aspersions against the High Court was approved in the meeting, as is evidenced in its 1st resolution that reads, “ Special Secretary (Technical) H&FW Department, Govt. of Orissa will move file for filing a review petition against the judgement”.

New Tricks of subterfuge

It is seen from the meeting taken by the Health Secretary, that ,the Special Secretary of the Department who hails from the pool of Doctors, collaborated with the said DMET in confusing the issue with a downloaded document of Canadian Blood Banking Association “where it is mentioned that the HIV positive scenario is 1 in 2.7 million than ELISA”. The quoted observation is a conundrum and the Health secretary, before signing the minutes, has failed to notice this confusing expression. However, one is at a loss to understand when the Special Secretary with a downloaded version of Canadian Blood Banking Association was allowed to mislead the meeting, why had the Health secretary not wanted to know how the scenario is seen by Indian authorities on blood screening by NAT, specifically as India has a high prevalence of the killing viruses when Canada is almost free of these killers.

The Chilling Scenario in India

A research reported in Indian Journal of Medical Research (127, February 2008, pp 140-147) is captioned “Multicenter evaluation of individual donor nucleic acid testing (NAT) for simultaneous detection of human immunodeficiency virus-I & hepatitis B & C viruses in Indian blood donors”.

The research was based on the ground that “India has a high prevalence of HIV-I, hapatitis C & B viruses (HCV and HVB) in the blood donors but has yet to implement nucleic acid testing (NAT) in blood screening”. It had tested 12,224 samples along with their serological results obtained from representative eight blood banks in India and had submitted its findings to the Journal on 26 September 2006.

Luminaries in the field namely R.N.Makroo, N. Choudhury, L. Jagannathan, M. Parihar-Malhotra, V. Raina, R. K. Chaudhary, N. Marwaha, N. K. Bhatia, and A. K. Ganguli had conducted the research that the Department of Transfusion Medicine, Indraprastha Apollo Hospital, New Delhi, had patronized.

They reported, “Data from our study suggested that the NAT yield for all three viruses (HIV, HCV and HVB) in India could be 29 times higher than that observed in Japan, and higher for HIV-I alone. Our observed HIV-I yield was over 515 times that observed in the US and Canada, 89 times that observed in Italy”.

So, citing a report of Canada where the prevalence of HIV-I is 515 times less than India, to frustrate the “unanimous recommendation” of the earlier committee, is not only low on merit but also is a mischievous attempt to mislead the Government.

The study cited above has concluded that its “observed NAT yield for all three viruses was 1 in 1528. This study was conducted in 2006. Now the 1 has become 3 inasmuch as every blood unit is becoming 3 units of blood products viz. platelet, plasma and pack cell. This means, if the virus was escaping EISA test in one out of 1528 samples, it would be read as three escapes in 1528 samples. This estimation relates to 2006 when HIV-I was not as wide spread as it is today. So, in every 1528 cases, it can be safely said that multiples of three cases of HIV-I infection are not being detected through screening in ELISA method.

In Orissa, blood collection has reached 3 lakh units per year. Divided into the three categories, i.e. platelet, plasma and pack cell, the total collection becomes 9 lakh units. If the 2006 study is applied to this volume of 9 lakh units, at least 1767 transfusion takers are possibly getting AIDS infected with the virus escaping detection, as ELISA is not efficient to detect the virus during the “window period”.

Orissa has 81 blood banks out of which 56 are running under joint banner of the state government and Red Cross whereas only one blood bank functions directly under the Government. rest are privately managed. Out of all these 81 blood banks the ELISA facility is also not available in 23 blood banks. After we exposed the malady, the government has ascertained through review that these blood banks having no ELISA facility are using rapid test kits to detect AIDS virus! The meeting held on 24 July under chairmanship of the Health Secretary (where he was in fact not even present) has noted this in its resolution No.2 and suggested that “No blood bank should procure any rapid test kit for hepatitis B & hepatitis C and HIV at their level”. The rapid test is a method through which the viruses escape detection. Taken into consideration, this makes it clear that non-detection of AIDS virus is alarmingly rampant in Orissa.

Yet, the mandarines in the health department have kept the High Court oder for adoption of NAT PCR method inoperative and are conniving to go in litigation against the said order.

Just imagine, how unsafe is Orissa .

ORISSA UNDER THE GRIP OF AIDS: DMET TRIES TO FOIL THE HIGH COURT ORDERS

Subhas Chandra Pattanayak

“Donation of blood is a noble work. In order to achieve this avowed objective all necessary safeguards must be taken while collecting, testing, storing and supplying blood. Otherwise, instead of saving the life, the contaminated blood would take the life. It is not disputed that during window period, unless the special test known as Antigen Test is conducted through Polymer Chain Reaction (PCR) method, the virus cannot be identified. Therefore, the Government must ensure that in all Blood Banks the Polymer Chain Reaction (PCR) method is available to identify the virus of HIV during window period”.

Thus said the High Court of Orissa a year ago on 28 July 2011 in W.P. (C) No.133441 of 2009 while asking the State Government to pay the writ petitioner Rs.3 lakhs as cash compensation against deficient screening of blood without using the NAT PCR method, as a result of which, the 17 months old child of the petitioner was infected with AIDS.

By saying, “the Government MUST ensure that in all Blood Banks the Polymer Chain Reaction (PCR) method is available to identify the virus of HIV during window period”, the High Court has made it an unavoidable must for the Government to use the NAT PCR screening method in all the Blood Banks in Orissa.

It is a blatant contempt of Court to delay implementation of this mandamus.

The Orissa Government, therefore, had taken up the matter in a specifically held “Meeting on Implementation of NAT PCR in Blood Banks” under Chairmanship of Dr. Pramod Meherda, IAS, MD, National Rural Health Mission and Project Director of Orissa State AIDS Control Society.

Members present in meeting were: Dr. Mangala Prasad Mohanty (Honorary Secretary of Indian Red Cross Society – Orissa State branch), Kamalakanta Dash (FA, OSACS), Dr. P. K. Acharya (Additional Project Director, OSACS), Dr. Sudhir Kumar Ghosh (Professor and HoD, Microbiology Dept, VSS Medical College, Burla), Dr. Banojini Parida (Professor and HoD, Microbiology Dept, MKCG Medical College, Berhampur), Dr. Pritilata Panda (Associate Professor, Microbiology Dept, MKCG Medical College, Berhampur), Hrushikesh Mohapatra (Drugs Controller, Orissa), Dr. Bijay Kumar Swain (Joint Director, Health Services (T.B.Cell) Orissa), Dr. Jyotsna Patnaik (D.D., STI and JD, BS), Dr. Bimocha Pragna Pati (Associate Professor, Microbiology Dept, SCB Medical College, Cuttack), Dr. L. N. Hati (Ex-Director, State Blood Transfusion Council, Orissa), Dr. Chhanda Charan Sahu (Blood Bank Officer, BCSU, Anugul), Dr. Debashish Mishra (Director, Model Blood Bank, Capital Hospital, Bhubaneswar) and Dr. Benudhar Satapathy (Director, Central Red Cross Blood Bank, Cuttack).

This special meeting for the specific purpose of implementation of the High Court orders was held in the conference hall of OSACS on 25 February 2012 after collection of various documents and medical literature. The minutes thereof records, “the matter was placed before the committee with all the supporting documents like Hon’ble High Court’s judgment, correspondence letter to NACO, Transfusion Medicines Technical Manual, Screening of donated blood for Transfusion, Recommendation of WHO on Transmissible Infection, Proceedings of Karnataka Government on NAT PCR and supply order along with purchase of All India Institute of Medical Sciences, New Delhi”.

This specific meeting, actively participated by subject matter specialist noted supra, unanimously decided to implement the High Court order as that was the most unavoidable and appropriate way to save the people from the transfusion-transmissible-infections(TTIs).

Its resolution said,

“All the Committee members went through the documents and also verified the possible grey zone documents of each individual disease (TTIs) and also went through the document from the website i.e. Journal of Association of Microbiologists, USA. After thorough discussion on NAT PCR technology, the Committee unanimously recommended that the NAT PCR technology, which is the latest testing facility, need to be introduced for screening of blood units to reduce the grey zone period of transfusion- transmissible-infections like HIV-I, II, Hepatitis B and HCV, as it is the latest and foremost technology available in India”.

But, despite this recommendation, the State Government failed to appreciate the urgency of its implementation. We exposed this menacing lack of concern for human life in these pages on 8 July 2012; and then a new case, seeking redressal in TTIs, gained cognizance of the High Court. This prompted the Government to remember the February meeting.

When the February meeting had unanimously recommended for adoption of NAT PCR method for screening of blood to eliminate the possibility of TTIs like HIV-I, II, Hepatitis B and HCV, it had constituted a sub-committee under chairmanship of the Special Secretary of Health to determine the manner of its execution. That sub-committee, after lapse of long five months, met on July 24.

But surprisingly, the D.M.E.T., Orissa, though not a member of that sub-committee, attended the meeting and tried to foil the High Court order with misleading emphasis on continuance of the outdated and deficient methods of blood screening presently in vogue in Orissa.

Our sources say, the meeting ended with no decision, notwithstanding how harmful be that to health of the people.

Shocking Reality: AIDS Being Aided By Government of Orissa

Subhas Chandra Pattanayak

It is shocking. But it is the reality. The Government of Orissa is contributing to spread of AIDS by sleeping over evidences of transfusions of HIV positive blood in hospitals in the State, in absence of facilities for proper screening.

The reality has come to light through a very poor person of Baramba Tahsil, Pratap Kumar Nayak, whose son of only 17 months of age is infected with the dreaded disease due to presence of the virus in the blood he was transfused with during an operation.

In a chilling case before the Orissa High Court (W.P.(C) No.13441 of 2009) Nayak narrated that his son Adarsh was born on 21 Oct.2007 in a Public Health Center (PHC) in Nayagarh district by way of normal delivery. But a day thereafter it was found that the baby had no anal canal. On contact, the PHC, not equipped with a pediatric specialist as it is, advised Nayak to consult Khurda hospital, where, a Dr. Jayaram Patra diverted him to a Dr. Subrat Mohanty, pediatrician, who again diverted Nayak to a private hospital of Bhubaneswar, The Neelachal Hospital. Nayak admitted his 3 days old son in this hospital on 24 Oct. 2007. The next day, Dr. Mohanty conducted the operation and claimed that it was successful. The baby was given transfusion of a bottle of blood, obtained from Red-Cross Blood Bank, Municipal Hospital, Bhubaneswar on requisition by the surgeon and against payment of its cost, in course of the operation. At the time of discharge, he was advised for a second operation after 10 moths for which Nayak admitted his son to the same Neelachal Hospital on 18 August 2008. As transfusion of blood was made a prerequisite to operation, on requisition of the hospital, a bottle of blood was also procured from the said Red Cross Blood Bank, Municipal Hospital, Bhubaneswar on 19.8.2008 against payment of its cost and the baby was operated on that day. The second operation was also claimed to have been successful like the earlier one and the baby was discharged after ten days of the operation. As advised by the Doctor, the baby was again admitted in Neelachal Hospital on 25.2.2009 for final surgery.

As usual, before operation, the blood of the baby was tested. Shockingly, the report indicated HIV positive. Dr. Mohanty withheld operation and advised Nayak and his wife to go to ICTC Centre for testing of their blood on 2.3.2009. On testing their blood it was found to be negative and the blood of the child was found to be HIV positive. Thereafter the baby was taken to S.C.B. Medical College & Hospital, Cuttack for collection of blood sample and the same was sent to M.K.C.G. Medical College, Berhampur for testing and also for CD 4 counting and the count was 1139 cells per M.M. on 17.3.2009. On 26.8.2009 Dr. Mohanty refused to operate the baby on the ground that there is no facility in Neelachal Hospital for operation of HIV positive patient.

As the parents’ blood test proved that they had no HIV infection, it was proved that the baby was infected with AIDS because of the blood transfused to him on being procured from the blood bank.

But, before the High Court, the State Government asserted that the blood supplied by the Blood Bank was screened for infectious diseases, specifically AIDS and was found negative. Where from the infection then came to the baby born to parents not at all infected with HIV positive?

The infection comes through (i) Unsafe sex, (ii) child born through HIV affected persons, (iii) through needles, and (iv) through blood transfusion.

The High Court determined that the baby being hardly 17 months old, he had no scope of infection from unsafe sex. His parents were not infected; hence infection through parents was ruled out. There was no possibility of infection through needles, as the hospital used only disposable needles to which the parents of the baby were witnesses. Thus the only cause of infection was the transfusion of infected blood.

How could then the HIV virus was not detected during screening of the blood? It was found that, blood screening in Orissa is not being done in Nuclear Antizen Test (NAT) or Polymer Chain Reaction (PCR) method, as a result of which, HIV virus is escaping detection.

As per medical science, the length of time following the infection of an individual to develop detectable antibodies is about three months after the infection. This is called the “Window Period”. The blood that Nayak received was certainly collected in this “Wndow Period”. NAT/PCR method could have detected the infection during the “Window Period”, but, as these methods are not in use in Orissa, the poor baby, for no fault of his own or of his parents, developed HIV positive.

“There is no provision in the State to identify virus during the Window Period. Unless special test known as Antizen Test is conducted through Polymer Chain Reaction (PCR) method, the virus cannot be identified during the Window Period i.e. during three months of infection. Therefore, the receipt given by the blood bank stating therein that the blood units are tested against HIV seems to be a myth” claimed Ms. Sujata Jena, Nayak’s lawyer in the High Court.

The Court has agreed with her and awarded cash compensation to the infected child, by making the following direction a must for the Government:

Needless to say that blood donated by one saves life of another. Donation of blood is a noble work. In order to achieve this avowed objective all necessary safeguards must be taken while collecting, testing, storing and supplying blood. Otherwise, instead of saving the life, the contaminated blood would take the life. It is not disputed that during window period, unless the special test known as Antizen test is conducted through Polymer Chain Reaction (PCR) method, the virus cannot be identified. Therefore, the Government must ensure that in all blood Banks the Polymer Chain Reaction (PCR) method is available to identify the virus of HIV during window period. We, further direct opposite party no.1-State to provide free medical treatment to the baby of the petitioner who is a HIV patient.

The judgment was delivered on 28 July 2011.

A year has elapsed. The State Government has not honored the judgment.

Infected blood is going on being transfused sans any check.

AIDS is admittedly menacingly spreading in the State.

Innumerable Nayaks are perishing.

The Government of Naveen Patnaik is so very busy in serving POSCO and the likes, that there is perhaps no time for it to read the High Court verdict even.

Any blood collected in camps and through campaigns such as of Ama Odisha may be HIV infected blood in “window Period”.

Everyone getting a transfusion is vulnerable to AIDS as recalcitrance of the government as discussed above is aiding to its spreading.

Will the High Court please take a note of it?