Chioma Umeha
Following its Advisory meeting in April 2018, the
World Health Organisation (WHO) has issued its first listing of Essential
Diagnostics. The list is split into general laboratory tests (n= 58) and
specific tests for key infections (HIV. TB, hepatitis, syphilis and human
papilloma virus) (n=55). It is also split into sections relating to testing in
primary care settings versus hospital laboratory settings.
With respect to fungal diseases and mycology,
several key tests are included: microscopy, blood culture, other cultures and
cryptococcal antigen test. These provide a good start for a mycology service.
Four levels of clinical setting and laboratory
services are mentioned from primary care point of care testing, through
district hospitals with laboratories, to regional and specialized hospitals and
laboratories and finally national reference laboratories. All tests are not
appropriate for all settings, either because of complexity or because of the
need to deliver results fast.
The WHO will issue a call for proposals each year
to incorporate additional tests. They will base such applications on need and
on the evidence supporting the clinical value of each test.
Professor David Denning of the University of
Manchester and President of the Global Action Fund for Fungal Infections
declared: ‘This is an excellent first step by the WHO in ensuring that ill
people can have a proper diagnostic evaluation, which for fungal infections is
critically important. GAFFI engaged with the WHO ahead of the Advisory meeting
and is pleased that some of the key tests required for fungal disease have been
included, and that the door is open for more on an annual basis.’
Professor David Denning giving his welcome speech at the Essential Diagnostics for
Advanced HIV and Serious Fungal Diseases workshop in April at Hotel Africana,
Kampala, Uganda
In June 2016, Lee F. Schroeder, Jeannette Guarner,
Ali Elbireer, Philip E. Castle, and Timothy K. Amukele published a call to the
WHO for a Model List of Essential Diagnostics1. In March 2017, the WHO Expert
Committee on Selection and Use of Essential Medicines recommended the
development of a Model List of Essential In Vitro Diagnostics (EDL), to
complement the WHO Model List of Essential Medicines (EML). The announcement
today is the product of this announcement and plan.
