This critical need for significant improvements in Pathology and Laboratory Medicine services has been highlighted by Professor Mark Lawler, from the School of Medicine, Dentistry and Biomedical Sciences at Queen's University Belfast, together with other international experts.
‘Lack of access to adequate pathology is one of the critical gaps in health systems in between poor countries and rich countries. There is an urgent need for nations to recognize this or else the gap will only widen the disparities between these countries.’
Speaking from New York, Professor Lawler said: Pathology and Laboratory Medicine are the tools we use to ensure accurate, early diagnosis of disease, make timely decisions on therapeutic interventions and assess the success of those treatments. If we don't have good quality pathology services, we risk the lives of hundreds and thousands of people in limited resource settings".
The expert lead by Professor Lawler published a series of eight recommendations, which if implemented would help deliver modern, high-quality affordable Pathology and Laboratory Medicine services in low and middle-income countries by 2030.
"In Europe or the USA, we take for granted that if you see your doctor with symptoms of liver disease, you will be diagnosed based on a blood test, and given the correct treatment. Similarly, we wouldn't dream of diagnosing breast cancer without performing a biopsy. But, in far too many countries around the world, diagnosis and treatment can be based on no more than a good guess." said, Lancet Series Lead Dr. Kenneth Fleming.
The Research presented in the Lancet Series brings out the critical gaps in low and middle-income countries which are the insufficient availability of pathologists; inadequate education and training; poor infrastructure and a lack of quality assurance.
"There is an urgent need for nations to recognize that lack of access to adequate pathology is a critical gap in health systems in resource-limited settings; without immediate and sustained intervention, this gap will only widen disparities between poor countries and rich countries," said Dr. Shahin Sayed, Aga Khan University Hospital.
"Exciting developments in Point of Care Testing (POCT) and molecular technologies are lessening requirements for sophisticated laboratory equipment and specialist laboratory skills in resource-limited settings, thus facilitating rapid test results so that patients are screened and treated on the same day. However, while POCT can allow low and middle-income countries to bypass or "leapfrog" poorly functioning laboratory systems, it must only be provided as part of an overarching National Laboratory Strategic Plan. Unregulated, inaccurate, POCT will only worsen the situation - so Look before You Leapfrog." said Professor Lawler who is senior author on Paper 3 in the series. He also believes that New technologies can significantly enhance service delivery if used appropriately.
"Economic studies are essential to determine whether POCT is affordable, cost-effective, and an appropriate component of a well-functioning system in resource-limited settings. New diagnostic tests will be most relevant if they and their accompanying new treatments are within the financial reach of patients in low and middle-income countries", said Professor Sue Horton, University of Waterloo, Canada.
"This landmark series in the Lancet, one of the most prestigious medical journals in the world, highlights the role that Queen's is playing in driving improvements in health at a global level and resonates strongly with our One Health Agenda." said
Professor Chris Elliott, Pro Vice-Chancellor, Faculty of Medicine Health and Life Sciences at Queen's.
"Working with partners in low and middle-income countries represents a key way in which Queen's can bring its valuable expertise to bear in addressing truly global challenges that affect people's lives," said Professor Richard English, Pro Vice Chancellor for Internationalisation and Engagement at Queen's.
"The time to act is now. Addressing our recommendations and ensuring immediate investments in Pathology and Laboratory Medicine represent the most impactful approach to deliver better healthcare to low and middle-income countries and save hundreds of thousands of lives," added Professor Lawler