End of wrong treatment? ICMR’s bid to provide quality diagnosis

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Published: December 15, 2018 5:50:32 PM

In order to ensure quality diagnosis at all levels of healthcare facilities, the ICMR has articulated a new list of essential diagnostics.

The new draft is on the lines of the essential medicines list.

Today, many people are unable to get tested for diseases because they cannot access diagnostic services while many others are incorrectly diagnosed, leading to a situation where they do not receive the required treatment or even the wrong treatment. In order to ensure quality diagnosis at all levels of healthcare facilities, the Indian Council of Medical Research (ICMR) has articulated a new list of essential diagnostics. The new draft is on the lines of the essential medicines list and is scientifically designed.

The draft list, which has been put out for consultation, is based on the WHO’s list of essential diagnostics for key areas like HIV and Hepatitis and takes into account the priority areas of non-communicable diseases and diseases prone to outbreaks such as dengue, Hindustan Times reported quoting senior ICMR scientist Dr Kamini Walia as saying. ICMR cannot fix the prices of the tests as it is not an implementing agency.

If the draft diagnostic list figured into consideration by a committee which is in the process of developing a new national medicine list for 2018, the prices will be regulated under the Drug Price Control Order, 2013, according to Central Drugs Standard Control Organisation (CDSCO), India’s apex drug regulator.

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This committee has a wider mandate to include certain devices and products, like sanitary napkins, in addition to carrying out the routine work of updating the medicine list. The task is carried out once every three years.

The first-ever draft list of essential diagnostics comprises of as many as 130 general laboratory tests and 26 disease-specific tests, which includes tests for HIV, hepatitis, dengue, and malaria.

In the backdrop of preparing the draft diagnostics list, two national-level consultations of stakeholders and a consultation with device manufacturers were held this year.

Earlier this year, WHO had published its first-ever essential diagnostics list which is a catalogue of the tests needed to diagnose the most common conditions as well as a number of global priority diseases.

On similar lines to the WHO Essential Medicines List, which has been in use for four decades now, the Essential Diagnostics List is intended to serve as a reference for the country to update or develop its own list of essential diagnostics. It seeks to ensure appropriate and quality-assured supplies, training of health care workers and safe use for the benefit of patients.

Diagnostic tests at village-level

Pregnancy tests, blood-sugar monitoring, malaria, urine albumin to detect kidney disease, blood sugar tests for diabetes and test for filaria, a parasitic disease that causes swelling of lymph nodes. These tests will be performed by an ASHA worker, Auxiliary Nurse Midwife or other health workers.

Diagnostic tests at community health centres

The draft list contains specialised tests like fine-needle aspiration cytology for detecting cancerous lumps.

Diagnostic tests at district-level

The Pulmonary Function Test, which is primarily conducted to identify the severity of pulmonary impairment, has also been included as an essential test at district hospitals. Also, diagnostic tests to detect eye diseases have been included at this level. The draft list, however, does not contain any of the essential diagnostic tests for tertiary care and medical college hospitals in the country.

ICMR scientist Dr Walia said that primary and secondary level care were in focus while preparing the draft list in line with the government’s policies.

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