The WHO publishes a new List of Basic Diagnostics and encourages countries to prioritize investment in testing

To address the lack of access to tests and testing services in multiple countries, the WHO has published an annual list of basic diagnostics (EDL) since 2018, a list of recommended in vitro diagnostics that should be available at the site of care and in laboratories in all countries to increase timely and rescue diagnoses.

The latest edition, published today, includes the COVID-19 tests recommended by the WHO (PCR and antigen), expands the package of tests for vaccines and infectious diseases and non-communicable diseases (such as cancer and diabetes) and introduces a section on endocrinology, which is important for reproductive and women’s health. The list includes tests for the first time that should not be delivered in countries, either because they are not cost-effective, unreliable, or have been surpassed by newer, easier-to-use technology.

‘Accessing quality tests and lab services is like having a good radar system that takes you where you need to go. Without it, fly blindly, ‘said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “All countries should pay special attention to the diagnostic area and use the baseline census to promote better health, protect the population and provide services to those at risk.”

The use of accurate, quality diagnostics is the first step in the development and implementation of treatment, control and, in many cases, disease and outbreak prevention strategies. Their critical role in the healthcare system is the current COVID-19 pandemic in focus.

‘Testing affects most medical decisions,’ said Dr Marângela Simão, WHO Assistant Director-General for Access to Medicines and Health Products. ‘In all countries, the use of appropriate diagnostic tests can help inform evidence-based treatment and responsible drug use, resulting in improved resource allocation and better health outcomes.’

EDL is an evidence-based guide that studies prevalence globally and recommends an appropriate test for each condition. These guidelines aim not only to improve the health system’s ability to achieve accurate diagnoses, but also saves valuable health resources that would otherwise be lost on inadequate treatment or prolonged hospital stays.

As well as tests intended for laboratory use, EDL recommends a number of diagnostics that should be available at the primary care or community level. This is particularly important for rural areas in low- and middle-income countries, where medical facilities and equipment may be lacking, and health care providers are often forced to make treatment decisions solely on the basis of patient symptoms.

The recommendations in the list are based on solid evidence and take into account the suitability of the country. The procedure is overseen by the Strategic Advisory Group of Experts on In Vitro Diagnostics (SAGE IVD), a group of experts from around the world with many years of experience in the field of IVD and their application, use, regulation and evaluation. Experts evaluate data on the usefulness, impact, and accuracy of each test to decide which one to recommend.

EDL is not prescribed – it is designed as a policy tool for countries to create their own national censuses based on their local context and needs. The WHO will soon publish a detailed guide for countries wishing to draw up a national census. So far, the WHO has worked with Nigeria, India, Bangladesh and Pakistan to support the development of its national EDLs, and is currently in talks with additional mostly African countries seeking assistance to strengthen their diagnostic services.