Hundreds of thousands of lives could be saved from disease in low and middle income countries according to an academic from Queen’s University Belfast.

Professor Mark Lawler, from the School of Medicine, Dentistry and Biomedical Sciences at Queen’s University Belfast, together with other international experts, has highlighted the critical need for significant improvements in Pathology and Laboratory Medicine services and infrastructure to drive better quality healthcare for the billions of citizens worldwide who are living in resource-limited settings.

Speaking from New York, where the Lancet Series on Pathology and Laboratory Medicine in Low- and Middle-Income Countries was being launched, 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 resource limited settings”

The expert group published a series of eight recommendations, which if implemented would deliver modern high quality affordable Pathology and Laboratory Medicine services in low and middle income countries by 2030. They also issued a “Call to Action” for all stakeholders to come together in a Global Alliance to ensure timely implementation of their recommendations. 

Lancet Series Lead Dr Kenneth Fleming, University of Oxford, UK, and National Cancer Institute, USA said: “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.”                                                                                           

Research presented in the Lancet Series highlights the key critical gaps in low and middle income countries: insufficient pathologists; inadequate education and training; poor infrastructure and a lack of quality assurance.

Dr Shahin Sayed, Aga Khan University Hospital, Nairobi, Kenya and Secretary General of the College of Pathologists of East Central and Southern Africa said: “There is an urgent need for nations to recognise 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.”

New technologies can significantly enhance service delivery, if used appropriately. Professor Lawler who is senior author on Paper 3 in the series said: “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.”

Professor Sue Horton, University of Waterloo, Canada said: “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”.

Professor Chris Elliott, Pro Vice Chancellor, Faculty of Medicine Health and Life Sciences at Queen’s said: “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.”

Professor Richard English, Pro Vice Chancellor for Internationalisation and Engagement at Queen’s said: “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.”

Professor Lawler added: “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 across low and middle income countries and save hundreds of thousands of lives.”

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Media inquiries to Jemma Greenlees at Queen's Communications Office on Tel: (028) 90973087 or email j.greenlees@qub.ac.uk.