Wrong HIV results are dangerous, traumatic and scandalous, but who’s accountable?

By Dr Leslie Ramsammy

The Health Ministry and its subject Minister have confirmed that at least eight women were incorrectly diagnosed with HIV. This is a dangerous development and can negatively impact on the fight against HIV and AIDS in our country. The muddling of test results must have been traumatic for families. Given Guyana’s very robust and successful fight against HIV, this scandal weakens our ability to fight the disease and brings disrepute to Guyana’s leadership role in the fight against HIV.

Dr George Norton was very supportive during my tenure as Health Minister. In turn, I wish him well in the onerous responsibilities he has been given. I have noticed much that troubles me in the health sector since the new Government took over. Yet, I have remained quiet, and I have given Dr Norton the space he needs to make sure health continues to improve in our country. As much as I wish him well, I want to see good for all Guyanese and this Ministry is one that could ensure better lives for all.

I stand ready to be of help to Dr Norton and his Ministry. To serve the people, the Health Ministry must not become a political football, but should remain an area where we should be able to work together in solidarity. If we cannot work together in health, how can we work for national unity? It is in this spirit that I am not using the scandal of wrong HIV test results to attack the Minister or the Government.

The HIV test results fiasco is an example, however, of how we must demand better answers and ensure mechanisms are in place to prevent this kind of scandal from ever happening. Reading Dr Norton’s explanation is enough to tell me that he is being badly advised and even misled. For the Minister to find out from the media that eight women were wrongly given HIV positive test results is unforgiveable. Even more troubling is that his junior minister and senior managers knew about the fiasco and didn’t inform him, assuming that Dr Norton, indeed, found out from the media.

According to Dr Norton, the wrong test results are not because of inaccurate testing, but are due to a mix-up of result reports. He has been advised that the HIV results for a number of persons were batched and the reports were then given out to the wrong women.

The problem is, if eight women who were negative received HIV positive results because of mixing up of results, then another eight who are positive would have also wrongfully received negative test results. Thus, there are probably sixteen and not eight wrong results handed out, if in fact testing was accurate, but wrongly distributed. If the testing was accurate and the problem was a mixing up of results, then the number of test results should not change, but just that persons would have received wrong results.

The Minister has been made a fool of. In his place I would have been livid and would have seriously reprimanded my officers. Such scandals impact on how confident people are in the system. If the media hadn’t questioned the Minister, would this scandal have simply been swept under the mat?

Those who were in charge should be made accountable. The protocols that are in place for testing, particularly HIV testing, should have prevented this kind of mix-up. Dr Norton explained that the protocol was changed. If that is so, then who changed the protocol and who authorised it?

Technicians and technical officers in their quest for improved performances and for better systems do introduce changes in protocols from time to time. However, these must be approved by the Minister, but was he ever asked to do so? These processes are well established at the Ministry and I had hands-on knowledge of them, as I played a leading role in developing many of them.

Guyana’s testing and reporting protocols were developed and approved by international organisations like the US CDC, PAHO/WHO and UNAIDS. They were designed to prevent wrong results and distribution of wrong results.

Observing and examining what were told by the Ministry tells me that there’s a cover-up and the Minister is being made to look foolish and incompetent. I, therefore, urge the Minister to get down to the truth and hold the people accountable, lest this is repeated and worsened.

Indeed, this isn’t the first instance in the last several months of wrong results being given to persons, which means that something is actually wrong with the testing itself or the competency of those who are conducting the tests. But it reveals that a porous system that allows wrong results to reach all the way to consumers has become a part of the system. It demonstrates that the protocols have been weakened because the established protocol would have prevented such wrong results.

Guyana has a successful HIV Program. We are leaders in the fight against HIV. Many of the global objectives were articulated in Guyana’s strategy since 2001. It was Guyana that boldly came forward in 2001 and announced universal access to Anti-retroviral treatment when globally it was thought impossible. It was Guyana which announced in 2001 the end of mother-to-child transmission (MTCT) of HIV by 2015 and Guyana has reached this stage. It was Guyana that insisted on early treatment for HIV positive people, from diagnosis, rather than waiting on reduction of CD4. Today these are global targets.

With our proven leadership in the fight against HIV, the scandal of wrong HIV test results, given the careful and vigilant system we developed in the past, can only hurt us as a country. It weakens our overall programme and it hurts our leadership role in the regional and global fight against HIV.