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The Political Science of RDT kits procurement in Nepal

When any seemingly bizarre decision is made by Politicians, most of the time it is either for the love of adventurism or love of their own self. If a decision seems inevitable, we hardly learn to discern the true disposition of the leaders involved in that decision making. So a bizarre decision will give more insight into the inner working of the decision makers. In another words, one would not need any anatomy class to figure out the routes of complex nerves winding up in the brain of those in question. By the end of this write up, you might learn some obvious but pragmatic approach of Political Science which runs in high fashion during the state of emergencies.  

As the world is strong arming against the coronavirus, Nepal too followed the example and enforced an adverse but a necessary lockdown. However, we have an issue of contention that will form most part of our discussion. It is the question of why the Government of Nepal has kept procuring substandard RDT kits repeatedly despite numerous calls from health experts to ditch the RDT kits in favor of the PCR based testing kits. Here, I will not be digging into the science of microbiology to weigh advantages of PCR over RDT, instead I will try to give a glimpse of the world of Political arbitrariness.

In early April, the first batch of RDT kits arrived from China and no sooner it landed, a huge controversy rocked the nation. The Omni group was accused of procuring goods at exorbitant rates. Though government announced a cancellation of the contract, 75000 RDT kits were bound to be acquired for the use. As the issue of quality of RDT kits were raised by the experts, the Ministry of Health and Population (MoHP) informed that the RDT kits acquired from the Omni group will be first assessed for its quality before being put to use. The assessment was to be done by the National Health Research Council but after a couple of days the Cabinet approved the use of the RDT kits without waiting for any assessment report. This was a surprising development given the Ministry’s own dictate to assess the kits for its quality.

We will reserve questions for the later part. Let us uncover more details of the procurement. The Omni group bought the RDT kits from Guangzhou Wondfo Biotech co. ltd, a Chinese company. There is another interesting fact. The RDT kits produced by this Chinese company have not been approved by the Chinese government for the use. Therefore we can safely assume that the kits were severely substandard.

For now I would refrain myself from making any statement which may seem to arise purely out of my prejudices against the Government. Therefore I will continue with facts for some more paragraphs. It is important that we look at the approach other countries have taken on the use of RDT kits. In India, RDT kits were procured from China in huge quantities but the tests conducted with RDT were extremely inaccurate. The Indian Government proceeded to ban the use of RDT kits and continue with only PCR tests. The UK government in a bid to curb the unrestrained spread of the virus, decided to use RDT kits bought from the Chinese companies and that too failed to accurately detect the presence of virus. With it the UK government decided to stall the use of those kits.

However, even with numerous confirmed reports of the high inaccuracy of the RDT tests, the Government of Nepal has not budged in its endeavor to buy more RDT kits. Even when the government’s health expert have shown grave concerns, there has not been slight inclination to ditch the faulty RDT kits and of those PCR kits in use, most of them were received in donation. The Swiss Government and the Indian Government each donated about 30,000 PCR based test kits whereas some other countries also contributed in aiding the supply of PCR based test kits albeit in smaller amount. So it’s time we start asking questions.

Why the Government of Nepal chose to use the RDT kits which were not approved for the use in the country of its origin? Why was the contract awarded to a company which had a murky past record? Why is the Government not heeding to their own health expert’s advice? Why when the RDT kits has been ruled out of use in other countries, the Government of Nepal has refused to learn anything from them?

When we add all the facts, it is indubitable that there is no way the Government of Nepal lacks knowledge of the inefficacy of the RDT kits. Therefore, the attempt to buy the RDT kits is plain deliberate. This raises another question. Why to deliberately buy RDT kits when your own health experts deem it to be detrimental to the effort to contain the virus? To this question there are two possible answers.

The first possible case is that the Politicians running the Government have spent hours doing research of their own and that they have come up with an ingenuous way to detect the Coronavirus cases using only RDT kits and that the findings need to be kept confidential in-order to avoid wrath of multi-national companies manufacturing PCR based test kits. Given the expertise of our Politicians in the field of Microbiology and the recent data on RDT tests, this possibility is highly unlikely. The odds of happening this is so minuscule that I think I am the only one to have ever given a thought to it.

The next possibility is of massive financial irregularities. The unwritten rule of commission has driven the procurement deals of the Government for a long time. Any company offering a higher percentage per unit of procured material is likely to be awarded the contract. The substandard RDT kits producer has to have a market to sell them and as their quality is far below the approved standards, they have to “work harder” to seal the deal.  More it becomes hard for the producer of substandard goods, more gains lurk in for the decision makers. Hence, the choices are made not in the interest of the cause they are supposed to fight for but for the team which forms part of the deal. That might explain why there is a deliberate attempt to buy RDT kits despite the contrary opinion of the experts.

I will weigh more on the second possibility as it doesn’t require any microbiological research activity on part of the Politicians. The arbitrary nature has gripped the decision making in the form of “fast track procedures” to award a contract to a company for the procurement. The state of emergency has also played its part. Without a state of emergency, it would have been extremely difficult to justify the act.  The Politics of emergencies contains this inevitable latent part. To get away with any latent quality is always tough because it’s harder to detect it in the first place let alone deal with it.

The Ministry of Health and Population (MoPH) in its “Health Sector Emergency Response Plan” for the Coronavirus pandemic has explicitly mentioned that if Nepal reaches a confirmed cases of beyond 10000, the existing health system would not be able to manage the pandemic and that Nepal would require International Humanitarian Assistance.  The cases are increasing and it is quite possible that we might reach that number soon if not acted on scientific advice. If the leaders fail to take the steps so earnestly requested to take, the responsibility of all the adversity faced by the people should completely befall upon them. Therefore it is imperative that we start holding them accountable when we can and avert a disaster. 

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