Alice Street, Michelle Taylor, James Smith and Ian Harper » Diagnostics for Development
Having been left in the long grass for several years while donors, activists, governments and public health experts focused on the question of access to vital medicines, the issue of diagnosis is today at the very top of the global health agenda. The rise of diagnosis as a global health issue has tracked its reformulation into a question of access to diagnostic devices. A new wave of point of care, rapid detection, low-cost diagnostic devices has emerged as a multi-faceted solution to the poverty of laboratory infrastructures in resource poor settings, the high costs of treatment that follow from over-diagnosis, the burden of morbidity generated by diagnostic error and, increasingly, the imperative to monitor and evaluate the “impact” of globally funded public health programs. Tiny, modest-looking technologies, such as the new immunochromatographic rapid test for sleeping sickness that detects antibodies against Trypanosoma brucei gambiense in 15 minutes, are imbued with the promise of healthier, more economical and more equitable futures. Bilateral donors, philanthropic organisations, ministries of health, university researchers, and frontline health workers are all working hard to turn those promises into a reality.
But how much work can the diagnostic device itself do?