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Review
. 2025 Jun 21;405(10496):2241-2254.
doi: 10.1016/S0140-6736(25)00804-9. Epub 2025 May 20.

Moving the dial on diagnostics: an update from the Lancet Commission on diagnostics

Susan Horton  1 , Michael L Wilson  2 , Annie N Y Cheung  3 , Kristen DeStigter  4 , Mikashmi Kohli  5 , Shahin Sayed  6 , Lee F Schroeder  7 , Richard Sullivan  8 , Bien-Soo Tan  9 , Millicent Alooh  10 , Bernice Dahn  11 , Lluis Donoso-Bach  12 , Patricia J Garcia  13 , Sarwat Hussain  14 , Kekeletso Kao  5 , Lai-Meng Looi  15 , Madhukar Pai  16 , Mario Plebani  17 , Yenew Kebede Tebeje  18 , Grace Umutesi  19 , Kamini Walia  20 , Kenneth A Fleming  21
Affiliations
Review

Moving the dial on diagnostics: an update from the Lancet Commission on diagnostics

Susan Horton et al. Lancet. .

Abstract

The Lancet Commission on diagnostics made recommendations for ten topics: national strategy (including national essential diagnostics lists), access in primary care, workforce, regulatory framework, national financing, affordability, appropriate use of technology, needs in conflict or fragile situations, advocacy, and an international alliance with oversight capabilities. Since 2021, progress in these areas has benefitted greatly from the adoption of a World Health Assembly resolution on diagnostics and the work of a broad coalition, as assessed by literature surveys by subject matter experts, quantitative findings (where feasible), and an anonymous survey of knowledgeable and engaged individuals. Greater progress was observed where there was political will and the production of diagnostics coincided with industrial policy goals, also in areas where changing the legal and health policy frameworks was involved. Progress was slower on recommendations with substantial resource implications (eg, labour force, affordability, and diagnostics for conflict situations). It is expected that the Global Diagnostics Coalition will consolidate and accelerate progress.

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Conflict of interest statement

Declaration of interests LFS received travel expenses and speaker honoraria from the American Association of Clinical Chemistry, American Society of Clinical Pathology, and the Patient-Centered Laboratory Utilization Guidance Services; and grants from the Gates Foundation and the National Institutes of Health. KDS received grants from the Philips Foundation; conference travel help from the Gates Foundation and European Congress of Radiology; is on the advisory board of Philips Health and Delft (unpaid); is a board member of the Society of Chairs in Radiology, Chair of International Relations Committee of Association of Academic Radiologists, and Member of Writing group of American Institute of Ultrasound in Medicine (unpaid); consults for the Gates Foundation, Philips, GE, Butterfly, and KA Imaging (unpaid); is co-founder of Imaging the World and Imaging the World Africa (non-profit for Uganda, Malawi, and Kenya); is owner of Imaging the World Coalition for Health Uganda; and receives donated software for Imaging the World from McKesson PACS, Koios Medical, and DeepTek. KAF, PJG, and MLW are members of the WHO Strategic Advisory Group of Experts on In-Vitro Diagnostics. SHo is a member of the WHO Strategic and Technical Advisory Group on Medical Devices. All other authors declare no competing interests.