London School of Hygiene & Tropical Medicine

Pathology is the cornerstone of modern medicine, ensuring that patients are correctly diagnosed and given an appropriate treatment. However, a new Series in The Lancet highlights how common presumptive treatment – treatment without a confirmed diagnosis – is likely to be in many low- and middle - income countries (LMICs) as a result of a serious shortage of pathologists, laboratory services and basic medical tests.

As authors warn that the shortage of pathologists in LMICs will have a serious impact on patient care, Ngozi Erondu, Assistant Professor of Health Information, explains why pathology services are integral to achieving universal health coverage.

“This Series on improving pathology and laboratory medicine services (PALMs) in LMICs highlights a rarely discussed yet critical element of achieving universal health coverage: rapid and accurate disease detection to combat disease outbreaks. From malaria to Ebola, not being able to confirm causes of diseases quickly and effectively in LMICs has contributed to delays in protecting patients, stopping outbreaks and even increased drug resistance through erroneous prescribing of antibiotics, anti-malarials and other critical medicines.

“The author’s rightly raise the exciting aspect of point-of-care testing in resource-constrained settings—though this must be within a system that provides continuous training and supervision to community health workers. The authors provide compelling evidence to stimulate governments and global health partners to invest in improving PALM access in LMICs in order to remove the barriers identified, especially workforce capacity planning and physical infrastructure requirements.”