A robust laboratory and diagnostic framework has been identified as a key pillar in the strategic response to the COVID-19 pandemic by the World Health Organization. However, there has been growing concern about the lack of diagnostic testing for COVID-19 in many low- and middle-income countries (LMICs). Contexts can vary widely, and there are many reasons for the lack of COVID-19 testing, ranging from supply, distribution, and cost to capacity and prioritization.
The COVID-19 Clinical Research Coalition conducted a brief survey to provide high-level insight into the prioritization, availability, access, and affordability of COVID-19 diagnostics in LMICs. The survey link was emailed to the coalition membership and other stakeholders, as well as to several relevant networks and listservs, for participation from 8-19 July 2021. Recipients were invited to share the survey within their networks.
Respondents were predominantly from low- and middle-income countries, as requested, and the following key points emerged:
- Obstacles to diagnostics access are many, including a limited number of testing locations, low access outside major cities, high cost to individuals and health ministries, test kit or commodity stock-outs, and shortage of testing capacity.
- Capacity for molecular diagnostic testing as well as rapid antigen testing exists in most of the respondents’ countries.
- The cost of testing can be particularly high in private facilities.
- Of concern was the lack of access to all available diagnostics in all public facilities.
- Vulnerable groups such as pregnant women and those at highest risk for severe disease were perceived to have lower access to COVID-19 diagnostic testing.
- Most respondents felt that diagnostics were given either high or medium priority in their respective countries.
- A majority of respondents (>88%) reported that diagnostics need to be used more widely and made more available.
Regional bodies such as the Africa CDC and PAHO, and global entities such as the World Health Organization, the ACT Accelerator’s Diagnostics Partnership, and FIND, have partnered with health ministries to increase the diagnostic capacity and test kit availability in many low- and middle-income countries. However, despite these joint efforts, more remains to be done to fill the diagnostic gaps that exist in many low-resource settings.