India may soon have an essential list of diagnostic tests along the lines of National List of Essential Medicines (NLEM).
According to the WHO, “essential medicines are those that satisfy the priority health care needs of the population and are intended to be available within the context of functioning health systems at all times in adequate amounts, in the appropriate dosage forms, with assured quality, and at a price the individual and the community can afford.”
Having a list of essential medicines helps to monitor the costs of medicines so that the medicines included are available at affordable costs. Appropriate use of medicines listed in the NLEM promotes rational use of drugs. And, rational use of antimicrobial drugs reduces development of antimicrobial resistance.
Similarly, a national list of essential diagnostic tests would have several advantages such as facilitating therapeutic decisions resulting in improved patient care, affordable tests, reduced out of pocket expenditure and also promote rational use of essential medicines. It would also mean better regulation of diagnostic tests. These tests may be available as either point of care tests or in laboratories.
Ideally speaking, there should be no discrimination of diagnostic tests as essential or non-essential. All tests are essential.
But, if there is to be an essential list of diagnostic tests, then the first priority should be on diagnostic tests for antimicrobial resistance (AMR), a subject of immense public health concern. An essential list of diagnostic tests can be a strategy to check the rising prevalence of AMR. Rapid and correct diagnosis of infections would permit right and more targeted treatment thereby reducing overuse and/or inappropriate use of antimicrobials and in turn, the risk of antimicrobial resistance. This list should be introduced immediately and the rest can wait the bureaucracy. AMR tests should either be made free of cost or their subsidized costs should be uniform across the country.