Making diagnostic tests as essential as medicines

The World Health Organization (WHO) has launched the first edition of the Model List of Essential in vitro Diagnostics (EDL),1 an initiative that we hope will prove to be as important as the launch of Essential Medicines List 45 years ago. The global health community has focused on access to health products for prevention (vaccines) and treatment (medicines) over the last 20 years, but despite the consequences of underdiagnosis and misdiagnosis (including mistreatment, health complications and costly unnecessary interventions), there has been very little focus in the global health dialogue to date on access to appropriate diagnostic tests to ensure appropriate treatment. In high-income countries, tests are generally available through clinical laboratories but in low-income and middle-income settings, these services are not accessible, so more focus needs to be on reliable tests for community settings. It is clear that without quality-assured diagnostic tests, the practice of medicine is blind and curable conditions may not be treated. As one example, hepatitis C virus (HCV) affects an estimated 71 million people worldwide, but it is estimated that only 20% have been diagnosed.2 It can be cured with a 3-month course of treatment that now is affordable in many low-income and middle-income countries and that can be given in community settings. Yet in many countries, testing for hepatitis Cis …