The future of diagnostics in Africa.
| Title: | The future of diagnostics in Africa. |
|---|---|
| Authors: | Kebede Y; Africa Centers for Disease Control and Prevention, Addis Ababa, Ethiopia. yenewk@africacdc.org.; Ndlovu N; African Society for Laboratory Medicine, Addis Ababa, Ethiopia.; Nabadda S; Ministry of Health, Kampala, Uganda.; Sawadogo C; Directorate of Biomedical Laboratories, General Directorate of Access to Health Products, Ministry of Health, Ouagadougou, Burkina Faso.; Fuller D; Eureka Co, Munich, Germany.; Pai M; McGill School of Population and Global Health, McGill University, Montreal, Quebec, Canada.; Ashenafi A; Africa Centers for Disease Control and Prevention, Addis Ababa, Ethiopia.; Vojnov L; World Health Organization, Geneva, Switzerland.; Kadam R; Foundation for Innovative New Diagnostics, Geneva, Switzerland.; Kallarakal A; Clinton Health Access Initiative, Boston, MA, USA.; Jani I; Instituto Nacional de Saúde, Maputo, Mozambique.; Mushavi A; Ministry of Health and Child Care, Harare, Zimbabwe.; Jallow F; The Global Fund to Fight AIDS, TB and Malaria, Geneva, Switzerland.; Coulibaly SO; World Health Organization, Africa Office, Brazzaville, Congo.; Baptiste S; International Treatment Preparedness Coalition, Johannesburg, South Africa.; Ehrenkrantz P; Gates Foundation, Seattle, WA, USA.; Mertz C; Gates Foundation, Seattle, WA, USA.; Kang G; Gates Foundation, Seattle, WA, USA.; De Lussigny S; Unitaid, Geneva, Switzerland.; Ghadrshenas A; Unitaid, Geneva, Switzerland.; Fleming K; Green Templeton College, University of Oxford, Oxford, UK.; Kao K; Foundation for Innovative New Diagnostics, Geneva, Switzerland.; Williams J; United States Agency for International Development, Washington, DC, USA.; Van Germet W; Stop TB Partnership, Geneva, Switzerland.; Kaiser B; Stop TB Partnership, Geneva, Switzerland.; Gadde R; Clinton Health Access Initiative, Boston, MA, USA.; Rodriguez W; Foundation for Innovative New Diagnostics, Geneva, Switzerland.; Fongwen N; Africa Centers for Disease Control and Prevention, Addis Ababa, Ethiopia.; Mataka A; African Society for Laboratory Medicine, Addis Ababa, Ethiopia.; Mashate S; African Society for Laboratory Medicine, Addis Ababa, Ethiopia.; Bryant J; The Global Fund to Fight AIDS, TB and Malaria, Geneva, Switzerland.; Ondoa P; African Society for Laboratory Medicine, Addis Ababa, Ethiopia.; The Global Fund to Fight AIDS, TB and Malaria, Geneva, Switzerland.; Otieno O; The Global Fund to Fight AIDS, TB and Malaria, Geneva, Switzerland.; Kachuwaire O; The Global Fund to Fight AIDS, TB and Malaria, Geneva, Switzerland.; Maryogo-Robinson L; Association of Public Health Laboratories, Silver Spring, MD, USA.; Staley S; Association of Public Health Laboratories, Silver Spring, MD, USA.; Agarwal N; PATH, Seattle, WA, USA.; Brodsky S; PATH, Seattle, WA, USA.; Patil A; PATH, Seattle, WA, USA.; Mesfin M; PATH, Seattle, WA, USA.; Anupindi R; Stephen M Ross School of Business, University of Michigan, Ann Arbor, MI, USA.; Rupani S; The Global Fund to Fight AIDS, TB and Malaria, Geneva, Switzerland.; Mbulawa M; National Health Laboratory, Health Services Management, Ministry of Health and Wellness, Gaborone, Botswana.; Albert H; Foundation for Innovative New Diagnostics, Geneva, Switzerland.; Kohli M; Foundation for Innovative New Diagnostics, Geneva, Switzerland.; Pai N; McGill School of Population and Global Health, McGill University, Montreal, Quebec, Canada.; Loembe M; African Society for Laboratory Medicine, Addis Ababa, Ethiopia.; Nyaruhirira A; Management Sciences for Health, Center for Pharmaceutical Management, Pretoria, South Africa.; Titanji B; Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.; Bhadelia N; Boston University Center on Emerging Infectious Diseases, Boston, MA, USA.; Desalegn D; Ministry of Health, Addis Ababa, Ethiopia.; Mimbe D; Association of Public Health Laboratories, Silver Spring, MD, USA.; Ochieng E; PATH, Seattle, WA, USA.; Mataranyika M; Namibia Ministry of Health and Social Services, Directorate for Clinical Support Services, Windhoek, Namibia.; Biscornet L; Public Health Authority, Ministry of Health, Victoria, Seychelles.; Mulenga N; Clinton Health Access Initiative, Boston, MA, USA.; Tsai Y; Clinton Health Access Initiative, Boston, MA, USA.; Islam R; Clinton Health Access Initiative, Boston, MA, USA.; Williams F; Clinton Health Access Initiative, Boston, MA, USA.; Ndasi J; African Society for Laboratory Medicine, Addis Ababa, Ethiopia.; Ntoumi F; Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of Congo; Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.; Lamorde M; Resolve to Save Lives, Abuja, Nigeria.; Vubil A; Instituto Nacional de Saúde, Maputo, Mozambique.; Sultane T; Instituto Nacional de Saúde, Maputo, Mozambique.; Pal A; Clinton Health Access Initiative, Boston, MA, USA.; Magnet S; PATH, Seattle, WA, USA.; Maggiore P; Clinton Health Access Initiative, Boston, MA, USA.; Luo R; World Health Organization, Geneva, Switzerland.; Sayed S; Department of Pathology, Aga Khan University, Karachi, Pakistan.; Shakoor S; Department of Pathology, Aga Khan University, Karachi, Pakistan.; Umutesi G; University of Washington, Seattle, WA, USA.; Domingo G; PATH, Seattle, WA, USA.; Bitilinyu-Bangoh J; Public Health Institute of Malawi, Ministry of Health, Lilongwe, Malawi.; Dieye A; Laboratoire de Pharmacologie et de Pharmacodynamie, Université Cheikh Anta Diop, Dakar, Sénégal.; Otieno C; African Society for Laboratory Medicine, Addis Ababa, Ethiopia.; Tamadea L; Economic Community of Central African States Commission, Regional Disease Surveillance Systems Enhancement Project, Libreville, Gabon.; Murenzi G; School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.; Carter J; Amref Health Africa Headquarters, Nairobi, Kenya.; Ocen F; African Society for Laboratory Medicine, Addis Ababa, Ethiopia.; Capri A; Health Products Policy and Standards Department, World Health Organization, Geneva, Switzerland.; Schroeder L; Department of Pathology, University of Michigan, Ann Arbor, MI, USA.; Wilson M; University of Chicago, Chicago, IL, USA.; Gerth-Guyette E; PATH, Seattle, WA, USA.; Nsamba D; Ministry of Health, Lusaka, Zambia.; Awinibuno I; Directorate of Allied Health, Ministry of Health, Accra, Ghana.; Odiabara K; Medical Laboratory Services Division, Federal Ministry of Health, Abuja, Nigeria.; Kujinga T; Pan-African Treatment Access Movement, Harare, Zimbabwe.; Rahman F; Matahari Global Solutions, Kuching, Sarawak, Malaysia.; Ndlovu Z; Médecins Sans Frontières, Southern African Medical Unit, Cape Town, South Africa.; Dumas D; Clinton Health Access Initiative, Boston, MA, USA.; Sambe N; Clinton Health Access Initiative, Boston, MA, USA.; Bansal Y; Clinton Health Access Initiative, Boston, MA, USA.; Qin ZZ; Department of Digital Health, Stop TB Partnership, Geneva, Switzerland.; Donoso-Bach L; Department of Medical Imaging, Hospital Clínic of Barcelona, University of Barcelona, Barcelona, Spain.; Estelle R; Direction de la Pharmacie du Medicament et des Laboratoires, Ministerie de la Sante Publique, Yaounde, Cameroon.; Dlamini S; Ministry of Health, Mbabane, Eswatini.; Obiekea C; Resolve to Save Lives, Abuja, Nigeria.; Bradley K; United States Agency for International Development, Washington, DC, USA.; Peter T; Clinton Health Access Initiative, Boston, MA, USA. |
| Source: | Nature medicine [Nat Med] 2026 May; Vol. 32 (5), pp. 1623-1633. Date of Electronic Publication: 2026 Apr 22. |
| Publication Type: | Journal Article; Review |
| Language: | English |
| Journal Info: | Publisher: Nature Publishing Company Country of Publication: United States NLM ID: 9502015 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1546-170X (Electronic) Linking ISSN: 10788956 NLM ISO Abbreviation: Nat Med Subsets: MEDLINE |
| Imprint Name(s): | Publication: New York Ny : Nature Publishing Company; Original Publication: New York, NY : Nature Pub. Co., [1995- |
| MeSH Terms: | Africa/epidemiology ; Disease Outbreaks/prevention & control ; Humans |
| Abstract: | Persistent gaps in access to quality diagnostic tests undermine progress toward improved health outcomes and resilience to disease outbreaks in Africa. Furthermore, resources for strengthening laboratory systems have faced growing constraints owing to recent reductions in official direct financial assistance, highlighting an urgent need to identify investments that are high impact and minimally donor reliant. In this Perspective, we present a set of priority systems strengthening interventions based on expected impact and feasibility. These include the need for efficient and integrated testing networks, the establishment and implementation of national essential diagnostic lists, modernized procurement and supply chain practices, improved digital health standards and targeted strengthening of testing infrastructure for epidemic-prone diseases. These initiatives should be customized to local contexts and supported by reliable financing, enhanced national leadership and management capacity and updated policies. We propose that collective action focused on these priorities will improve health outcomes and be cost-saving-and will be superior to existing, more fragmented efforts to close gaps in testing. This also provides a pathway to self-reliance in health security and universal healthcare in the Africa region.; (© 2026. Springer Nature America, Inc.) |
| Competing Interests: | Competing interests: The authors declare no competing interests. |
| References: | GBD 2021 Demographics Collaborators. Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet 403, 1989–2056 (2024).; Torres Munguía, J. A., Badarau, F. C., Díaz Pavez, L. R., Martínez-Zarzoso, I. & Wacker, K. M. A global dataset of pandemic- and epidemic-prone disease outbreaks. Sci. Data 9, 683 (2022). (PMID: 36357405); Africa CDC. Epidemic Intelligence Weekly Report, January 2025. https://africacdc.org/download/africa-cdc-epidemic-intelligence-weekly-report-january-2025/ (accessed 23 January 2025).; Romanello, M. et al. The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future. Lancet. 398, 1619–1662 (2021). (PMID: 34687662); Charnley, G. E. C., Kelman, I. & Murray, K. A. Drought-related cholera outbreaks in Africa and the implications for climate change: a narrative review. Pathog. Glob. Health. 116, 3–12 (2022). (PMID: 34602024); Wadilo, F. et al. Prevalence of group B Streptococcus maternal colonization, serotype distribution, and antimicrobial resistance in Sub-Saharan Africa: a systematic review and meta-analysis. J. Glob. Antimicrob. Resist. 32, 134–144 (2023). (PMID: 36813256); Ogundele, O. J., Pavlova, M. & Groot, W. Socioeconomic inequalities in reproductive health care services across Sub-Saharan Africa. A systematic review and meta-analysis. Sex. Reprod. Healthc. 25, 100536 (2020). (PMID: 32526462); Joint United Nations Program on HIV/AIDS. Impact of US funding cuts on global AIDS response. Weekly updates, 2025. https://www.unaids.org/en/impact-US-funding-cuts (accessed 23 March 2025).; World Health Organization. Funding cuts impact access to TB services endangering millions of lives, 2025. https://www.who.int/news/item/05-03-2025-funding-cuts-to-tuberculosis-programmes-endanger-millions-of-lives (accessed 23 March 2025).; Fleming, K. A. et al. The Lancet Commission on diagnostics: transforming access to diagnostics. Lancet 398, 1997–2050 (2021). (PMID: 34626542); World Health Organization. Resolution WHA76.5. Strengthening diagnostics capacity. in Seventy Sixth World Health Assembly, Geneva, 30 May 2023 https://apps.who.int/gb/ebwha/pdf_files/WHA76/A76_R5-en.pdf (accessed 24 January 2025).; Alemnji, G. A., Zeh, C., Yao, K. & Fonjungo, P. N. Strengthening national health laboratories in sub-Saharan Africa: a decade of remarkable progress. Trop. Med. Int. Health 19, 450–458 (2014). (PMID: 24506521); Nkengasong, J. N. et al. Laboratory medicine in Africa since 2008: then, now, and the future. Lancet Infect. Dis. 18, e362–e367 (2018). (PMID: 29980383); Africa CDC. Building testing capacity for epidemic-prone diseases, 2023. https://africacdc.org/download/building-testing-capacity-for-epidemic-prone-diseases/ (accessed 23 January 2025).; World Health Organization. Regional strategy on diagnostic and laboratory services and systems, 2023–2032 for the WHO African region, 2023. https://www.afro.who.int/sites/default/files/2023-07/AFR-RC73-7-Regional%20strategy%20on%20diagnostics%20and%20laboratory%20services%20and%20systems%202023-2032%20for%20the%20WHO%20African%20Region.pdf (accessed 23 January 2025).; World Health Organization. Universal health coverage, 2023. https://www.who.int/health-topics/universal-health-coverage#tab=tab_1 (accessed 24 January 2025).; Ashenafi, A. et al. Diagnostics for detection and surveillance of priority epidemic-prone diseases in Africa: an assessment of testing capacity and laboratory strengthening needs. Front. Public Health 12, 1438334 (2024). (PMID: 39360262); Jani, I. V. & Peter, T. F. Nucleic acid point-of-care testing to improve diagnostic preparedness. Clin. Infect. Dis. 75, 723–728 (2022). (PMID: 35015842); Peeling, R. W., Boeras, D. I., Marinucci, F. & Easterbrook, P. The future of viral hepatitis testing: innovations in testing technologies and approaches. BMC Infect. Dis. 17, 699 (2017). (PMID: 29143676); Nyanchoka, M. et al. Implementing essential diagnostics-learning from essential medicines: a scoping review. PLoS Glob. Public Health 2, e0000827 (2022).; World Health Organization. The selection and use of essential in vitro diagnostics: report of the fourth meeting of the WHO Strategic Advisory Group of Experts on In Vitro Diagnostics, 2022 (including the fourth WHO model list of essential in vitro diagnostics) 2023 (WHO Technical Report Series, no. 1053). https://www.who.int/news/item/19-10-2023-who-releases-new-list-of-essential-diagnostics-new-recommendations-for-hepatitis-e-virus-tests-personal-use-glucose-meters (accessed 24 January 2025).; Moussy, F. G., Berumen, A. V. & Pai, M. The WHO list of essential in vitro diagnostics: development and next steps. EBioMedicine 37, 1–2 (2018). (PMID: 30389503); Pai, M., Walia, K. & Boehme, C. C. Essential medicines and essential diagnostics: a package deal. Lancet Public Health 4, e492 (2019). (PMID: 31451443); World Health Organization. Nigeria flags off policy document to boost diagnostic testing, 2022. https://www.afro.who.int/countries/nigeria/news/nigeria-flags-policy-document-boost-diagnostic-testing (accessed 12 October 2025).; FIND-ASLM. 2022. Defining tier-specific laboratory testing in African countries Lessons for the development of national essential diagnostics lists. Study report. https://www.finddx.org/what-we-do/cross-cutting-workstreams/diagnostic-systems-strengthening/ (accessed 24 January 2025).; Bigio, J. et al. The inclusion of diagnostics in national health insurance schemes in Cambodia, India, Indonesia, Nepal, Pakistan, Philippines and Vietnam. BMJ Glob. Health 8, e012512 (2023). (PMID: 37479500); Wairagkar, N. et al. The African Medicines Agency - a potential gamechanger that requires strategic focus. PLoS Glob. Public Health 5, e0004276 (2025). (PMID: 39951416); Africa CDC. Africa CDC and AU-NEPAD established diagnostic advosry committee to harmonize regulatory processes for in vitro diagnostics (IVDs) to accelerate access to diagnostics for the health security of the continent, 2023. https://africacdc.org/news-item/africa-cdc-and-auda-nepad-established-diagnostic-advisory-committee-dac-to-harmonize-regulatory-processes-for-invitro-diagnostics-ivds-and-to-accelerate-access-to-diagnostics-for-the-health-securi/ (accessed 31 March 2025).; World Health Organization. Global strategy on digital health 2020–2025 (2021).; Labrique, A. B. et al. Best practices in scaling digital health in low and middle income countries. Global Health 14, 103 (2018). (PMID: 30390686); Mujuni, D. et al. Beyond diagnostic connectivity: leveraging digital health technology for the real-time collection and provision of high-quality actionable data on infectious diseases in Uganda. PLoS Digit. Health 3, e0000566 (2024). (PMID: 39178177); Rwanda Ministry of Health. Health intelligence center to drive real-time, evidence-based decisions, 2025. https://www.moh.gov.rw/news-detail/new-health-intelligence-center-to-drive-real-time-evidence-based-decisions (accessed 25 April 2025).; Neumaier, M. Diagnostics 4.0: the medical laboratory in digital health. Clin. Chem. Lab. Med. 57, 343–348 (2019). (PMID: 30530888); Labrique, A., Vasudevan, L., Mehl, G., Rosskam, E. & Hyder, A. A. Digital health and health systems of the future. Glob. Health Sci. Pract. 6, S1–S4 (2018). (PMID: 30305334); Brodsky, S. Connected diagnostics and the future of global health, 2023. https://www.path.org/our-impact/articles/connected-diagnostics-and-the-future-of-global-health/ (accessed 25 January 2025).; DHIS2. 2024. Leverging DHIS2 for mpox response. https://dhis2.org/mpox-response/ (accessed 12 October 2025).; Digital Square. Digital global health goods. https://digitalsquare.org/digital-health-global-goods (accessed 24 January 2025).; Association of Public Health Laboratories. Global laboratory eTools. https://www.lab-etools.org/ (accessed 24 January 2025).; Perrin Franck, C. et al. iCHECK-DH: guidelines and checklist for the reporting on digital health implementations. J. Med. Internet Res. 25, e46694 (2023). (PMID: 37163336); World Health Organization. Global Initiative on Digital Health, 2024. https://www.who.int/initiatives/global-initiative-on-digital-health (accessed 25 January 2025).; World Health Organization. Implementome. Supporting science-based policy and decision-making in digital health. https://gdhub.unige.ch/implementome/main (accessed 12 February 2025).; Karanja, S. et al. Utilization of digital tools to enhance COVID-19 and tuberculosis testing and linkage to care: a cross-sectional evaluation study among Bodaboda motorbike riders in the Nairobi Metropolis, Kenya. PLoS ONE 18, e0290575 (2023). (PMID: 37682928); Transform Health. Health for all in the digital age. https://transformhealthcoalition.org/ (accessed 6 February 2025).; Kao, K. et al. Strengthening health systems through essential diagnostic lists and diagnostic network optimization. PLoS Glob. Public Health 3, e0001773 (2023). (PMID: 36996019); Nichols, K. et al. Bringing data analytics to the design of optimized diagnostic networks in low- and middle-income countries: process, terms and definitions. Diagnostics 11, 22 (2020). (PMID: 33374315); Chênes, C., Albert, H., Kao, K. & Ray, N. Use of physical accessibility modelling in diagnostic network optimization: a review. Diagnostics 12, 103 (2022). (PMID: 35054270); Alemnji, G. et al. Building and sustaining optimized diagnostic networks to scale-up HIV viral load and early infant diagnosis. J. Acquir. Immune Defic. Syndr. 84, S56–S62 (2020). (PMID: 32520916); Ondoa, P. et al. Preparing national tiered laboratory systems and networks to advance diagnostics in Africa and meet the continent’s health agenda: Insights into priority areas for improvement. Afr. J. Lab. Med. 9, 1103 (2020). (PMID: 33102173); Glencross, D. K., Coetzee, L. M. & Cassim, N. An integrated tiered service delivery model (ITSDM) based on local CD4 testing demands can improve turn-around times and save costs whilst ensuring accessible and scalable CD4 services across a national programme. PLoS ONE 9, e114727 (2014). (PMID: 25490718); Brunetti, M. et al. Application of diagnostic network optimization in Kenya and Nepal to design integrated, sustainable and efficient bacteriology and antimicrobial resistance surveillance networks. PLoS Glob. Public Health 3, e0002247 (2023). (PMID: 38055687); AMREF Health Africa. Transforming diagnostics in Kenya: the success of diagnostic network optimization, 2024. https://newsroom.amref.org/impact-stories/2024/11/transforming-diagnostics-in-kenya-the-success-of-the-diagnostic-network-optimisation/ (accessed 12 October 2025).; OptiDx. Bringing the power of data to diagnostic network planning, 2021. https://www.optidx.org/ (accessed 24 January 2025).; Albert, H. et al. Designing an optimized diagnostic network to improve access to TB diagnosis and treatment in Lesotho. PLoS ONE 15, e0233620 (2020). (PMID: 32492022); Girdwood, S. et al. The integration of tuberculosis and HIV testing on GeneXpert can substantially improve access and same-day diagnosis and benefit tuberculosis programmes: a diagnostic network optimization analysis in Zambia. PLoS Glob. Public Health. 3, e0001179 (2023). (PMID: 36963019); Albert, H. et al. Optimizing diagnostic networks to increase patient access to TB diagnostic services: development of the diagnostic network optimization (DNO) approach and learnings from its application in Kenya, India and the Philippines. PLoS ONE 18, e0279677 (2023). (PMID: 38033120); Kiyaga, C. et al. Uganda’s new national laboratory sample transport system: a successful model for improving access to diagnostic services for early infant HIV diagnosis and other programs. PLoS ONE 8, e78609 (2013). (PMID: 24236026); Ndlovu, Z. et al. Multidisease testing for HIV and TB using the GeneXpert platform: a feasibility study in rural Zimbabwe. PLoS ONE 13, e0193577 (2018). (PMID: 29499042); African Society for Laboratory Medicine. Status report on laboratory leadership in Africa, 2025. https://aslm.org/resource/status-report-on-laboratory-leadership-in-africa/ (accessed 25 April 2025).; Yadav, P. Health product supply chains in developing countries: diagnosis of the root causes of underperformance and an agenda for reform. Health Syst. Reform. 1, 142–154 (2015). (PMID: 31546312); Kuupiel, D., Tlou, B., Bawontuo, V., Drain, P. K. & Mashamba-Thompson, T. P. Poor supply chain management and stock-outs of point-of-care diagnostic tests in Upper East Region’s primary healthcare clinics, Ghana. PLoS ONE 14, e0211498 (2019). (PMID: 30811407); Kuupiel, D., Bawontuo, V. & Mashamba-Thompson, T. P. Improving the accessibility and efficiency of point-of-care diagnostics services in low- and middle-income countries: lean and agile supply chain management. Diagnostics 7, 58 (2017). (PMID: 29186013); World Health Organization. Global health expenditure database, 2018. https://apps.who.int/nha/database (accessed 24 January 2025).; World Health Organization. 2025. Global price reporting mechanism, 2025. https://apps.who.int/hiv/amds/price/hdd/ (accessed 25 January 2025).; Mazzucato, M. & Roy, V. Rethinking value in health innovation: from mystifications towards prescriptions. J. Econ. Policy Reform 22, 101–119 (2019).; Smith, R., Yadav, P. & Roberts, M. Getting Health Products to the Poor: a Management Science Perspective (Springer, 2013).; Yadav, P., Tata, H. & Babaley, M. The Global Fund and pharmaceutical procurement: a case study. Health Policy Plan. 26, 308–316 (2011).; Laboratory services and medical supplies. Management Science for Health, 2012. https://msh.org/wp-content/uploads/2013/04/mds3-ch47-labservices-mar2012.pdf (accessed 23 January 2025).; Fonjungo, P. et al. Laboratory equipment maintenance: a critical bottleneck for strengthening health systems in sub-Saharan Africa?. J. Public Health Policy 33, 34–45 (2012). (PMID: 22071568); Africa CDC. 2023. Laboratory Equipment Management, A Guidance to African Union Member States, 2023. https://africacdc.org/download/laboratory-equipment-management-a-guidance-to-african-union-member-states/ (accessed 23 January 2025).; McNerney, R., Sollis, K. & Peeling, R. W. Improving access to new diagnostics through harmonised regulation: priorities for action. Afr. J. Lab. Med. 3, 123 (2014). (PMID: 29043177); Alemnji, G., Zeh, C., Bhairavabhotla, R., Wattleworth, M. & Williams, J. Implementation of all-inclusive global purchasing agreements for viral load and infant diagnosis in PEPFAR-supported countries. J. Infect. Dis. 232, S155–S159 (2025). (PMID: 40976862); Mfuh, K. O., Abanda, N. N. & Titanji, B. K. Strengthening diagnostic capacity in Africa as a key pillar of public health and pandemic preparedness. PLoS Glob. Public Health 3, e0001998 (2023). (PMID: 37310963); Peter, T., Keita, M. S. & Nkengasong, J. Building laboratory capacity to combat disease outbreaks in Africa. Afr. J. Lab. Med. 5, 579 (2016). (PMID: 28879145); Njukeng, P. A., Njumkeng, C., Ntongowa, C. & Abdulaziz, M. Strengthening laboratory networks in the Central Africa region: a milestone for epidemic preparedness and response. Afr. J. Lab. Med. 11, 1492 (2022). (PMID: 35747554); Iskandar, K. et al. Surveillance of antimicrobial resistance in low- and middle-income countries: a scattered picture. Antimicrob. Resist. Infect. Control 10, 63 (2021). (PMID: 33789754); Musa, K. et al. Laboratory surveillance, quality management, and its role in addressing antimicrobial resistance in Africa: a narrative review. Antibiotics 12, 1313 (2023). (PMID: 37627733); Vounba, P., Loul, S., Tamadea, L. F. & Siawaya, J. F. D. Microbiology laboratories involved in disease and antimicrobial resistance surveillance: strengths and challenges of the central African states. Afr. J. Lab. Med. 11, 1570 (2022). (PMID: 35402201); Ombelet, S. et al. Bacteriology in low resource settings working group. Clinical bacteriology in low-resource settings: today’s solutions. Lancet Infect. Dis. 18, e248–e258 (2018). (PMID: 29519767); Ongarello, S., Bausch, D. G., Hannay, E. & Bright, R. A. Current testing systems are a barrier to achieving the 7–1–7 target for detection, notification, and response to public health threats. Lancet Glob. Health 11, e1340 (2023). (PMID: 37591580); Bochner, A. F. et al. Implementation of the 7–1–7 target for detection, notification, and response to public health threats in five countries: a retrospective, observational study. Lancet Glob. Health 11, e871–e879 (2023). (PMID: 37060911); Mremi, I. R. et al. Twenty years of integrated disease surveillance and response in Sub-Saharan Africa: challenges and opportunities for effective management of infectious disease epidemics. One Health Outlook 3, 22 (2021). (PMID: 34749835); Mandyata, C. B., Olowski, L. K. & Mutale, W. Challenges of implementing the integrated disease surveillance and response strategy in Zambia: a health worker perspective. BMC Public Health 17, 746 (2017). (PMID: 28950834); Phalkey, R. K., Yamamoto, S., Awate, P. & Marx, M. Challenges with the implementation of an Integrated Disease Surveillance and Response (IDSR) system: systematic review of the lessons learned. Health Policy Plan. 30, 131–143 (2015). (PMID: 24362642); Lasley, J. N., Appiah, E. O., Kojima, K. & Blacksell, S. D. Global veterinary diagnostic laboratory equipment management and sustainability and implications for pandemic preparedness priorities. Emerg. Infect. Dis. 29, 1–12 (2023). (PMID: 36958021); Gooding, K., Bertone, M. P., Loffreda, G. & Witter, S. How can we strengthen partnership and coordination for health system emergency preparedness and response? Findings from a synthesis of experience across countries facing shocks. BMC Health Serv. Res. 22, 1441 (2022). (PMID: 36447261); Nsanzimana, S. et al. Toward a new paradigm of North-South and South-South partnerships for pandemic preparedness: lessons learned from COVID-19 and other outbreaks. Am. J. Trop. Med. Hyg. 107, 1162–1165 (2022). (PMID: 36375450); Christoffels, A. et al. A pan-African pathogen genomics data sharing platform to support disease outbreaks. Nat. Med. 29, 1052–1055 (2023). (PMID: 37161068); Possas, C., Marques, E. T. A., Risi, J. B. Jr. & Homma, A. COVID-19 and future disease X in circular economy transition: redesigning pandemic preparedness to prevent a global disaster. Circ. Econ. Sustain. 1, 1463–1478 (2021). (PMID: 34888566); van der Westhuizen, H. M. et al. A consensus statement on dual purpose pathogen surveillance systems: the always on approach. PLoS Glob Public Health 4, e0003762 (2024). (PMID: 39541405); El Morr, C. et al. AI-based epidemic and pandemic early warning systems: a systematic scoping review. Health Informatics J. 30, 14604582241275844 (2024). (PMID: 39172555); Brehm, B. The case for investment: insights from five African manufacturers on local manufacturing of diagnostic tools, 2023. https://www.path.org/our-impact/articles/investment-insights-local-manufacturing-diagnostic/ (accessed 24 January 2025).; Kanyerezi, S. et al. Near real-time genomic characterization of the 2025 Sudan Ebolavirus outbreak in Uganda’s Index case: insights into evolutionary origins. https://virological.org/t/near-real-time-genomic-characterization-of-the-2025-sudan-ebolavirus-outbreak-in-uganda-s-index-case-insights-into-evolutionary-origins/990 (accessed 12 October 2025).; Grobusch, M. P. et al. Marburg virus disease outbreak in Rwanda, 2024. Clin. Microbiol. Infect. 31, 161–163 (2025). (PMID: 39581545); Butera, Y. et al. Genomic and transmission dynamics of the 2024 Marburg virus outbreak in Rwanda. Nat. Med. 31, 422–426 (2025). (PMID: 39681304); World Health Organization. World Health Assembly adopts historic Pandemic Agreement to make the world more equitable and safer from future pandemics. https://www.who.int/news/item/20-05-2025-world-health-assembly-adopts-historic-pandemic-agreement-to-make-the-world-more-equitable-and-safer-from-future-pandemics#:~:text=+%20Agreement’s%20adoption%20follows%20three%20years%20of,on%20Pathogen%20Access%20and%20Benefits%20Sharing%20system (accessed 12 October 2025).; Africa CDC. Establishment of a biobanking network as a sustainable mechanism to accelerate development and evaluation of diagnostic tests in Africa, 2020. https://africacdc.org/download/establishment-of-a-biobanking-network-as-a-sustainable-mechanism-to-accelerate-development-and-evaluation-of-diagnostic-tests-in-africa/ (accessed 12 October 2025).; Horton, S. et al. Moving the dial on diagnostics: an update from the Lancet Commission on diagnostics. Lancet 405, 2241–2254 (2025). (PMID: 40409332) |
| Grant Information: | INV-061962 Bill and Melinda Gates Foundation (Bill & Melinda Gates Foundation) |
| Entry Date(s): | Date Created: 20260422 Date Completed: 20260521 Latest Revision: 20260521 |
| Update Code: | 20260521 |
| DOI: | 10.1038/s41591-026-04308-7 |
| PMID: | 42020602 |
| Database: | MEDLINE |
Journal Article; Review