Africa has increased technical capacity for diagnosing infectious diseases since the COVID-19 epidemic but with ongoing outbreaks of diseases there is an urgent need to address the gaps in diagnostic capacity and disease surveillance says new research published in the journal, Frontiers Public Health.
Africa Centres for Disease Control and Prevention (Africa CDC) says the continent experienced 180 public health emergencies, of which 90% were infectious diseases and 75% were related to zoonotic diseases in 2023. The events included mpox, diphtheria, dengue, Lassa fever, measles, poliomyelitis, Rift Valley fever and cholera.
Africa CDC has made a list of priority epidemic-prone diseases for Africa which was used as a risk ranking tool for the survey. The list aims to guide actions for epidemic preparedness and response, and to inform research and technology development which includes creating and providing vaccines, diagnostics, and therapeutics. The disease ranking process updates with new evidence.
"The study conducted by the Africa CDC aims to identify gaps in diagnostic capabilities and surveillance systems, providing valuable insights to guide policymaking, resource allocation, and interventions that strengthen Africa's preparedness for future epidemics," said Dr Aytenew Ashenafi at the Centre of Laboratory Systems Division, Africa CDC in Addis Ababa, Ethiopia who led the study.
The Africa CDC conducted this study to assess laboratory capacities, disease priorities, and public health surveillance systems across African Union Member States, with a focus on identifying the major challenges in building and enhancing testing capacities for effective outbreak detection and response to epidemic-prone diseases.
Dr Ashenafi said the significance of the study lies in its ability to pinpoint gaps in diagnostic capabilities and surveillance infrastructure, which are critical for timely and accurate responses to health emergencies.
The researchers carried out an online self-assessment survey in 15 African Union Member States of 22 epidemic-prone diseases between February and April 2023. The assessment aimed to identify major challenges in testing for epidemic-prone diseases. The survey assessed the ability to diagnose epidemic-prone diseases at different lab levels. It explored the challenges of building and keeping testing capacity to improve outbreak response and reduce public health impacts. The survey data analysed, by country, the diagnostic capacity for priority infectious diseases. It looked at the diagnostic technologies in use, existing surveillance programmes, and challenges limiting diagnostic capacity. The Africa Laboratory Technical Working Group was consulted to test the validity of the survey which was in English and French.
From the southern region, South Africa, Lesotho, Malawi, Mozambique, Eswatini and Madagascar participated in the study. Carbo Verde, The Gambia, Liberia and Sierra Leone were respondents from west Africa. In East Africa, Ethiopia, and Somalia shared their status and from central Africa, the Central Africa Republic was the only participant. From north Africa Mauritania and Sahrawi took part.
"One surprising aspect of the study could be the variation in laboratory capacities across African Union Member States, with some countries facing significant limitations that may be more pronounced than expected, highlighting the need for targeted investments in laboratory capacity to improve diagnostic capabilities and surveillance systems," said Dr Ashenafi.
Eighty-five percent of countries that responded to the survey cited inconsistent laboratory supplies such as PCR reagents, extraction kits and consumables as the primary challenge to developing laboratory capacity to diagnose future epidemics. This was followed by inadequate infrastructure (45%), limited government funding (43%), inadequate equipment management (35%) and inadequate human resources (25%), said the study.
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By providing valuable insights into these challenges, the study will guide policymaking, resource allocation, and the development of targeted interventions aimed at strengthening Africa's preparedness for future epidemics.
Dr Ashenafi said the study findings will contribute to building a more robust and resilient public health system across the continent, improving the ability to respond to disease outbreaks and prevent future health crises.
"Countries need to prioritise rapid diagnostic tests and portable technologies while strengthening national and regional laboratory networks," he said. "The study's findings provide a roadmap for African member states to identify critical gaps in laboratory capacity and surveillance systems, enabling targeted investments, informed policy development, and regional collaboration to strengthen epidemic preparedness and resilience," Dr Ashenafi noted.
