Africa’s Diagnostics Revolution – A Work In Progress

As we collectively process the outcomes from the 2023 World Health Assembly (WHA), which serendipitously took place during the same week as Africa Day – a celebration of African unity, we are witnessing history in the making. Earlier this year, the WHO (World Health Organization) Executive Board voted in favour of including the resolution “Strengthening diagnostics capacity” on the WHA 2023 agenda. This is a critical victory for African people. It signalled a firm understanding by the WHO of the importance of increasing access to quality diagnostics in low-to-middle-income countries (LMICs) – and particularly African countries.

Today, diagnostics can drive 70% of all clinical decision making, yet they are apportioned less than 5% of hospital budgets. The Lancet Commission on Diagnostics indicates that the median availability of diagnostics is at circa 19% in basic primary care facilities surveyed in low-income and lower-middle-income countries. Diagnostic laboratory services are essential to the delivery of quality healthcare but have historically been a neglected component of health systems in LMICs.1,2

Grossly limited access to timely, good quality diagnostics remains the weakest link in the health-care cascade. Diagnosis informs treatment and care decisions right at the beginning of any patient’s healthcare journey. Consequently, prioritising diagnostics across Africa can empower individuals, improve health outcomes and ultimately drive economic growth – because healthier populations are more economically active.3

It is pivotal that the WHA has formally recognised and elevated the important place of diagnostics for the first time. This is a call to action that goes beyond the efforts of any single government or organisation. It requires a concerted and coordinated effort from all stakeholders to address the systemic barriers that hinder access to quality diagnostics. This WHA Resolution opens the door for policy changes, new partnerships and resource mobilization to drive tangible progress towards building resilient healthcare systems in Africa and beyond. Such progress is key to secure Global Health security.

On the Pan-African Organisation’s 60th Anniversary, the focus for Africa Day this year is “Accelerating the implementation of the African Continental Free Trade Area to bring greater prosperity to the continent”. This links firmly to the 2023 WHA theme, “WHO at 75: Saving lives, driving health for all,” because prosperity and health are but two sides of the same coin.

The World Bank highlights that “Universal healthcare allows countries to make the most of their strongest asset: human capital. Supporting health represents a foundational investment in human capital and economic growth”.4

Diagnosis is the cornerstone of universal healthcare. The WHA’s acknowledgement of the value of diagnostics reinforces the need to ensure diagnostic testing reaches even the most remote communities. Only through collaboration can we create sustainable and inclusive healthcare systems that correctly prioritise the needs of people and, ultimately, allow African economies to thrive – Public Private Partnerships are one vehicle.

The WHA has signalled that governments should recognise diagnostics’ vital role and prioritise their inclusion in national health agendas. Leveraging partnership with the Private sector, Governments have an opportunity to invest in significantly strengthening laboratory infrastructure, improving supply chain management and implementing quality assurance programmes that create coherent healthcare journeys.

Policies that promote diagnostics at the primary healthcare level and facilitate reimbursement mechanisms will go a long way in ensuring equitable access where access is limited by poverty. In the private sector, we must continue to advocate for member countries to support the proposed resolution and focus on the 2030 sustainable development agenda.5

Although a resolution is not legally binding, it is a powerful indication of the issues the WHO deems important and worthy of attention. The WHO resolution contains clear recommendations and calls to action for member states and prompts a monumental mindset shift, urging policymakers to commit and establish national diagnostics strategies. These strategies encompass infrastructure, workforce capacity and smart regulatory design.

As providers of healthcare solutions, we will seize this opportunity to establish a more significant investment in diagnostics as a pillar of health system resilience and health security and prioritise diagnostics in funding negotiations with government stakeholders.

The creation of robust healthcare systems requires a long-term vision. It demands sustainable funding models that ensure the availability and affordability of diagnostics for al. Initiatives that build innovative financing mechanisms – like public-private partnerships, insurance schemes and international funding commitments – are catalysts for healthier, more prosperous people. A timely investment now is an investment in the health and well-being of future generations.

The WHA has given diagnostics time to shine, and we must pool resources, expertise and technology to accelerate progress. Now, more than ever, increasing the percentage of healthcare budgets allocated to diagnostics is crucial.

A simple HIV viral load test can determine the amount of HIV circulating in a body and confirm if patients are responding to medication or if second-line therapies should be considered. Roche created the Global Access Programme to contribute to the UNAIDS 95-95-95 goal of treatment for all. Through the programme, Roche is expanding access to quality, sustainable diagnostic testing for countries hardest hit by HIV.6 over the last 9 years, Roche has leveraged the power of partnership and today delivers circa 60% of all HIV viral load testing in Africa.

Diagnosis is the catalyst for more effective disease management and better quality of life. New analysis from the Centers for Disease Control and Prevention reveals that the number of people receiving lifesaving HIV treatment through PEPFAR has increased 300 times in under 20 years, from 2004 to 2022.6,7

Early, accurate diagnosis enables appropriate and targeted treatments, reducing the need for prolonged hospital stays, unnecessary procedures and ineffective medications. As the World Health Assembly concludes and we reflect on the key takeaways, we can celebrate that diagnostics are no longer an afterthought but have been formally acknowledged as a central pillar of healthcare.

This giant leap provides a solid foundation for driving change in Africa. Now, we must work together to translate these global commitments into actionable steps, ensuring that diagnostics are accessible, affordable and integrated into healthcare systems across the continent.

Together, we can empower individuals, build resilient healthcare systems and save lives. Let’s seize this opportunity to power progress, transform the narrative and ensure that every African has access to quality diagnostics and healthcare.

By: Dr Allan Pamba – Executive Vice-President Diagnostics, Africa at Roche Diagnostics