The past 15 years have seen extraordinary innovations in technology and informatics to transform diagnostics, but the Commission warns that the benefits are not shared equitably. The global market for in vitro diagnostics and diagnostic imaging is valued at US$843 billion. High-income countries dominate, and just four companies in the USA and Europe account for half of the global supply of in vitro diagnostics, while four companies from the USA, Europe and Japan account for three-quarters of the global supply of imaging equipment.
"The COVID-19 pandemic has illustrated the risks involved in relying on a small number of medical suppliers. Expanding the production of diagnostics by locating more research, development and production in low- and middle-income countries is a key priority," says Professor Susan Horton, Deputy co-Chair of the Commission, University of Waterloo (Canada) [1].
Other recommendations from the Commission include improving affordability, enhancing regulatory frameworks to oversee quality and safety of diagnostics, and democratizing diagnostics (increasing availability of point-of-care tests, self-sampling and self-testing).
Writing in a linked Comment, Dr Sabine Kleinert, Senior Executive Editor and Dr Richard Horton, Editor-in-Chief of The Lancet add: "Rapid lateral flow, PCR, and antigen tests for SARS-CoV-2 are discussed daily by politicians, journalists, and the public and available for home self-use or in public places, at least in many high-income countries. Genetic testing to identify SARS-CoV-2 variants early helps in monitoring the spread of the virus and informs vaccine strategies. This rapid need for diagnostic capacity and testing has also further increased inequity, shown the manufacturing and capability deficiencies in countries where it is needed most, and raised the ugly spectre of nationalism as a reaction to a global emergency...More attention to diagnostics as a fundamental element of health systems will not only help end the COVID-19 pandemic and strengthen preparedness to combat future pandemics, but will also be crucially important for general disease prevention, high-quality health care, and improved health outcomes globally."
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