TAG: GS 2: GOVERNANCE; GS 3: SCIENCE AND TECHNOLOGY
THE CONTEXT: The Indian Council of Medical Research (ICMR) has invited suggestions for the revision of the National Essential Diagnostics List (NEDL) by February 29, 2024.
This move aims to optimize the availability of essential diagnostic tests across all tiers of healthcare facilities in India.
NATIONAL ESSENTIAL DIAGNOSTICS LIST (NEDL)
- ORIGIN: Inception started with release of essential diagnostics list (EDL) by World Health Organisation.
- WHO LIST: WHO released first edition of essential diagnostics list (EDL) in May, 2018.
- INDIA’S NEDL: India became the first country in 2019 to compile such a list to make the availability of diagnostics an essential component of the healthcare system.
- Even though WHO’s EDL acts as a reference point for development of national EDL, India’s diagnostics list has been customised and prepared as per landscape of India’s health care priorities.
- DEFINITION: Essential diagnostic tests are defined as those “that satisfy the priority healthcare needs of the population and are selected with due regard to disease prevalence and public health relevance, evidence of efficacy and accuracy, and comparative cost-effectiveness”.
- DIAGNOSTIC SERVICES INCLUDED: The list includes general laboratory tests for a broad range of common conditions for the diagnosis of communicable and non-communicable diseases, disease-specific tests for HIV, hepatitis, tuberculosis, dengue, malaria, and area-endemic diseases, and imaging tests such as X-rays, computerised tomography scans, magnetic resonance imaging scans, and ultrasound sonography.
IMPORTANCE OF NEDL
- Essential Medicine List (EML): Ensuring the availability of high-quality diagnostics is essential for the optimal utilization of the Essential Medicine List (EML).
- Sustainable Development Goal (SDG) 3.8 – Universal Health Coverage (UHC): NEDL is a crucial component in working towards achieving SDG 3.8, which aims at Universal Health Coverage.
- Enhanced Healthcare Delivery: NEDL’s implementation is anticipated to elevate healthcare delivery by promoting evidence-based care, resulting in better patient outcomes and reduced out-of-pocket expenditures.
- Utilization of Public Health Facilities: NEDL is expected to facilitate the effective use of public health facilities.
- Disease Surveillance and Outbreak Identification: The list will contribute to the effective assessment of disease burden, trends, surveillance, and prompt identification of outbreaks.
- Addressing Antimicrobial Resistance: NEDL plays a role in tackling the challenge of antimicrobial resistance.
- Standardization of Technology/Diagnostic Services: Implementation of NEDL will standardize technology and diagnostic services.
- Promotion of Research and Development (R&D): The initiative will encourage R&D for new, appropriate, and effective diagnostics, potentially leading to cost reductions.
NEED FOR REVISITING THE LIST
DEMAND OF THE TIME: India’s NEDL was based on consideration of the disease burden data across different states of the country, in alignment with the national programmes. Since a considerable time has elapsed following the release of the first NEDL in 2019, the ICMR has invited suggestions for the revision of the existing list, that is, the addition or deletion of diagnostic tests, from all relevant stakeholders.
FACOTRS TO CONSIDER NOW:
- ICMR has now asked stakeholders to consider factors such as how essential a test is, the disease burden, and the alignment with Indian public health standards before proposing any additional tests to the existing list.
- Essentiality of the test: It defined essential diagnostic tests as those that satisfy the priority health care needs of the population and are selected with due regard to disease prevalence and public health relevance, evidence of efficacy and accuracy, and comparative cost-effectiveness.
- Disease burden: The test should focus on conditions with a high disease burden or having significant public health relevance, where the introduction of a diagnostic test will have a clear impact on disease diagnosis and management.
- Alignment with Indian Public Health Standards (IPHS) 2022: It should have a documented use and necessity at the level for which it is suggested, and any proposed addition should align with the availability of equipment, infrastructure and manpower, as per the Indian Public Health Standards, 2022.
- NEW ADDITIONS IN DIAGNOSTICS NEEDED: Suggestions for the inclusion of point-of-care tests are encouraged, and the diagnostics suggested for addition should have obtained the necessary regulatory approvals.