The World Health Organisation has made universal health coverage its primary area of focus. According to Professor Madhukar Pai, Director of Global Health Programmes, McGill University, Canada, the first WHO list of essential tests to improve diagnosis is extremely timely.
“We can’t deliver universal health coverage without diagnosing common conditions. Also, essential medicines alone are not enough, we need essential diagnostics to maximise the impact of essential medicines,” Pai, who is among the 19 experts of WHO’s Strategic Advisory Group of Experts (SAGE) on in-vitro diagnostics, told The Indian Express through email.
Pai hoped that India would adopt the WHO’s Essential Diagnostics List (EDL), and soon publish its own national EDL. “This can then be used to ensure price controls and improve availability, affordability and quality of tests included in the national EDL,” he said.
Many people are unable to get tested for diseases because of lack of access to diagnostic services. Several are incorrectly diagnosed and, hence, do not receive the treatment they need. For instance, an estimated 46 per cent of adults worldwide with Type 2 diabetes are undiagnosed, risking serious health complications. Late diagnosis of infectious diseases such as HIV and TB increases the risk of spreading and makes the conditions more difficult to treat. To address the gap, the WHO published its first EDL, a catalogue of tests needed to diagnose common conditions as well as a number of global priority diseases. WHO Director-General Dr Tedros Adhanom Ghebreyesus said in a statement that an accurate diagnosis was the first step towards receiving effective treatment. The list, which concentrates on in-vitro tests (tests on blood and urine), contains 113 test, of which 58 are listed for detection and diagnosis of a wide range of common conditions, and the remaining 55 designed for detection, diagnosis and monitoring of priority diseases including, HIV, TB, malaria, and hepatitis B and C.
Some tests are suitable for primary healthcare facilities, which often lack laboratories — for instance, tests to diagnose a child for acute malaria, or glucometers for testing diabetes. These tests do not require electricity or trained personnel.
The EDL was developed following an extensive consultation within the WHO. The draft list was considered for review by WHO’s Strategic Advisory Group, Pai said. This list is dynamic and will be updated on a regular basis. It can work as a reference for countries to update and develop their own list, he added.