Ensuring early and accurate diagnosis to improve access to healthcare

Effective screening and accurate, early diagnosis contribute to building resilient healthcare systems as they help save costs and resources. By enabling care at the earliest possible stage, they improve therapy outcomes and therefore represent a crucial public health strategy in all settings.

New screening programs, for example, can now help determine the risk of heart failure in some patients with type 2 diabetes and aid in preventing strokes by identifying older people at risk for atrial fibrillation. Healthcare professionals can also help identify asymptomatic individuals at risk of cardiovascular events in the long term such as premature death, heart failure or ischemic stroke. With cardiovascular disease remaining the leading cause of death globally atthese innovations can help prevent hospitalization and relieve the burden on healthcare systems.1

An accurate diagnosis means a physician knows how to make the best treatment decisions for their patients. For example, there are many different types of cancer, each of which requires aAn accurate diagnosis means people with a potentially life-threatening disease feel confident they are on the right treatment and it also means that healthcare systems know that they are investing in the right solutions. An early diagnosis in cancer can significantly increase a patient’s chance of survival.

In the case of cervical cancer, screening with a Human Papillomavirus (HPV) test can identify women at risk for disease, so that progression of an HPV infection can be stopped before a life-threatening invasive cancer ever develops. In breast cancer, diagnosis at an early rather than late stage is strongly associated with cancer survival. Depending on tumor subtype, between 83% and 96% of patients diagnosed at an early stage will survive at least 5 years2, compared with only 10%-39% when diagnosed at an advanced stage3. Stage at breast cancer diagnosis varies dramatically by country and region. Late-stage diagnosis occurs in around 6% of United States women compared with 75% of sub-Saharan African women, emphasizing the importance of early diagnosis strategies as a major priority in this region4.

For many diseases, diagnosis can be complex, requiring specialist laboratory technicians or facilities for testing. Hospitals or clinics in many areas of the world are simply not equipped with the machines or operating technicians needed to meet demand. For people with rare diseases, a diagnosis is often not only delayed but also incorrect because symptoms can be confused with those of other more common conditions.

We are building partnerships with governments and NGOs to deliver programmes and improve access to timely, accurate screening and diagnosis for people all over the world, especially in resource-limited regions.

In 2014, we launched ato enable access to reliable testing solutions for patients in low- and lower-middle income countries. Our goal is to establish diagnostics as a frontline defense against diseases such as HIV/AIDs, Tuberculosis, Hepatitis B and C, Cervical cancer and COVID-19. Through this programme, Roche works with partners to build the infrastructure and capabilities required to run diagnostic programmes and provides sustainable pricing to governments and payers. In 2021, over 8 million people in Africa used our viral load testing to manage their HIV infection and to date over 11 million babies have been tested for HIV with Roche tests.

In May 2022, Roche entered ato support low- and middle-income countries in strengthening critical diagnostics infrastructure and broadening access to diagnostics, helping millions of previously undiagnosed people with Tuberculosis and HIV get diagnosed and treated. This includes building effective processes to collect, transport, test samples and return the results to patients for timely clinical interventions, as well as addressing challenges arising from a lack of network infrastructure, workforce capacity, access to roads, and IT systems.

The partnership will also include novel approaches to reduce the environmental and economic burden of healthcare waste generated during the testing process itself and the disposal of instruments and medical devices at the end of their lifecycle. Through the collaboration with the Global Fund, Ministries of Health and country-based partners, Roche will first support assessments and implementation of new technologies and knowledge transfer in 2 to 3 pilot countries, with the ambition to scale up and expand support in 10 countries over the next five years.

References

1. World Health Organization. Cardiovascular Diseases. Available fromAccessed 2022.

2. Yue Gong et al, Impact of molecular subtypes on metastatic breast cancer patients Nature. Scientific Reports, 7, 45411 (2017).

3. Yang Li et al, Prognostic significance of molecular subtype, metastatic site and primary tumor surgery for survival in primary mBC. Medicine, 27, e26619 (2021).

4. Elima Jedy-Agba et al, Stage at diagnosis of breast cancer in sub-Saharan Africa: a systematic review and meta-analysis. The Lancet, 12, E923-E935 (2016).