Nigeria becomes first Africa country to get Essential Diagnostic List

Nigeria has become the first African country to get Essential Diagnostic List (EDL), after about four decades since the existence of the Essential Medicines List (EML).

The EDL will enable Nigeria address the lack of access to tests and testing services.

The Minister of Health, Dr Osagie Ehanire, at the National Flag off and Dissemination of the Nigerian Essential List on Monday in Abuja, said that over the past few years, there has been increased recognition of the importance of diagnostic testing in healthcare, and especially in achieving the goal of Universal Health Coverage (UHC).

Quoting official sources, our correspondent reports that accurate and affordable diagnostics are central to effective health care, as quality diagnostics, when made available as part of healthcare services, influence disease diagnosis and treatment outcomes in patients and improve disease surveillance.

Experts say that poor investment in diagnostics, especially in low- and middle-income countries, has translated into high out-of-pocket expenses on diagnostics.

To address the lack of access to tests and testing services in multiple countries, the World Health Organisation (WHO), since 2018, has published a yearly essential diagnostics list (EDL), a basket of recommended in vitro diagnostics that should be available at point-of-care and in laboratories in all countries to increase timely and life-saving diagnoses.

Ehanire added that, until recently, there have been few strategic efforts designed to develop the evidence base on which policymakers can rationally increase and improve access to diagnostic testing.

“To this end, after about four decades since the existence of the EML, WHO has seen the need to develop an Essential Diagnostics List (EDL).”

The Minister, who was represented by Dr Abolanle Alonge, Head of Dentistry Division of the Federal Ministry of Health, said the commitment was reflected in the 2016 revised National Health Policy whose theme is “Promoting the Health of Nigerians to Accelerate Socio-economic Development”.

He said: “I am pleased to inform you that Nigeria is the first country to develop its Essential Diagnostics List in Africa and second in the world following India. This shows the great interest of this government in the improvement of health indices for the country.

“This first edition of the National Essential Diagnostics List (NEDL) is a guidance document needed to prioritize critical health in-vitro diagnostics (IVDs), based on wide availability and affordability through the national health system. It will support the selection, procurement, supply, donations, or provision of IVDs.

“After about four decades following the development of EML, the World Health Organization developed the Essential Diagnostics List (EDL) to provide evidence-based guidance to countries to create their national lists of essential diagnostic tests and tools, anticipating that the EDL will complement the List of Essential Medicines and enhance its impact.

“Similarly, the EDL is anticipated to improve patient’s care, in-country diagnostic capacity, affordability of tests, regulation, and quality of diagnostic tests, and capabilities of national laboratories.

“The WHO EDL is intended to provide evidence-based guidance to countries to create their national lists of essential diagnostic tests and tools.

“National essential medicines lists have been successful in facilitating access to treatment and promoting affordable prices, particularly in low resource countries, by prioritizing the most important medicines all countries need to make available to their populations.

“Diagnostics List as this occasion marks another giant stride towards achieving the core mandate of the Federal Ministry of Health “to develop and implement policies to strengthen the national health system for effective, efficient, accessible and affordable delivery of health services in partnership with relevant stakeholders”.

Ehanire said to ensure nationwide implementation of this important document, the ministry has also ensured the approval of this guidance document at the Emergency meeting of the National Council on Health.

“By this, all states in the Federation are encouraged to implement the use of the document in addressing needs and situations.

“The NEDL enlists 145 diagnostic test categories comprising 65 general IVDs to aid the diagnosis of a range of disease conditions; 73 disease-specific IVDs in clinical settings covering primary, secondary, tertiary, and national reference laboratories and seven lVDs for screening of blood donations.”

“It also includes 12 general IVDs and 15 disease-specific IVDs for use in community and health settings without laboratories,” he said.

He further stated that the Nigerian Laboratory sub-sector has experienced some gains in recent times, such as the improvement of in-country capacity for molecular testing leveraging on COVID-19 response and interventions, optimization of Gene Xpert platforms for molecular testing, and improved finance for health.

“As a government, we will continue to provide enabling environment to ensure successful implementation of the policies and guidance documents.

“We also encourage counterparts from the sub-National levels (State and local governments) and even the private sector to key in and leverage the National Essential Diagnostics List as it holds great benefits for Nigerians.

“I must acknowledge commitment and input from numerous Partners, especially WHO and the Global Fund, towards the development of this document and also thank the leadership of the National Laboratory Technical Working Group for providing guidance.

“It is my sincere hope that the implementation of the EDL will contribute to achieving the goal of the government under the leadership of President Muhammadu Buhari, to make quality healthcare accessible to Nigerians,” he explained.

In his goodwill message, the WHO Country Representative, Dr Walter Kazadi Mulombo said the Nigerian Essential Diagnostic List (NEDL) would benefit healthcare facilities across the country.

“The use of quality diagnostics as you are all aware is the first step in the strategies for treatment, control, and prevention of disease outbreaks, of which the COVID-19 pandemic has brought into focus this important role,” he said.

Mulombo, who was represented by Dr. Alexander Chinbaru, Public Health Emergency Advisory of WHO, said that, following increased recognition of the importance of diagnostic testing in healthcare, particularly as it plays a major role towards achieving UHC, WHO developed an EDL to address the lack of access to tests and testing services in many countries.

According to him, “The WHO Essential Diagnostic List which was first published in 2018, is a list of recommended in-vitro diagnostics that should be available at point of care and is intended as a guidance document for countries to create their national list based on their local context and needs.

“The overall goal of the EDL is to improve access to testing, diagnostic capacities during outbreaks, affordability of test, regulation, and quality of the diagnostic test. The National Essential Diagnostic List is anticipated to complement and enhance the impact of the Essential Medicines List (EML) which has recorded great improvement in the availability and affordability of medicines and quality of patient management.

“I, therefore, congratulate the Honorable Minister of Health on this important achievement as Nigeria joins the list of the first countries, including India, Bangladesh and Pakistan, that have adopted the WHO concept of Essential Diagnostic List and have produced one that is aligned to the disease prevalence in their countries.

“I encourage all the States and health facilities to use the National Essential Diagnostic List as this will not only improve the health system capacity to reach accurate diagnosis but will also save heath resources wasted on inappropriate treatment and a long stay in the hospital,” he explained.

Our correspondent reports that the WHO has worked with Nigeria, India, Bangladesh, and Pakistan to support the development of their national EDLs and is currently in discussions with many African countries that have requested assistance to boost their diagnostic services.