How diagnostics plays an important role in countries with poor access to healthcare

By Narendra Varde,

The goal of Universal Health Coverage is to ensure that every individual is able to obtain essential health care services without suffering financial ruin. While India pledged to meet this goal, we are still far from achieving it. It’s estimated that roughly 50 million households fall into poverty each year because of out of pocket health care expenses and lost wages.

The need for a publicly financed national healthcare system guaranteeing healthcare access to every Indian is not a novel idea. The desire was even expressed in the Bhore committee report, dating back to 1946! So, why is the goal of healthcare for all still so elusive 75 years later? Aside from the obvious problems of a post-colonial emerging democracy, there has been a fundamental flaw in our outlook towards healthcare. We tend to view healthcare access and services as an infrastructural problem, policy issue, or public-private investment issue. In doing so, we overlook the basic premise of universal healthcare – that equal access to quality healthcare is a basic human right.

A key requirement to improving healthcare access is the creation of a robust and efficient healthcare system that is not just geared towards disease treatment, but also has a strong focus on preventive care. This depends on awareness, immunizations, and most importantly, diagnostics.

A case in point would be India’s reduction of new HIV infections by 17% and AIDS-related deaths by 56% . This has been accomplished through government initiatives aimed at early diagnosis, enabling treatment and other measures that can reduce the transmission and burden of the disease. The achieved this through public-private partnership (PPP) between National Aids Control Organization (NACO) and private lab testing service providers such as Metropolis, and global technological partners such as Roche.

However, in general, the use of diagnostics remains poor across the country. For example, India is home to 27% of the world’s ‘missing’ TB patients – patients who are undiagnosed, improperly diagnosed, or inadequately treated, increasing the risk of transmission .

Another example, it is estimated that there are 96,922 new cervical cancer cases and 60,078 deaths annually in India. The incidence and mortality rates are 14.7 per lakh and 9.2 per lakh women, respectively, although the incidence varies within Indian population. Cervical cancer is treatable, if diagnosed at early stage through accurate and highly sensitive diagnostic testing solutions.

Although the impact of inadequate diagnosis should be evident from such figures, the role of diagnostics has only been given due recognition in recent years, with the World Health Organization publishing its first Essential Diagnostics List just three years ago! Nevertheless, this was a step in the right direction and the landscape has been further transformed by the COVID-19 pandemic realizing the importance of in vitro diagnostics for better patient management. From having just, a single lab to test for COVID-19 in Jan 2020, there were 2288 labs established by the year’s end, even in far-flung regions like Ladakh, Nagaland, and Lakshadweep. Government has established diagnostic laboratory services for other conditions in 33 states and union territories, thereby improving access.

This increased focus on diagnostics reflects an encouraging mindset change of both public and private stakeholders in the Indian healthcare sector. The Indian government has proposed an investment of 15,000 crore INR into the sector to upgrade its capacity and there is increased advocacy from stakeholders for appropriate policymaking and investment in the sector. Industry also witnessed some positive developments with MNCs and international pharma brands creating social business models aiming to widen healthcare access, adding both economic and social value, further driving innovation in the sector.

The challenge now for industry will be to shift the conversation from the value of diagnostics in managing COVID-19, to a broader conversation about the value of diagnostics in tackling bigger healthcare challenges. To keep the momentum there is a need to accelerate the role of diagnosis by aligning the Centre and States with key policies and jointly encourage them to achieve a common objective. This will improve the quality of diagnostic testing and higher output of skilled lab technicians to address the shortfall of roughly 35% of qualified lab technicians at India’s Public Health Centre Labs. We need to encourage the support from government, keep diagnostics in the public eye, and leverage the voice of clinicians that want better access to new technology. Communications and engagement will therefore be critical.

Lastly, we must recognise healthcare as a basic human right, and focus more on the critical role of diagnostics, augment lab capacities, encourage use of home-based testing solutions and its access to the last mile strata of the society.

(The author is Managing Director, Roche Diagnostics India and Neighbouring Market. Views or opinions represented in this article are personal and belong solely to the author and do not reflect the official position or policy of the Financial Express Online.)