A policy roadmap for sustainable mass-testing

Population-wide mass testing with affordable self-tests can drastically reduce lives lost and minimize economic and societal costs during pandemics, especially if deployed before vaccines. During COVID-19, however, the development of self-test manufacturing and distribution capacity lagged behind vaccine rollout and was dismantled once surges subsided, returning us to a prepandemic state. As no new capacity has since been secured, future mass-testing would again face costly delays. To mitigate this risk, we propose a policy roadmap for an economically viable mass-testing system that can be sustained between crises and rapidly scaled during emergencies. Public investment in R&D to improve the sensitivity of affordable self-tests-not to achieve a single benchmark, but to advance point-of-need technologies across medical and nonmedical applications-is essential. Improved sensitivity would enable new uses in routine health screening, food safety, and environmental monitoring, generating steady demand and production capacity that can expand as needed. This demand would support a robust system anchored by four mutually reinforcing pillars: scalable manufacturing, real-time data infrastructure, predictive analytics, and sustainable financing. Prioritizing sensitivity can transform mass testing from a reactive measure into a durable public health foundation.