FM SEPTEMBER 2018 ISSUE - digital edition

public health
WHO RELEASES ESSENTIAL
DIAGNOSTICS LIST
The world body plans to update the list every year to ensure basic minimum
range of lab facilities in the public health system
DR SUMIT GHOSHAL
Several years ago, the World
Health Organisation (WHO)
published its List of Essential
Medicines, which most countries,
including India, adopted and modified
to create their own National List of
Essential Medicines (NLEM).
After lengthy deliberations that
began in March 2017, the WHO
has taken the initiative further and
published a model list which it has
named the Essential Diagnostics List
(EDL). The list has separate sections
for primary and secondary healthcare
establishments, and sub-sections for
disease-specific laboratory tests.
Thus, the general list in the primary
care section mentions commonly used
laboratory tests such as haemoglobin
estimation and WBC count, clinical
chemistry and immune-assays
including HbA1c and blood lactate
levels, while due emphasis is also given
to microbiology (blood and urine).
THE HIGHLIGHTS OF THE
SECOND SECTION OF THE
LIST ARE THE TESTS WHICH
SHOULD BE AVAILABLE IN
HEALTHCARE FACILITIES
WITH A GOOD CLINICAL
LABORATORY AT HAND.
In the disease-specific sub-section
are tests for HIV, hepatitis-B antigen,
antibodies to HCV as well as various
species of Plasmodium and a whole
range of tests to diagnose TB.
The highlights of the second
section of the list are the tests which
should be available in healthcare
facilities with a good clinical laboratory
at hand. Here the clinical chemistry
list incorporates AST-ALT, alkaline
phosphatase, serum pH value and
blood gases along with BUN-creatinine
and several others.
“The disease-specific IVDs (in vitro
diagnostic tests) were selected from
WHO evidence-based guidelines,
which are referred to in the EDL with
links to the respective documents. An
additional factor considered by WHO
80 / FUTURE MEDICINE / SEPTEMBER 2018