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. Not all tests are appropriate for all settings, either due to complexity or 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.”
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.
1. Schroeder LF, Guarner J, Elbireer A, Castle PE, Amukele TK. Time for a Model List of Essential Diagnostics. N Engl J Med. 2016 Jun;374(26) 2511-2514.