Another example that comes to mind about the region not being all that it seems, was some research I did about 10 years ago. I needed to establish the demand and usage for CD4 lab tests. CD4 tests are tests that measure your T helper cells. They are used when you are treating HIV positive patients, in tracking the recovery of their immune systems. Officially Saudi Arabia claims HIV prevalence in the Kingdom at 0.1%, one of the lowest in the world. This is a measure of the % of the population who are HIV positive. The Saudi authorities will claim this population is almost exclusively made up of unfortunate organ transplant patients receiving infected foreign organs or people who were exposed to contaminated US blood products in the early 1980s (virtually all of these patients will be dead 30+ years now), and not people who are homosexuals, drug users or use prostitutes, because officially, none of that exists in Saudi Arabia. Now I could take that number, and use that to start estimating how many of these people will require treatment, and from that, the level of testing required to monitor their health. Saudi labs largely operate to UK standards (the entire lab system was basically set up by the British). But I could also speak directly to lab managers, and they told me. And then when you look at the amount of CD4 testing that was going on, scale it up for all the labs capable of doing that testing, you realise the actual number of people being treated for HIV infection is much more than can be, based on official statistics. So the prevalence rate must be much higher.
