In a recent post I introduced the WHO’s draft of the Essential Diagnostics List (the EDL). The EDL is a catalog of in vitro diagnostics (IVD) designed to complement the Essential Medicines List. The EDL is not necessary meant to be a global list, but something to be adopted and adapted by each country, and tests added, subtracted, or prioritized based on each country’s disease burden. While the draft is still in development, at least one country is already on track to have adopted a country specific EDL by the end of the year!
India is working towards being the first country to have an EDL by the end of 2018. It so happens that the draft of the EDL was announced while India was in the process of rolling out a Free Diagnostics Initiative (FDI) in 29 of its states. The goal of the FDI is to “ensure the availability of a minimum set of diagnostics appropriate to the level of care to reduce out of pocket expenditure on diagnostics and to encourage appropriate treatment of based on accurate diagnosis”. Similar to the EDL, the FDI plans for different IVDs at different levels of laboratories, from community healthcare centers to reference laboratories. The development of an EDL seems like a natural product of India’s FDI. Talk about perfect timing!
The Indian Council on Medical Research (ICMR), comprised of clinicians, microbiologists, and medical device industry leaders, has convened to adapt the EDL to India’s infection patterns and diseases. They plan to have their national EDL ready to present by the beginning of 2019. The ICMR intends that an Indian EDL will optimize utilization of the Indian EML. “The objective is to test and treat rather than treat and test” states Dr. Kamina Walia of the ICMR. The ICMR also realizes that in order for diagnostics to be affordable, the country’s laboratory infrastructure will need to be strengthened, including building laboratory capacity where none currently exists.
It is so exciting to see the EDL already under consideration by a nation. It’s even more exciting to hear medical experts speak about how laboratory infrastructure should be strengthened, and to know that medical device industry leaders are coming to the table. It’s going to be fun to watch this develop over the next decade.
Do you want to be involved in the EDL project? There is time! The WHO is accepting applications for IVDs to be added to the second edition of the EDL, which will be released in 2019. The deadline for submissions is September 15, 2019. Instructions can be found here.
–Sarah Riley, PhD, DABCC, is an Assistant Professor of Pediatrics and Pathology and Immunology at Washington University in St. Louis School of Medicine. She is passionate about bringing the lab out of the basement and into the forefront of global health.