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Hindustan Times
08-06-2025
- Health
- Hindustan Times
Human cost of poor-quality testing in India
Ramesh, a 32-year-old construction worker, first visited his local clinic when he was having persistent cough and it refused to go away. For over two months, he had been suffering from coughing, recurring fever, and unexplained weight loss. The classic symptoms that should have raised red flags for tuberculosis (TB). But due to limited infrastructure and inadequate diagnostic support, his condition was misread as simple bronchitis. The technician, lacking proper training and resources, failed to spot early signs of TB. The doctor, relying on this flawed report, prescribed a general course of antibiotics and sent Ramesh home. Two more painful months passed. Ramesh's condition worsened. His cough began producing blood, and severe fatigue left him unable to work. This story reflects a deeper systemic failure of our country. Low-quality diagnostic services, often driven by under-resourced facilities, lack of quality checks, and poor training, lead to misdiagnosis, delayed treatment, worsening health, and higher health care costs. In situations like Ramesh's, the need is not for centralised, high-end laboratories but for accessible, quality-assured diagnostics at the point of care, especially for conditions like respiratory infections, diarrhoeal diseases, sexually transmitted infections (STDs), and chronic diseases like diabetes and kidney dysfunction. Many of these tests do not require the National Accreditation Board for Testing and Calibration Laboratories (NABL) accreditation. What's crucial is to ensure standardised quality control for every batch of diagnostics and robust supply chains so that tests are accurate, affordable, and always available where they are needed most. Most of the syndrome-based approaches such as fever, STDs where the diagnostic should be available at a point of care with a quality check. The cervical cancer diagnostics should be provided with appropriate quality checks, the same is with glucose levels, HB levels as well as basic diagnostics for lipids, kidney, liver tests. Point-of-care diagnostics for respiratory tract infections and diarrhoeal diseases must be made widely available, given the high mortality associated with these conditions. Just like medicines, every batch of diagnostic kits should undergo stringent quality checks and be supported by robust supply chain and storage systems. Currently, many government hospitals and public health facilities function without NABL accreditation. This underscores the need to build a parallel grassroots-level accreditation system, modeled along the lines of National Accreditation Board for Hospitals & Healthcare Providers (NABH), but adapted to rural realities. Such a system would ensure minimum quality benchmarks, especially for programme-related diagnostics and should be integrated into national health schemes including those under the Ayushman Bharat PM-JAY. The lack of structured quality control has allowed an influx of unreliable diagnostic tools in both public and private sectors. Each diagnostic batch, like medicines, must undergo quality verification before deployment. This is especially critical for widespread conditions like cervical cancer, glucose imbalance, anaemia (Hb levels), and liver/kidney dysfunction, where inaccurate results can lead to incorrect treatment or no treatment at all. To ensure sustained quality, regular training and upskilling of lab technicians must be mandated. Training should focus not only on basic test operations but also on ethical diagnostic practices, quality assurance, storage standards, and the correct use of surveillance tools, which should never be substituted for clinical diagnostics. According to the National Health Profile 2023, only 12% of primary health centers (PHCs) have diagnostic labs and many of those do not meet even basic standards. The result is a massive diagnostic gap in rural India, pushing patients toward unregulated, low-quality private labs. The consequences are severe: delayed or missed diagnoses, prolonged disease burden, high out-of-pocket costs, and ultimately, preventable deaths. While decentralised diagnostics are essential, India must also invest in national reference labs to support complex testing and surveillance. Establishing 50 NABL-accredited reference labs, each serving approximately 25 million people, would ensure comprehensive national coverage. These hubs should be equipped with Artificial Intelligence (AI)-assisted digital microscopy, real-time PCR machines, and cloud-based data systems for seamless health care integration. Public-private partnerships can be leveraged to train lab personnel at these reference centers, ensuring they are equipped with both theoretical knowledge and hands-on skills. Curriculum should emphasise AI tools, quality protocols, and patient-centric diagnostic delivery. Diagnostics are not just support tools; they are central to effective healthcare delivery. Without timely, accurate testing, even the best clinical decisions can fail. As India aspires toward Universal Health Coverage and a $ 5 trillion economy, strengthening diagnostic services, particularly at the last mile, is not optional. It's an urgent public health imperative. This article is authored NK Ganguly, former director general, Indian Council of Medical Research (ICMR).
Hans India
06-05-2025
- Health
- Hans India
India bears 13% of global asthma burden: Olive Hospital calls for greater awareness and access on World Asthma Day
On World Asthma Day, Olive Hospital in Hyderabad has reiterated its focus on improving awareness and accessibility of asthma treatment in India, where the condition continues to pose a significant public health challenge. India accounts for over 13% of the global asthma burden, with an estimated 17.23 million cases nationwide. According to the World Health Organization, asthma affects more than 262 million people globally and causes approximately 455,000 deaths each year. In India, high mortality and disability rates linked to asthma are often attributed to poor air quality, late diagnosis, and limited access to long-term treatment. This year's World Asthma Day theme, 'Make Inhaled Treatments Accessible for All,' highlights the importance of ensuring widespread availability of inhalers and other essential medications that can help manage the condition. Speaking on the occasion, Dr Syed Taha Mahmood, Consultant Pulmonologist at Olive Hospital, said, 'Asthma is a manageable condition when treated properly. Inhaled corticosteroids and bronchodilators can control most cases, but lack of awareness and access to treatment make it far more dangerous than it needs to be. It's time we address these gaps.' Prevalence rates vary across age groups in India, with studies showing current wheeze symptoms in 3.16% of children aged 6–7, 3.63% in those aged 13–14, and 3.3% in adults. Despite this, many cases go undiagnosed, particularly in children. Olive Hospital is advocating for improved education around asthma and access to medication. The hospital emphasises the importance of adhering to prescribed inhalers, identifying and avoiding common triggers such as allergens and pollution, and maintaining regular check-ups. Patients are also encouraged to work with healthcare providers to develop personalised asthma action plans to manage flare-ups. Olive Hospital underlines the role of a healthy lifestyle—regular exercise, avoiding tobacco, managing stress, and getting annual flu vaccinations—to support overall respiratory health. Typical symptoms of asthma include wheezing, shortness of breath, chest tightness, and persistent coughing—especially at night or early morning. These can be triggered by pollution, infections, cold air, and certain medications. Olive Hospital, a 210-bed multispecialty facility in Telangana, offers a range of medical services including cardiac care, emergency services, neurology, urology, orthopaedics, and diagnostics. It is accredited by the National Accreditation Board for Hospitals & Healthcare Providers. The hospital's initiative on World Asthma Day aims to ensure that asthma no longer remains a silent or underestimated condition and that no patient is left without the care they need. Would you like a shorter version of this for social media or a press summary?
