Having spent more than $2 billion buying hundreds of millions of rapid antigen tests at the height of the pandemic, Australian states and territories are now having to decide what to do with what's left over, including millions which will expire soon.
In total, state and territory governments purchased at least 518 million rapid antigen tests over the last year —or enough for each Australian to be given about 22.
Leading the way was Victoria, which ordered 210 million tests in total, but Western Australia bought the most on a per-person basis with its 110 million tests equating to 41 for every Sandgroper.
Victoria came in second place, with 32 RATs per person, behind New South Wales and the Northern Territory, with 18.
The ACT had enough for 14 each, while Queensland ordered just seven for each resident.
Despite giving away the most per person – 26 each – WA still has the largest amount left in its stockpile on a per capita basis.
Queensland distributed fewest RATs
But it is Queensland which has given away the smallest proportion of its original order, with around 65 per cent of the RATs it ordered still in storage.
It also has the largest proportion of its original order soon to expire, with nine per cent – or 3,470,000 RATs – either already thrown out, or due to expire in the next three months.
"Queensland Health is actively managing the expiry risk of RATs and is exploring several distribution strategies to minimise avoidable expiry and disposal risks," a spokesperson said.
"This includes donations of self-administered RATs to the not-for-profit and other non-government sector organisations.
"Queensland Health is also exploring avenues with the Therapeutic Goods Administration regarding extending the shelf-life of RATs."
It said "all possible avenues" were being explored to recycle expired tests.
Tests due to expire
WA is in second place by that metric, with 70,000 tests expired and another 2,040,000 expiring by the end of March.
The state government said around 132,000 tests were given away in October, 1.3 million in November, and 3.2 million in December – as WA prepared for what was expected to be a Christmas-induced COVID wave.
“WA Health is exploring sustainable options for the potential recycling or disposal of expired RATs,” a government spokesperson said.
South Australia and New South Wales did not say how many tests each had been distributed or held in storage.
WA Nationals MP Martin Aldridge has previously questioned how many RATs the WA government purchased, and said it was an area that needed to be reviewed.
"I understand the need to move quickly, but to spend $600 million with very little oversight, effectively the Department of Health went on an internet shopping frenzy trying to procure as many RATs as they could as quickly as they could," he said.
"Now they may have had the greatest of intentions, but there does need to be some scrutiny of the transaction.
"Rather than continue to shovel these things out the door, I think the government should be considering either opportunities to resell them, or indeed provide them to other countries such as Indonesia who have been struggling with the disease in their community."
The state government said it had already donated 10,000 tests to Nauru and 5,000 to Indonesia.
Professor of international health at Curtin University Jaya Dantas said while a good idea in theory, many developing countries were not interested in accepting donations because their populations were not testing for the virus.
'A frightening period'
Mr Aldridge also pointed to comments made during budget estimates last year, when the government admitted there was "no methodology" behind its decision to order 110 million tests, saying the aim was to get as many as possible.
"We ordered a lot, but you don't know how many you're going to need … it was a pretty frightening and dramatic period," Premier Mark McGowan explained last week.
"There was massive concern that we wouldn't have enough."
"And we saw around the world, essentially industries and businesses and people staying home and the whole thing closing because they didn't have RATs for people to test with, so we made sure we had enough."
Professor Dantas said it was understandable how Australia ended up with so many tests.
"When the RAT program was being rolled out across the country, what was not sure by the Health Departments was how much we would need," she said.
"So we know that as a contingency, we went in and ordered a lot more than we needed."
Call for more free tests to be given away
WA is continuing to hand out free RATs at pop-ups in shopping centres and at large events.
But University of Melbourne School of Population and Global Health head Nancy Baxter said for much of the rest of the country, tests were not reaching the right people because only certain groups were eligible for free tests.
"Having tests freely available to people would make it easier for people to manage the risk of COVID and to prevent spreading it," she said.
"People will use them more if they're free, so much better to get them in the hands of people that can use them to manage risk than to have them just expire on a shelf."
Professor Baxter pointed to Canada, where free tests are handed out to everyone through many grocery stores and pharmacies.
Another suggestion is to offer surplus tests to developing countries, although Professor Dantas said with low testing rates in many places, the RATs might still not get used.
RAT distribution red flags
WA's approach to buying RATs is likely to be probed as part of a review into its management of COVID.
The state's Auditor General, Caroline Spencer, has also raised concerns over how the tests have been managed by government departments.
RATs were ordered by two different parts of government – 86 million by WA Health and 24 million by the Department of Finance.
In reviewing both organisations' finances for the 2021-22 financial year, Auditor General Caroline Spencer gave what's known as a "qualified opinion on controls".
She found "significant weaknesses in controls over inventory specifically relating to the receiving, recording and distribution" in both.
"These weaknesses could result in the [misappropriation] of inventory and the misstatement of inventory balances on financial statements," she wrote.
In a statement, a Department of Finance spokesperson said its procurement of RATs was an "urgent government initiative" at a time when "a quick response was needed" to make tests available.
"The Auditor General identified some weaknesses in the Department's controls over inventory management of RATs, but importantly they did not identify any instances of [misappropriation] or material misstatement," she said.
"It is also important to note that this did not impact negatively on the delivery of the program to the community.
"Finance is reviewing its RATs inventory management and distribution process to identify where improvements to future programs of this nature could be made, and will provide the updated process to the Office of the Auditor General for review as part of the next annual audit."
A spokesperson for Health Support Services, which ordered tests for WA Health, also pointed out that the Auditor General did not identify any instances of irregularities in its RAT inventory balances.
"Following the [Auditor General's] audit, HSS completed all end-of-year stocktake activities as planned and continues to implement improved inventory management practices for RATs, including regular stock takes and cycle counting," they said.
