Bridging the Gap: Elevating Diagnostics in India’s Healthcare System

India’s healthcare system has undergone significant transformation over the past two decades, marked by advances in pharmaceuticals, hospital care, medical technology, and digital health. Despite these improvements, many individuals still face challenges in accessing accurate and timely diagnoses, a critical component of effective healthcare.

Diagnostics play a pivotal role in shaping clinical decisions, guiding treatment, and enabling disease prevention. According to the World Health Organization, approximately 70% of medical decisions are informed by diagnostic tests. Yet, in India, diagnostics account for less than 10% of the healthcare sector, highlighting a troubling gap that must be addressed.

Challenges in Accessing Quality Diagnostics

The Indian diagnostics market is projected to grow to ₹ 1,275 billion by 2028, with more than 300,000 laboratories anticipated (Frost & Sullivan). However, inconsistent regulation and quality control hinder progress. Many patients, particularly in underserved areas, may go undiagnosed or misdiagnosed, relying on unaccredited facilities for care. This imbalance not only affects individual health outcomes but also jeopardizes public health initiatives targeting diseases like tuberculosis.

The consequences of inadequate diagnostic access are far-reaching. Many patients resort to empirical treatments or abandon care altogether, which can exacerbate public health challenges. If India aims to achieve universal health coverage, it must prioritize diagnostics as a fundamental aspect of healthcare delivery.

Initiatives and Solutions for Improvement

There are encouraging developments aimed at expanding access to diagnostics. The National Essential Diagnostics List (NEDL), created by the Indian Council of Medical Research (ICMR), is designed to reduce out-of-pocket expenses and improve the availability of essential tests. Additionally, the Free Diagnostics Service Initiative (FDSI) under the National Health Mission offers free diagnostic services in public healthcare facilities.

To enhance the integration of diagnostics into the healthcare system, new infrastructure is emerging. Integrated Public Health Laboratories (IPHLs) are being established at district and sub-district levels to improve disease surveillance and integrate diagnostics across human, veterinary, and environmental health sectors. Furthermore, Viral Research and Diagnostic Laboratories (VRDLs) have seen significant growth, expanding from just two in 2016 to over 100 today, thereby strengthening outbreak response capabilities.

Public–private partnerships are also playing a crucial role in extending diagnostic services into underserved communities. The introduction of AI-driven innovations is beginning to revolutionize the speed and accuracy of diagnoses, which is particularly important in rural areas.

The experience of other health systems underscores the need for a shift in focus. Cities like Geneva, home to the World Health Organization and the Foundation for Innovative New Diagnostics, have shown how prioritizing diagnostics can enhance public health outcomes. For India, a similar approach is necessary but must be tailored to local realities.

To advance this agenda, three key principles should guide India’s health policy:

1. **Diagnostics-first primary care**: Essential tests must be accessible at every level of the healthcare system, ensuring treatment decisions are based on accurate information.

2. **Quality and consistency**: Strengthening national accreditation standards will ensure reliable and comparable test results across public and private laboratories.

3. **Innovation-driven access**: Developing regional diagnostic hubs, mobile laboratories, and AI-enabled solutions will help extend quality testing into rural and underserved communities.

Investing in local capabilities—such as encouraging the indigenous manufacturing of diagnostic equipment and consumables—will not only make services more affordable but also foster self-reliance in the healthcare sector.

India’s healthcare achievements are commendable, but true potential will only be realized when diagnostics receive the attention they deserve. By prioritizing accurate diagnosis as the foundation of care, India can ensure that every patient embarks on a health journey that is informed and effective. This shift is not merely a clinical priority; it is a public health necessity that will contribute to the development of a healthier, more resilient, and productive nation.