A synthesis report from FP Analytics with support from Roche
In taking stock of lessons learned since the COVID-19 pandemic, policymakers, civil society, global health experts, and the broader public have gained a new appreciation for the critical role that diagnostics play in ensuring global health security. Public health convenings and committees are increasingly focusing on the need for improved diagnostic accuracy and access, with the Lancet Commission on Diagnostics publishing a milestone report in 2021, which found that 47 percent of the global population—largely in lower- and middle-income countries (LMICs)—lack access to diagnostics. Seeking to address this significant gap, in May 2023, the World Health Assembly (WHA) adopted a resolution on diagnostics, encouraging governments and the private sector to invest in strengthening workforces, improving laboratory infrastructure, bolstering supply chain resilience, and increasing quality assurance in pursuit of global health goals, including the UN Sustainable Development Goals (SDGs).
Building on the international momentum around diagnostics, and recognizing that a wide range of stakeholders, from government agencies to the private sector, to civil society organizations and non-governmental organizations (NGOs), will be key to implementing this new resolution, FP Analytics partnered with Roche to hold a series of three convenings on diagnostics throughout 2023. The first two—held alongside the WHA and UN General Assembly (UNGA), respectively—highlighted the centrality of diagnostics in the early detection and treatment of communicable and non-communicable diseases (NCDs), and identified key investments and partnerships necessary to strengthen diagnostic capacity.
The third event—a roundtable discussion convened in November 2023—brought together experts from across global health, including NGOs, academia, private companies, and representatives from regional associations, to identify concrete steps toward realizing the goals laid out in the WHA resolution, and discuss how multi-stakeholder collaboration can catalyze action toward these goals. The discussion served as an opportunity for diagnostics experts to exchange views on the complexities of diagnostic systems, identify the obstacles preventing increased access to high-quality, affordable diagnostics, and find common ground on which to move forward and support the WHO, other multilateral institutions, and governments as they implement the resolution. While the roundtable took place under Chatham House rule, key takeaways and learnings are synthesized here.
Diagnostics are vital to sustainable, resilient global, regional, and national health systems, but their value is not widely recognized
Diagnostics are critical to the creation and maintenance of resilient, sustainable health systems. Indeed, it is almost impossible to treat an ailment that has not been identified and diagnosed, and this fact is true for individuals as well as across national, regional, and global populations. In addition to the central role that testing played in understanding and mitigating the spread of COVID-19, diagnostics remain key to the achievement of SDGs, including those related to HIV/AIDS, tuberculosis, and non-communicable diseases (NCDs) such as cancer and diabetes. Diagnostics are critical to enabling early intervention and treatment, and supporting a better understanding of the overall health of populations. Moreover, diagnostics facilitate the efficient deployment of resources, helping to prevent the inappropriate prescription of antibiotics that can lead to antimicrobial resistance (AMR) and so-called “superbugs,” reducing waste, and facilitating strategic use of often limited funds.
Despite these benefits, one major obstacle to prioritizing diagnostics within national healthcare systems is a lack of clear understanding of the value they confer. In particular, it can be challenging to communicate the return on investment of diagnostics due to the role of testing within the overall patient journey, which may depend on the cost and impact of the subsequent treatment administered. Clear demonstration of the value of specific diagnostic interventions can assist ministers of health and finance in setting strategic priorities, and can be facilitated by closing significant data gaps, pursuing innovative research, and producing informative and evidence-based analysis.
Improving access to diagnostics requires multi-level, multi-stakeholder collaboration
As noted in the recent UN Declaration on universal health coverage, improving access to diagnostics, particularly for the least resourced and most remote communities, requires whole-of-society strategies and collaboration. Implementing contextually relevant, mutually reinforcing policies at the global, regional, national, and local levels will be critical to close gaps in access to diagnostics, requiring a shared vision for multi-level, multi-stakeholder, cross-sectoral cooperation.
At the global level, this may involve strengthening global supply chains to remove bottlenecks and launching action-oriented investment and partnerships between the private health sector and multilateral institutions such as the WHO and the World Bank. To that end, identifying and establishing a shared understanding on global, regional, and national priorities for diagnostics procurement and financing will be key. Indeed, the local level is especially important for implementation. Many LMICs are prioritizing investments in primary healthcare, and thus ensuring that health workers are able to access, utilize, and interpret diagnostic tests will be crucial to integrating accurate diagnostics into all levels of the healthcare system. Multi-stakeholder collaboration and exchange of knowledge is also essential to achieve and sustain impact locally. For example, multinational companies and manufacturers of diagnostic tests and inputs can support activities on the ground by putting their end-to-end organizational capabilities at the service of other stakeholders to ensure a consistent supply of necessary equipment and goods. In support of such partnerships, dialogues and participatory processes involving grassroots healthcare workers can help these companies better understand what the healthcare workforce requires from their medical and testing infrastructure, and where they may benefit from training and education. At each level of policymaking and investment, open dialogue and collaboration will help to inform a shared vision and set of goals to support the effective expansion of access to diagnostics.
Building a unified vision for diagnostics, and catalyzing implementation of the WHA resolution
Diagnostics have remained under-recognized as a crucial component of resilient health systems due to fragmented messaging from relevant stakeholders across the global healthcare eco-system. This disjointed messaging can undermine the strength and clarity of communication around diagnostics, but the WHA resolution represents a new opportunity to find common ground and speak with a more unified voice on this issue. Creating spaces for health actors to gather and share ideas, knowledge, and expertise will be crucial, including through specific convenings to leverage the expertise of all stakeholders in the global diagnostics ecosystem, providing each actor with the avenues to bring their knowledge to the table. As momentum around the goals of the resolution builds, and as the global community moves ever closer to the 2030 deadline for the UN SDGs, cross-sectoral collaboration at all levels will be pivotal to increasing access to accurate, affordable diagnostics. Capitalizing on the opportunities presented by the WHA resolution could change the trajectory of global health, if public, private, and non-governmental stakeholders are able to work together toward this common goal.
By Isabel Schmidt (Senior Policy and Research Analyst). This synthesis report was produced by FP Analytics, the independent research division of The FP Group, with support from Roche. FP Analytics retained control of this report. Foreign Policy’s editorial team was not involved in the creation of this content.