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A few districts in Tamil Nadu are running short of HIV test kits once again, causing concern among government doctors and public health personnel. The problem, which has emerged time and time again in recent years, is running critical HIV screening activities into difficulties, particularly for high-risk individuals and pregnant women.
Inconsistent supply shortages and unpreparedness
In spite of previous experience, the state has not yet put in place a surefire backup plan to deal with these supply bottlenecks. Sources identify the National AIDS Control Organization (NACO) as the primary supplier of test kits. But when there are delays, Tamil Nadu does not have a standard mechanism to deal with shortages.
A government source called for a twin-track approach.
"The primary objective is focused testing of high-risk groups and antenatal women. The ultimate goal is to screen the general population for HIV and sexually transmitted infections. So, we can meet the testing needs of high-risk groups through NACO’s supply; and the State Health Department, along with Tamil Nadu State AIDS Control Society (TANSACS), should put in place a mechanism to ensure availability of kits for the general population,” an official source said.
Influence on regular testing and hospital practice
The HIV prevalence among adults in Tamil Nadu is 0.20% in the age group 15-49. This necessitates active and mass testing, not just for high-risk groups but also for regular screening in public health care facilities.
In some districts, health workers have been instructed to save available test kits only for high-risk groups. Expectant mothers are still being tested at PHCs, but as a result of shortages, their partners are being referred to bigger government hospitals.
"Now, due to a shortage of kits, tests are done only for pregnant women in PHCs, and their spouses are referred to the government hospitals. We were told that oral instructions had been issued to the chief medical officers of the GHs to procure the required kits using the Chief Minister’s Comprehensive Health Insurance Scheme funds or make local purchases due to the shortage of kits,” said a doctor in a northern district to The Hindu.
Surgery without screening? A Risky Situation
Hospitals, particularly government medical colleges and district hospitals, are also in the squeeze. District AIDS Prevention and Control Units' dual test kits are being given priority for use in antenatal care. Meanwhile, elective surgeries, particularly general and orthopedic ones, are being postponed or are being conducted without HIV testing when kits are in short supply.
"The most affected are government hospitals and government medical college hospitals. The reason is that we screen patients who are taken up for general and orthopaedic surgeries. Now, if hospital administrators do not get kits through CMCHIS funds, surgeries could be performed without screening, thereby putting the surgical team at risk. This shortage surfaces now and then, and some hospitals have already spent a significant amount from the CMCHIS fund to procure kits to screen spouses of pregnant women and those undergoing surgeries. In fact, contact tracing (of those who test positive) has been left in the lurch for almost six months in some places,” said another government doctor.
Time for a permanent fix
Tamil Nadu's health workers are advocating for a systemic response to prevent such shortages from recurring. Critics argue that instead of relying on temporary district-level solutions or providing stopgap directions, a unified state-level action plan will ensure ongoing HIV screening, which is essential for public health protection and disease prevention.
(Input from various sources)
(Rehash/Muhammad Faisal Arshad/MSM)
