Editorials

Diagnostics in developing countries

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7111.760 (Published 27 September 1997) Cite this as: BMJ 1997;315:760

Time for an essential diagnostics programme

  1. Paul Garner, Heada,
  2. Ayyaz Kiani, Project coordinatorb,
  3. Anuwat Supachutikul, Senior research fellowc
  1. a International Health Division, Liverpool School of Tropical Medicine, Liverpool L3 5QA
  2. b Association for Rational Use of Medication in Pakistan, Islamabad, Pakistan
  3. c Health Systems Research Institute, Bangkok, Thailand

    Diagnostics are big business in developing countries. In Lahore private clinics advertise magnetic resonance imaging on public billboards, diagnostic clinics abound, and ultrasound examination on demand costs $2.50 to $10. In Bangkok there is one computed tomographic scanner for every 62 000 people, and 90% of private hospitals with more than 50 beds own one.1 While some of these changes might be anticipated as government policies shift towards enabling provision of private care,2 there is some evidence that governments themselves are spending public money to expand diagnostic services. For example, one provincial government in Pakistan borrowed $8m to upgrade basic healthcare facilities by providing medical equipment—mainly x ray machines, ultrasound scanners, and microscopes3; in Lesotho plans to upgrade basic health centres included the purchase of x ray facilities and laboratories4; and similar large expenditures are being considered by donors or governments in countries from …

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