Access to the Right Diagnostics

Poverty-related diseases cause a huge burden on global health, yet there is still a serious lack of understanding of many of these diseases. The use of high-quality diagnostics at the point-of-care can provide a wealth of epidemiological data that is fundamental to the development and implementation of strategies for treatment, control, and ultimately prevention. To date, access to reliable and affordable diagnostic testing remains illusive in low- and middle-income countries.

Most diagnostic tests for poverty-related diseases that are currently available require access to a clinical laboratory with sophisticated technologies and equipment, and are too expensive. Samples need to be shipped to the laboratory and availability of test results often takes much too long. Many of the rapid diagnostic tests that can be used outside the laboratory, at the point-of-care, do not meet the necessary quality standards to be reliable in the environment where they are most needed. In a rural setting where medical facilities and equipment are lacking or at best very basic. the healthcare providers are often forced to make treatment decisions based solely on the basis of clinical symptoms. With many poverty-related diseases having similar of overlapping symptoms, this is challenging at the best of times, and can have a serious impact on patient's lives.

While diagnostic testing accounts for only a few percent of global healthcare spending they impact the majority of medical decisions. Especially in many low- and middle-income countries where the healthcare systems are still in development and resources are limited, the use of proper diagnostics can help direct evidence-based treatment and rational use of medicines. resulting in improved allocation of resources and funding.

All newly-developed point-of-care diagnostics should meet the ASSURED criteria defined by the WHO.

• Affordable by those at risk of infection
• Sensitive with very few false-negatives
• Specific with very few false-positives
• User-friendly tests that are simple to perform and require minimal training
• Rapid, to enable treatment at first visit, and Robust: for example not requiring refrigerated storage
• Equipment-free
• Delivered to those who need it

and in the increasingly digital world of today, data generated should be linked to enhance follow-up care and public health studies which will improve epidemiological insights to direct further improvement of healthcare.

But these goals, as of yet, remain illusive!