Need for new diagnostics for developing countries

There is an urgent need in developing countries for new technologies for health diagnostics. One survey of international scientists familiar with the public health programs of developing countries found that the top-ranking overall priority was ‘‘modified molecular technologies for affordable, simple diagnosis of infectious diseases’’.  A study by the Gates Foundation and the NIH to identify ‘Grand Challenges for Global Health’ identified two priorities that involved diagnosis and measurement of patients’ health statuses.  In developed and developing countries alike, early and accurate diagnosis is important for identification of patients (through screening), management of patient care (case management and follow-up), and data collection for public public policy (epidemiology). 

But which health conditions in developing countries are most in need of diagnostic devices?  The World Health Organization conducted an unprecedented and comprehensive initiative to compile statistics for comparing the relative burden of diseases, conditions, injuries, and risk factors on a global scale (see DCP2 project).  By the measure of disability-adjusted life years (DALYs) in developing countries, infectious diseases constitute a large burden of disease in developing countries (32.1%; by comparison, they represent only 3.7% of total DALYs in developed countries). The trifecta of HIV/AIDS, malaria, and tuberculosis (TB), which has merited a dedicated focus from the international community (most notably the Global Fund, which has thus far committed $5.5 billion), constitutes an important 12% of DALYs in developing countries. Like infectious diseases, the burden of non-communicable diseases is significant (at 43.5% DALY, it even exceeds that of infectious diseases by a large margin) (Table 1); unlike infectious diseases, the burden of non-communicable diseases in developing countries is often underappreciated. Maternal, perinatal and nutritional diseases contribute a significant fraction of DALYs (11.8%) in developing countries (Table 1).

What is microfluidics and why is it a promising solution for new diagnostics for developing countries? 

*Parts of this article are adapted from C. Chin, V. Linder, and S.K. Sia, "Lab-on-a-chip devices for global health", Lab on a Chip, 7:41-57 (2007).