Abstract
BackgroundAs a novel and deadly acute respiratory syndrome, which later became known as coronavirus disease 2019 (COVID-19), spread beyond China in late January 2020, there were no laboratories in Africa that could test for the disease. However, in early March, just over a month later, 42 African countries had developed the expertise and resources to perform COVID-19 testing. Our goal was to document this public health success story, learn from it, and use it to inform future public health action.InterventionThree groups were primarily responsible for establishing COVID-19 testing capacity in Africa. The first group comprised early test manufacturers who reacted with incredible speed and ingenuity early in the pandemic, such as the German company TIB MolBiol that developed a molecular test for COVID-19 before the SARS-CoV-2 genome sequence was available. The second group included private and public donors such as the Jack Ma Foundation, and the last were the coordinators of the rollout, such as the World Health Organization and the Africa Centres for Disease Control and Prevention (CDC).Lessons learntThe first lesson was that speed is critical, especially during a crisis. It was also demonstrated that being a predictable and transparent trusted institution opens doors and improves effectiveness. Africa CDC, which was only three years old, was able to secure significant resources from external partners and rapidly build substantial testing capacity within Africa because it is a trusted institution.RecommendationsLow- and middle-income countries must build local trusted institutions to better prepare for public health challenges.
Highlights
As a novel and deadly acute respiratory syndrome, which later became known as coronavirus disease 2019 (COVID-19), spread beyond China in late January 2020, there were no laboratories in Africa that could test for the disease
When Côte d’Ivoire had its first suspected coronavirus disease 2019 (COVID-19) case in late January 2020, the nearest laboratory capable of performing COVID-19 testing was in Paris, France.[1]
Sub-Saharan Africa had less than 1% of the molecular testing capacity of that in the United States, thanks to HIV control efforts, every country had at least one location that could perform molecular testing once the SARS-CoV-2 molecular reagents were available.[4]
Summary
When Côte d’Ivoire had its first suspected coronavirus disease 2019 (COVID-19) case in late January 2020, the nearest laboratory capable of performing COVID-19 testing was in Paris, France.[1]. Nucleic acid-based tests ( called molecular or polymerase chain reaction [PCR] tests) work by directly detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA. These molecular tests are more specific and sensitive than antigen-based tests but are 3–10 times more expensive and require more complex instrumentation.[3] in early 2020, the overwhelming majority of COVID-19 tests available globally were molecular. Sub-Saharan Africa had less than 1% of the molecular testing capacity of that in the United States, thanks to HIV control efforts, every country had at least one location that could perform molecular testing once the SARS-CoV-2 molecular reagents were available.[4] This article tells the story of how 42 African countries were able to acquire COVID-19 PCR testing capacity in two months in early 2020
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