Pathology and laboratory medicine in partnership with global surgery: working towards universal health coverage

Abstract

Pathology and laboratory medicine (PALM) is the backbone of high-quality care across many specialties, particularly surgery. In surgery, PALM provides the cross-match to keep patients with bleeding ectopic pregnancies alive, the histopathology that differentiates a benign colonic polyp from a malignancy, the biochemistry that allows safe titration of anaesthetics, and the forensic pathology that quantifies the burden of disease. Pathology and laboratory medicine: the Cinderella of health systemsHigh-quality pathology and laboratory medicine (PALM) services are an integral part of health systems in high-income countries. New molecular diagnostic techniques, advances in precision cancer treatments, and population-based screening programmes for disease prevention or early detection have made PALM an even more important part of modern medicine and health care. And yet, even in high-income countries, the role of PALM is not well understood by the general public, and pathology remains a somewhat unpopular specialty in medicine. Full-Text PDF Laboratory medicine in low-income and middle-income countries: progress and challengesLaboratory medicine is essential for disease detection, surveillance, control, and management.1 However, access to quality-assured laboratory diagnosis has been a challenge in low-income and middle-income countries (LMICs) resulting in delayed or inaccurate diagnosis and ineffective treatment with consequences for patient safety.1 In the new Lancet Series2–4 on pathology and laboratory medicine (PALM) in LMICs, Michael Wilson and colleagues2 provide a comprehensive analysis of the challenges and gaps that limit access to PALM services. Full-Text PDF Access to pathology and laboratory medicine services: a crucial gapAs global efforts accelerate to implement the Sustainable Development Goals and, in particular, universal health coverage, access to high-quality and timely pathology and laboratory medicine (PALM) services will be needed to support health-care systems that are tasked with achieving these goals. This access will be most challenging to achieve in low-income and middle-income countries (LMICs), which have a disproportionately large share of the global burden of disease but a disproportionately low share of global health-care resources, particularly PALM services. Full-Text PDF Improving pathology and laboratory medicine in low-income and middle-income countries: roadmap to solutionsInsufficient awareness of the centrality of pathology and laboratory medicine (PALM) to a functioning health-care system at policy and governmental level, with the resultant inadequate investment, has meant that efforts to enhance PALM in low-income and middle-income countries have been local, fragmented, and mostly unsustainable. Responding to the four major barriers in PALM service delivery that were identified in the first paper of this Series (workforce, infrastructure, education and training, and quality assurance), this second paper identifies potential solutions that can be applied in low-income and middle-income countries (LMICs). Full-Text PDF Delivering modern, high-quality, affordable pathology and laboratory medicine to low-income and middle-income countries: a call to actionModern, affordable pathology and laboratory medicine (PALM) systems are essential to achieve the 2030 Sustainable Development Goals for health in low-income and middle-income countries (LMICs). In this last in a Series of three papers about PALM in LMICs, we discuss the policy environment and emphasise three crucial high-level actions that are needed to deliver universal health coverage. First, nations need national strategic laboratory plans; second, these plans require adequate financing for implementation; and last, pathologists themselves need to take on leadership roles to advocate for the centrality of PALM to achieve the Sustainable Development Goals for health. Full-Text PDF