The future of diagnostics in Africa

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.