Unaddressed testing gaps undermine health outcomes and disease resilience in Africa, requiring urgent investments to create high-impact, minimally donor-reliant systems. A proposed set of priority interventions includes efficient testing networks, national essential diagnostic lists, procurement reforms, digital health standards, and epidemic-prone disease testing infrastructure.
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. Fig. 1: A staged process for national EDLs. GBD 2021 Demographics Collaborators.
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Yenew Kebede, Aytenew Ashenafi & Noah FongwenFoundation for Innovative New Diagnostics, Geneva, SwitzerlandClinton Health Access Initiative, Boston, MA, USA Ashley Kallarakal, Renuka Gadde, Namwaka Mulenga, Yucheng Tsai, Robia Islam, Fona Williams, Arnab Pal, Paolo Maggiore, Devan Dumas, Ndeye Sambe, Yashika Bansal & Trevor PeterAngela MushaviFatim Jallow, Juliet Bryant, Pascale Ondoa, Osborne Otieno, Obert Kachuwaire & Sidharth RupaniNeha Agarwal, Shiri Brodsky, Abha Patil, Miraf Mesfin, Edwin Ochieng, Sophie Magnet, Gonzalo Domingo & Emily Gerth-GuyetteJoseph Bitilinyu-BangohLluis Donoso-Bach All authors contributed to the analysis and development of recommendations for one or more of the topic areas described in this Perspective, as well as reviewed the manuscript.
Y.K. and T.P. drafted the manuscript based on the reports developed by all authors.thanks Palwasha Khan and Peter Waiswa for their contribution to the peer review of this work. Primary Handling Editor: Karen O’Leary, in collaboration with theSpringer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author or other rightsholder; author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
Africa Africa Diagnostic Tests Health Outcomes Disease Outbreaks Systems Strengthening Priority Interventions Efficient Testing Networks National Essential Diagnostic Lists Procurement Reforms Digital Health Standards Epidemic-Prone Disease Testing Infrastructure
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