Essential Diagnostics: A Key Element of Universal Health Coverage

Abstract

Good primary care is an essential precondition for a decent healthcare system. In fact, primary health care is at the heart of Universal Health Coverage (UHC). UHC, in turn, is critical to achieve the sustainable development goals. While access to essential medicines is explicit in UHC, access to essential diagnostics has received little attention. In May 2018, the World Health Organization (WHO) published the first Essential Diagnostics List (EDL), and declared its commitment to give equal importance to diagnostic tests and essential medicines. The EDL has been positively received by a variety of stakeholders, including industry. The EDL offers countries a benchmark that they can use to measure and improve diagnostic services, and preliminary data from India show limited access to essential tests at the primary care level. Some countries, notably India, have already begun developing National EDLs (NEDLs). Hopefully, such national efforts will enable the implementation of EDLs, and improve access to diagnostics. It is time for Low-and Middle-Income Countries (LMICs) to not only increase coverage of health care, but also improve quality of care. Access to essential tests is the first key step in improving quality of care.

Essential in-vitro laboratory diagnostic services provision in accordance with the WHO standards in Guragae zone primary health care unit level, South Ethiopia

“…Diagnosis is the first critical step to offer quality healthcare and to contain emergencies. Although the WHO essential diagnostic lists (EDL) is a critical step in the right direction, the impact of the EDL will be enhanced when countries adopt the EDL to their own national needs and put in place mechanisms to implement the EDL [26]. WHO published the first EDL in May 2018 [27], it defines essential diagnostics as those that satisfy the priority health care needs of the population and are selected with due regard to disease prevalence and public health relevance.…”

Point of care tests for invasive fungal infections: a blueprint for increasing availability in Africa

“… 73 , 74 The EDL will translate to real access to the tests contained only when country governments adopt it, adapt it to the prevailing local disease prevalence, and implement it. 75 To date, only India has developed a national EDL, while a few other countries such as Nigeria, Bangladesh, and Pakistan have begun work with WHO to develop their national EDLs. 76 It is imperative that more African countries follow suit.…”

Measuring and improving the quality of tuberculosis care: A framework and implications from the Lancet Global Health Commission

“…A heavy reliance on outdated diagnostic technologies also contributes to misdiagnoses: many countries continue to rely on often inaccurate smear microscopy [20], [21]. In turn, health systems must ensure patient safety, appropriate prevention and detection, case notification, timely treatment, and continuous and integrated of care.…”