November 17, 2016 |

Friday Think: Could the next big idea in global health be a list?

A list of essential diagnostics could ensure all countries have tools to provide early diagnosis and identify outbreaks.
A gloved hand holds an unused Ov16 diagnostic device for onchocerciasis (river blindness).
Health workers use the SD BIOLINE Onchocerciasis IgG4 Rapid Test for diagnosing if people have been exposed to the parasite that causes river blindness. Photo: PATH/Will Boase.

A quick swab of the mouth or prick of the finger. In just a few minutes, a doctor can tell if a patient has an infection or if the sample must be sent to a lab to deliver results within days. It’s a routine occurrence in doctors’ offices across high-income countries every day. But in many low- and middle-income countries, health care providers don’t have access to the diagnostic tools they need, either because existing tests are too costly and not appropriate for low-resource settings, or because the test doesn’t yet exist for that disease.

The impact can be devastating: a wrong diagnosis can lead to the wrong treatment or a failure to recognize a disease with epidemic potential.

In a recent commentary in the New England Journal of Medicine, a group of diagnostic experts have suggested an innovative idea to improve global access to diagnostic tools: create a list.

More specifically, they’re calling for the creation of an essential diagnostics list, to complement the World Health Organization’s (WHO’s) Model List of Essential Medicines (EML), which would detail the vital diagnostic tests that should be available in each country depending on its burden of disease. In short: these lists would support one another, complementing and amplifying existing global health efforts.

Two professors—Drs. Lee Schroeder and Timothy Amukele—sum this up in The Conversation op-ed,Africa has an essential medicines list. Now it needs one for diagnostics”:

The list of essential diagnostic tests would mean medicines on the essential medicines list could be used in a safer and more rational way. Crafting the diagnostics list to complement these essential medicines addresses the disease priorities that have been identified by the Model List of Essential Medicines.

The essential diagnostics list would be tailored to local burdens of disease in the same way that the Model List of Essential Medicines is designed to be individualised by Ministries of Health.

For over 40 years, the EML has helped countries identify the minimum medicine needs to deliver basic health care services to their populations. The authors believe an essential diagnostic list could do the same for diagnostics. They also believe a list could encourage governments to make broader improvements to health systems to support diagnosis, as well as spur new diagnostic research and development by exposing areas where we lack appropriate and effective tools.

The end result would be a health system where people were more accurately diagnosed and treated, where disease outbreaks could be identified earlier, and diagnostic tests performed according to a high standard.

Earlier this week, PATH and other Global Health Technologies Coalition members sent a letter to WHO urging the organization to spearhead the creation of an essential diagnostic list.

“We’re excited to support the call for an essential diagnostics list. It’s an innovative, cost-effective idea that could advance diagnostic access,” said Carolyn Reynolds, vice president of Policy and Advocacy at PATH. “When we hear the word innovation, we often think about the next big drug or device; yet this idea shows how innovative policy ideas can also help bring health within reach for everyone.”

To learn more about the proposal for an essential diagnostics list, read the full article in The ConversationFriday Think is an occasional series on PATH blog.

During the week we scour the news for the hottest stories on innovation. Our feature, Friday Think, highlights one we’ve found particularly fascinating.

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  • Marissa Chmiola is a communications officer with the Advocacy and Public Policy Program at PATH.