Do away with hub-and-spoke model when every spoke can be a hub
Study authors stated: Although Xpert MTB/RIF, endorsed by WHO in 2011, revolutionised TB and rifampicin resistance detection, its impact has been limited. High costs and operational requirements (eg, stable electricity, temperature control, and dust-free environments) have confined its use to centralised laboratories in hub-and-spoke models. New molecular and point-of-care diagnostics are emerging that might be deployed in primary care clinics or even in communities. Portable battery-operated molecular testing platforms, such as the Molbio Truenat platform (endorsed by WHO in 2020), offer the potential to further decentralise molecular testing.
This randomized control study provides pathbreaking science to call for transforming every 'spoke' into a hub by deploying WHO recommended point-of-care molecular tests like Truenat which are battery-operated (with solar power recharging capabilities), laboratory independent, and decentralised. More importantly, it is a multi-disease molecular testing platform for over 40 diseases, such as TB, HIV (including viral load, testing) hepatitis B and C virus, human papilloma virus (HPV - which causes a lot of cervical cancers), several sexually transmitted infections, leprosy, vector-borne diseases like malaria, among others.
Earlier this week while launching an important WHO report on antimicrobial resistance, WHO Director General Dr Tedros Adhanom Ghebreyesus too had underpinned the importance of "rapid and point-of-care molecular testing" for preventing AMR - because correct and timely diagnosis for multiple diseases must be made accessible to all equitably - especially those who are underserved. Linkage to standard treatment, care and support also should be made accessible to all if we are to prevent AMR, along with optimal infection prevention and control, vaccination, water, sanitation and hygiene, and other health and social support.
Shobha Shukla, Bobby Ramakant CNS (Citizen News Service)
(Shobha Shukla is the founding Managing Editor of CNS (Citizen News Service) and Bobby Ramakant works as CNS Health Editor. Both are on the boards of Global Antimicrobial Resistance Media Alliance (GAMA) and Asia Pacific Media Alliance for Health, Gender and Development Justice (APCAT Media). Follow them on Twitter/X: @Shobha1Shukla, @BobbyRamakant, @CNS_Health)
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