In a move that will have a positive impact on improving access to diagnostic services in developing countries such as India, the WHO has released its first Essential Diagnostics List. Most developing countries have an essential medicines list, but not a similar one on diagnostics.
Many people are unable to get tested for several diseases because of the lack of essential diagnostics services. At times, this leads to incorrect diagnosis, and, consequently, either wrong treatment or a lack of treatment, according to the global health organisation. For instance, according to the WHO, an estimated 46 per cent of adults with Type-2 diabetes worldwide are undiagnosed, risking serious health complications and higher health costs.
Late diagnosis of infectious diseases such as HIV and tuberculosis increases the risk of spreading of the infection, and making them more difficult to treat.
The WHO's first Essential Diagnostics List—a catalogue of the tests needed to diagnose the most common conditions as well as a number of global priority diseases—aims to address this gap. Similar to the WHO's Essential Medicines List, which has been in use for four decades, the Essential Diagnostics List will serve as a reference for countries to update or develop their own list of essential diagnostics.
“An accurate diagnosis is the first step to getting effective treatment,” Dr Tedros Adhanom Ghebreyesus, WHO director-general, said in a statement released to global mediapersons. “No one should suffer or die because of a lack of diagnostic services, or because the right tests were not available.”
The list concentrates on in-vitro (in-laboratory) tests, that is, tests of specimens such as the blood and urine. It contains 113 tests; of these, 58 tests are listed for detection and diagnosis of a wide range of common conditions, providing an essential package that can form the basis for screening and management of patients. The rest of the 55 tests are designed for detection, diagnosis and monitoring of “priority” diseases such as HIV, tuberculosis, malaria, hepatitis B and C, human papillomavirus and syphilis.
Some of the tests are particularly suitable for primary healthcare facilities—that would have huge relevance in India, where the government is planning to ramp up its primary healthcare facilities—that often have poorly resourced, or, at times, non-existent laboratory services.
For instance, the WHO cites tests that can rapidly diagnose a child for acute malaria or glucometers to test diabetes. These tests do not require electricity or trained personnel, WHO said. Other tests are more sophisticated and therefore intended for larger medical facilities.
“Our aim is to provide a tool that can be useful to all countries to test and treat better, but also to use health funds more efficiently by concentrating on the truly essential tests,” said Mariângela Simão, WHO assistant director-general for Access to Medicines, Vaccines and Pharmaceuticals. “Our other goal is to signal to countries and developers that the tests in the list must be of good quality, safe and affordable.”
The WHO will also update the list regularly and expand it significantly over the next few years to include antimicrobial resistance, emerging pathogens, neglected tropical diseases and additional non-communicable diseases.