For the first time in its history, the World Health Organization (WHO) has released an essential diagnostic exam list, meant to focus on common and priority healthcare concerns. Designating these tests as essential encourages primary healthcare facilities that might not provide adequate diagnostic exams to update their practice.
WHO’s Essential Diagnostic Exams
The list primarily focuses on a collection on in-vitro diagnostic exams (tests that focus on human specimens such as urine and blood), featuring 113 different products that enable the quick and effective diagnosis of various healthcare issues. The first 58 are meant to detect and diagnose common conditions, forming a foundation for patient management and screening. These tests include measurements of liver enzymes, blood sugar, white and red blood cells, and tests meant for one-time events such as pregnancy. The remaining 55 products focus on what the WHO considers “priority” diseases — for instance malaria, HIV and tuberculosis.
The construction of this list mirrors WHO’s revolutionary 1977 “Essential Medicines” list, which revolutionized how access to medicine was perceived. The list’s global reach fostered the idea that certain “essential” medicines were so necessary that they should be widely available, regardless of monetary resources.
Many of the tests listed on the diagnostic exam list are acceptable for primary healthcare facilities in less affluent areas, where diagnostic tests are often poorly resourced or even non-existent. This tool inevitably provides those who might otherwise not have access to these exams accurate diagnosis and more effective treatment.
Boosting Efficient Treatment in Impoverished Populations
Accessible diagnostic exams are particularly necessary for impoverished, rural communities that suffer from exposure to high levels of said “priority” diseases. According to the Center for Disease Control and Prevention, approximately 445,000 people died from malaria in 2016, the majority of which were sub-Saharan African children – diagnostic tests that can detect and diagnose children for acute malaria do not require electricity or trained personnel to be safe and accurate.
Limiting the spread of infectious, “priority” diseases is impossible without an accurate diagnosis, as accurate diagnosis ensures the fastest and most effective treatment (preventative or otherwise). Although increasing levels of poverty favor the spread of infectious disease, educating both the public and healthcare facilities of the necessity of certain diagnostic tests ensures the development of programs that can prevent infectious disease transmission.
In the case of malaria, the introduction of rapid diagnostic tests — such as those featured on WHO’s list — significantly increased disease surveillance data. Accurate data collection enables healthcare workers and researchers to discern an approximate number of malaria cases, as well as follow trends related to the disease over time. Such findings decrease the risk of either over or under diagnosis, and enable communities to prepare effectively for disease control.
Equipping the Vulnerable
The term “diagnostic exam” refers to any test used to accumulate clinical information with the intention of diagnosis (formulating a clinical decision), including both in-vitro tests and physical ones such as x-rays and ultrasounds. There are more than 40,00 different diagnostic exams available to doctors and patients, covering a plethora of medical conditions. Diagnostic exams account for a small portion of healthcare expenditure, only 2.3 percent in the U.S. and 1.4 percent in Germany, however, they impact approximately 70 percent of all healthcare decisions.
In the future, WHO hopes to add a “devices” category to their essential diagnostic exams list focusing on diagnostic equipment, including automated blood analyzers, fiber-optic scopes and CT scanners. The WHO hopes that the list will serve as a tool that will benefit even the most vulnerable within society, and help all countries effectively concentrate their funds on essential tests.