Antigen test for Covid-19: Policy tangled in red tape
The government's Covid-19 testing expansion policy has been caught up in a bureaucratic red tape, leaving many suspected coronavirus patients dependent on expensive and time-consuming RT-PCR testing for diagnosis of the disease.
A final draft of the policy, formulated months ago, suggests introducing antigen testing, but the authorities concerned have not yet approved it despite an extensive exercise involving different bodies of the health ministry for the last two months.
The final draft is now lying with the Directorate General of Health Services (DGHS).
Experts say the policy should have been approved on an urgent basis to boost the number of daily tests and allow suspected Covid-19 patients to avail the alternative testing facilities.
With a population of over 160 million, Bangladesh still conducts the lowest testing in the world with just 10,465 tests per one million people, according to www.worldometers.info.
India is testing 42,170 people per one million.
An antigen test reveals if a person is currently infected with a pathogen. Once the infection is gone, the antigen disappears. This test is considered highly accurate and can provide results in minutes.
RT-PCR, considered a gold-standard technology for Covid-19 detection, traces pieces of the coronavirus through analysing sputum or mucus samples collected from the human body -- nasal and throat.
"In a pandemic situation, the crucial thing is to make the right decision at the right time. We have limitations in PCR testing facilities. The decision of introducing an antigen test was a good one, but the way it was delayed is unacceptable," Muzaherul Huq, former regional advisor for South East Asia at World Health Organisation (WHO), told The Daily Star on Monday.
He said the government was delaying the process unnecessarily.
"Coordination between the [health] ministry and the DGHS is remarkable and observable. We all are seeing the lack of this coordination, which is putting people's lives at risk," he said.
The exercise of introducing the antigen test started in early July, but it is still going on.
Let's have a look at the process.
On July 5, Prof Nasima Sultana, additional director general of DGHS, sent a letter to the secretary of health services division, mentioning the urgency for forming a Covid-19 sample testing expansion policy.
In that letter, she mentioned that the DGHS had already prepared a draft policy and it could be approved with necessary guidelines on an emergency basis.
On July 7, the draft of the policy was submitted to the director general of DGHS.
The directorate sent the draft policy to the health ministry on July 9.
Later, the ministry formed a committee of experts to prepare a sample testing expansion policy. The committee finalised its report incorporating opinions on August 4 and sent it to the health services division of the ministry.
An official of the division said, "After submitting the report, the committee came up with a presentation on August 18."
After incorporating meeting opinions, the draft was submitted to the ministry on August 23, the official said, preferring anonymity.
On August 31, the health ministry sent a letter, signed by Bilkish Begum, deputy secretary of the ministry, to the DGHS, asking the DG to send the final draft of the policy to the health services division.
Contacted, Prof Abul Bashar Mohammad Khurshid Alam, director general of DGHS, told The Daily Star that they were working on it and would send it back soon to the ministry.
At the end of last month, Health Minister Zahid Maleque said the government was going to take an initiative to start rapid antigen testing in public Covid-19 labs to diagnose the coronavirus.
Officials at the ministry blamed the DGHS for delaying the process.
"The health services division wrote to the DGHS to send the proposal to the ministry officially," said an official, wishing not to be named.
"If we get the proposal today, we will approve it within a day or two without any delay," he added.
A senior official of the ministry said basically the ministry officials have to pursue the DGHS officials repeatedly to get any update.
Preferring anonymity, he said, "It is already 14 days but the ministry is yet to get any reply. Tell me who is responsible?"