ICMR Initiates Revision of National Essential Diagnostics List

The ICMR document highlights that the list has been integral to the Free Diagnostic Service Initiative (FDSI) of the National Health Mission (NHM) since 2019.

In a significant stride towards fortifying public health, the Indian Council of Medical Research (ICMR), India's apex body for biomedical research, has initiated the revision process for the National Essential Diagnostics List (NEDL). India is the first country to release the NEDL.

The ICMR has issued a public call for suggestions to finalise the revised list by February 29, 2024.

This comprehensive catalogue outlines the minimum number of diagnostic tests that should be available at various levels of healthcare facilities, ranging from village-level setups to district hospitals. The revision process aims to enhance the effectiveness of the list in addressing the evolving healthcare landscape.

NEDL Transforming Healthcare Facilities

Introduced in 2019, the NEDL is a critical tool for India's healthcare system. It encompasses general laboratory tests for a spectrum of common conditions, aiding in diagnosing both communicable and non-communicable diseases.

Additionally, it includes disease-specific tests for major health concerns such as HIV, hepatitis, tuberculosis, dengue, malaria, and area-endemic diseases. The list also covers essential imaging tests like X-rays, computerised tomography scans, magnetic resonance imaging scans, and ultrasound sonography.

Essential diagnostic tests, as per the NEDL, are those that fulfil the priority healthcare needs of the population. These tests are selected based on disease prevalence, public health relevance, evidence of efficacy and accuracy, and comparative cost-effectiveness.

The focus is on conditions with a high disease burden or significant public health relevance, where introducing a diagnostic test can have a tangible impact on disease diagnosis and management.

Since 2018, the World Health Organisation (WHO) has advocated for developing and implementing National Essential Diagnostics Lists to ensure the availability of In-Vitro Diagnostics (IVDs) across various healthcare facilities. India's NEDL was crafted by considering disease burden data across states, aligning with national programs.

The ICMR document highlights that the list has been integral to the Free Diagnostic Service Initiative (FDSI) of the National Health Mission (NHM) since 2019.

It emphasises that the initial NEDL was formulated based on disease burden data, with consideration given to workforce, infrastructure, and logistical support at each health facility in line with Indian Public Health Standards (IPHS) guidelines.

ICMR's Call for Stakeholder Input

Given the time elapsed since the release of the first NEDL in 2019, the ICMR is actively seeking suggestions for revising the existing list. Stakeholders are encouraged to propose additions or deletions of diagnostic tests.

The criteria for proposing additional tests include assessing the essentiality of the test, disease burden, alignment with Indian Public Health Standards (IPHS) 2022, and suggestions for including point-of-care tests. Additionally, any diagnostics suggested for addition should have obtained the necessary regulatory approvals.

While the initiative aims to fortify healthcare delivery in India, there remains uncertainty regarding whether the finalisation of the NEDL will result in price capping for diagnostic tests, similar to the approach taken for drugs.

The ICMR's invitation for suggestions is part of a broader effort to ensure that diagnostics remain integral to healthcare delivery in the country.

This move comes at a juncture when India's healthcare sector acknowledges the potential of AI, which is slowly making its way into medical tourism.

The recent 'Heal in India' initiative underscores the government's commitment to leverage the potential of health tourism, aligning with global advancements in healthcare technology.

As the NEDL undergoes a revision, the healthcare landscape in India anticipates positive transformations that will further strengthen the nation's public health infrastructure.