Towards frugal diagnosticsAugust 6, 2019
Bio-specimen collection for diagnostics and bio-banking are very important steps in healthcare and precision medicine development. In the first stage, bio-specimen collection for diagnostics is an essential tool for clinicians to give the best therapies for their patients. Even as the reach of diagnostic assays have improved drastically in the past few decades, especially in molecular diagnostics, sample collection systems have not evolved to make the assays affordable technologically and financially. The majority of bio-specimens collected must be processed to separate the sub-constituents. For example, blood must be processed to collect serum, plasma and cells, following which these fractions must be transported in cold chain. These requirements make bio-specimen collection a big barrier to reaching out to a large number of patients in low-resource regions.
The next step in developing precision medicine depends on performing large-scale genomic studies with Indian bio-specimens and comparing them with their western counterparts. This research is largely left to research institutes as hospitals in India are primarily focused on patient care and are not equipped to perform population-based genomic studies. Bio-banking, therefore, must have state sponsorship along with participation from research institutes and private players for genomic data generation and curation. Bio-banking itself has become a science and a new line of thinking is emerging to identify indicators or biomarkers for the quality
and usability of the techniques coming
into the market. More so, Indian researchers and clinicians must now look for technologies developed or in development in India. This can truly help the patients, as such collaborations can make new technologies more suitable for Indian conditions.
Technologies such as Insta-Preserve RT (room temperature) in development at Institute for Applied Research and Innovation, which removes all the barriers like sample pre-processing and cold chain in transport and storage, can help in several ways. By nature, this technology neutralizes the pathogens, so pre-processing and pathogen containment facilities are not required. Thus, it improves the quality of the sample and reduces the cost incurred in this step. The samples do not need to be stored at -80oC or in liquid nitrogen chambers, but can be stored at ambient room temperature (15-30oC). These kinds of technologies can lead the way to frugal diagnostics or bio-banking and make the next generation of genomics happen in countries like India. Of course, the development of new technologies to meet global standards must involve the help of governmental organizations like Indian Council of Medical Research and doctors who are interested in collaborating in developing novel and apt technologies for India.