Reading for 11/11

"Requirements for High Impact Diagnostics in the Developing World" highlights the need for accurate, practical diagnostic tests for several widespread diseases, particularly in sub-Saharan Africa. While diagnostic tests may seem like a secondary priority to direct treatment, I was struck by the estimates based on modeling that predicted the number of lives saved by early, consistent diagnosis of various diseases. Further more, from an economic and health resources perspective, the level to which early diagnostic tests in developing countries could save later treatment costs is really significant. The authors predict that an accurate, widely used test for malaria in febrile young children could prevent 447 million unnecessary treatments per year, a number that represents a significant burden on health care services. Because health care systems in many developing countries, particularly in sub-Saharan Africa, are already so under-resourced, the burden of cost and services relieved by diagnostic testing would have a very significant impact on health care systems. Furthermore, diseases such as TB, STI's, and HIV/AIDS have been shown to exhibit correlations, and thus any reduction in the prevalence or later development of any one of these diseases could positively impact the treatment and prevention of the others. e.g. because STI's increase the risk for HIV infection, early diagnosis and thus treatment of STI's could reduce HIV incidence rates.

According to the authors' discussion, one of the greatest obstacles facing the development of effective diagnostic tests is the need for tests that can be used with limited laboratory facilities in developing countries. Thus the development of these tests and the strengthening of health care infrastructures, especially in rural areas, go hand in hand. As health care systems and facilities get stronger, diagnostic tests will be more accessible. The authors also discuss the issue of intellectual property and patent rights towards the end of the article. Although this may be somewhat unrealistic, I believe patent rights should be waved or partially bypassed in cases such as this, where the pooling of information could lead to more rapid development of high impact diagnostic tests for the developing world.