Health
Half of approved diagnostics for Africa’s priority epidemic diseases unavailable at primary healthcare level – Report
A new report has revealed that about half of the approved diagnostic tests for six epidemic-prone diseases prioritised by the Africa Centres for Disease Control and Prevention (Africa CDC) cannot be used in most primary healthcare facilities across Africa because they require laboratory infrastructure that is often unavailable.
The report found that 50 per cent of approved diagnostics for Mpox, dengue, cholera, bacterial meningitis, malaria and Ebola depend on laboratory facilities beyond the reach of many frontline health centres.
For Ebola alone, 88 per cent of approved diagnostic tests require laboratory infrastructure.
It also found that funding for diagnostic research and development has steadily declined since 2015, despite Africa’s continued vulnerability to infectious disease outbreaks.
Findings come months after the 2026 Bundibugyo ebolavirus outbreak, during which health authorities initially failed to detect the virus because available diagnostic tests were designed to identify the Zaire strain of Ebola.
The mismatch delayed confirmation of the outbreak by 10 days, highlighting the consequences of gaps in Africa’s diagnostic preparedness.
The report, titled Diagnostics Deficit: Funding, Access, and Preparedness Gaps in African Health Systems, was launched by global health organisations PATH and Impact Global Health ahead of the African Union Extraordinary Health Summit in Accra, Ghana.
Rapid diagnostic tests play a critical role in identifying outbreaks early, guiding treatment and helping health authorities contain the spread of infectious diseases. However, limited access to these tools, particularly in primary healthcare centres where many patients first seek treatment, continues to weaken disease surveillance and emergency response across the continent.
Uneven progress
The report examined six diseases selected from Africa CDC’s priority list for their epidemic and outbreak potential: mpox, dengue, cholera, bacterial meningitis, malaria, and Ebola. Measles, although also on the priority list, was excluded because comparable G-FINDER funding data were unavailable.
Researchers identified 577 approved diagnostic products across six diseases, with another 59 still under development.
However, innovation remains heavily concentrated in just two diseases. Dengue and mpox account for 84 per cent of all approved and pipeline diagnostic products, while cholera and bacterial meningitis, both identified by Africa CDC as major outbreak and antimicrobial resistance threats, have only seven approved or pipeline products each.
Despite a growing number of diagnostic products, access remains a major challenge. Of the 577 approved diagnostics, 288 require clinical laboratory infrastructure, limiting their use in PHC facilities.
While 83 per cent of malaria diagnostics can be deployed at the PHC level, most approved diagnostics for Ebola and mpox remain laboratory dependent, restricting their use in frontline health facilities.
Further review showed that investment in diagnostic research and development has continued to decline. Using G-FINDER data, the analysis found that annual funding for six diseases has fallen by nearly $4 million (approx. ₦6 billion depending on exchange rates) since 2015, dropping from almost $55 million to less than $26 million in 2024.
It warned that funding typically rises during major outbreaks before falling sharply once emergencies subside, a cycle that leaves African countries inadequately prepared for future epidemics.
Experts’ concerns
Commenting on the findings, Sabastine Wakdok, Director of Research at Impact Global Health, said a steady decline in funding reflects a diagnostic research system struggling to keep pace with Africa’s growing outbreak risks.
Mr Wakdok said investment in research and development for diagnostics targeting six priority diseases has continued to fall despite rising disease incidence across the continent.
He noted that funding often increases during outbreaks but drops sharply once the immediate crisis passes, leaving African countries inadequately prepared for future epidemics.
“Diagnostic R&D investment for six Africa CDC priority diseases has fallen nearly $4 million annually since 2015. More troubling, this decline persists despite rising disease incidence and outbreak risk,” he said.
He added that the continent was not receiving the sustained investment needed for epidemic-prone diseases, warning that outbreak-driven funding cycles leave Africa “perpetually underprepared.”
Also commenting, PATH’s Senior Director for the Centre for Advocacy and Policy, Bernard Aryeetey, said the challenge goes beyond developing new diagnostic technologies to ensuring they reach the people and health facilities that need them most.
Mr Aryeetey stressed that the availability of diagnostic tools alone is not enough if they cannot be accessed during outbreaks or integrated into frontline health systems.
“It is not solely whether diagnostics exist, but also whether they can reach clinics and surveillance systems when they are most needed, especially during outbreaks,” he said.
He warned that unless barriers relating to access, affordability, deployment and manufacturing readiness are addressed, people will continue to die needlessly even when effective diagnostic tools are available.
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Recommendations
To address identified gaps, the report called for sustained domestic and international investment in diagnostic research, arguing that emergency-driven funding alone cannot build resilient health systems.
It urged African governments to increase national financing for diagnostics while encouraging global health donors to provide predictable, long-term support.
Authors also recommended that Africa CDC make diagnostics a central pillar of the continent’s health security strategy and called on researchers and manufacturers to prioritise developing diagnostic tools for use in PHC facilities, rather than relying mainly on technologies that require sophisticated laboratory infrastructure.
To improve access across the continent, the report urged the African Medicines Agency to harmonise regulatory approval processes so that diagnostic tests approved in one African country can be recognised more easily in others.
It also highlighted Africa’s growing manufacturing capacity, noting that facilities across the continent can collectively produce more than 500 million diagnostic units annually.
However, weak demand, fragmented regulation, financing constraints and limited ecosystem support continue to prevent manufacturers from operating at scale.
The report concluded that although Africa has expanded its diagnostic pipeline in recent years, improving access, affordability, manufacturing capacity, and deployment will be critical to strengthening the continent’s preparedness for future disease outbreaks.
The federal government has called for increased African-led research, stronger partnerships and sustainable financing to improve the prevention, diagnosis and treatment of hepatobiliary cancers.
The Minister of State for Health and Social Welfare, Iziaq Salako, made the call at the fifth Africa Hepato-Pancreato-Biliary Cancer Consortium (AHPBCC) Conference on Thursday in Abuja.
Mr Salako, who was represented by Ali Gombe, director of clinical services, National Institute for Cancer Research and Treatment (NICRAT), said African countries needed evidence that reflected their populations, disease patterns and health system realities to guide effective cancer interventions.
He called for greater investment in research covering epidemiology, risk factors, genetics, prevention, diagnosis and treatment, supported by cancer registries, clinical trials and collaborative research networks.
He also advocated the use of digital health, genomics, and artificial intelligence to strengthen cancer prevention, diagnosis, treatment, and surveillance.
“Research should translate into affordable, accessible, sustainable interventions for African populations,” Mr Salako said, describing AHPBCC as a valuable platform for multidisciplinary collaboration.
He said Nigeria was strengthening cancer prevention and early detection while expanding diagnostic and treatment capacity under the National Strategic Cancer Control Plan.
According to him, cancer control required an integrated continuum covering risk reduction, health education, early diagnosis, referral, surgery, systemic therapy, radiotherapy, palliative care and survivorship.
Mr Salako said the government was strengthening financial protection through the National Cancer Health Fund, although hepatobiliary cancers were currently excluded, with plans to expand its coverage.
He also cited the Nigerian Cancer Access Partnership, which provides 50 to 60 per cent discounts on anti-cancer medicines, as well as plans for a catastrophic health fund.
He said prevention remained central, particularly through tobacco control, healthier lifestyles and control of viral infections associated with cancer.
“For liver cancer, particularly hepatitis, emphasis is placed on prevention and control of hepatitis B and C through vaccination, screening, diagnosis and treatment,” he said.
Mr Salako said Nigeria was also investing in specialists, laboratories, cancer treatment centres and research infrastructure, alongside mentorship, fellowships, specialised training and knowledge exchange.
He stressed that no country or institution could address the cancer burden alone, urging governments, researchers, academia, civil society, development partners and the private sector to work together.
Abdulfatai Olokoba, president, Society of Gastroenterology and Hepatology in Nigeria (SOGHIN), said the conference exemplified such partnerships among organisations working across the cancer and digestive disease fields.
Mr Olokoba said the collaboration brought together oncologists, surgeons, pathologists, radiologists, scientists, nurses and other specialists to improve knowledge and skills.
He said hepatobiliary cancers remained particularly challenging in Africa because of late presentation, limited resources and capacity gaps, as well as inadequate awareness.
According to him, the three-day meeting would examine prevention, treatment, research, survivorship, public health education, vaccination, surgical innovations and approaches tailored to African realities.
Lewis Roberts, president, African Institute for Liver and Digestive Diseases (AILDD), said hepatobiliary cancers often occurred at younger ages in Africa, resulting in substantial years of life lost.
Mr Roberts said prevention and early detection should remain priorities, noting that cancers diagnosed early were generally more treatable and less costly to manage.
He said conference workshops were examining earlier detection of bile duct, pancreatic and liver cancers using advanced endoscopic procedures, endoscopic ultrasound, ultrasound and FibroScan.
He said research should also explore blood-based methods that could detect cancers earlier without requiring patients to undergo more demanding procedures.
For patients diagnosed at advanced stages, Mr Roberts said research into tumour biology could enable targeted chemical and immune-based treatments tailored to individual cancers.
ALSO READ: Four in 10 cancers worldwide could be prevented, WHO warns
He, however, noted that the cost of some advanced treatments, including monoclonal antibodies, remained beyond the reach of many African health systems.
“We have to start now, and we have to start here,” he said, urging African scientists to develop solutions suited to the continent’s realities.
The News Agency of Nigeria (NAN) reports that the conference, attended by more than 300 delegates from over 30 countries, focuses on prevention, treatment, research and survivorship for cancers affecting the liver, pancreas and biliary tract.
The conference, which began on Wednesday and ends on Saturday, brought together experts from Africa, the United States, Europe, Asia and other regions. (NAN)
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The World Health Organisation (WHO) has recommended a Phase III trial of an Ebola vaccine to test whether it can protect against Bundibugyo virus disease.
WHO Director-General, Tedros Ghebreyesus, disclosed this in a video posted on his official X account on Thursday.
Ghebreyesus said two vaccines specifically developed against the Bundibugyo virus had entered Phase I safety trials in humans. At the same time, new animal studies had shown promising evidence that Ervebo, an Ebola vaccine, could also provide cross-protection against the virus.
He said the findings prompted WHO to recommend Ervebo for inclusion in a Phase III trial, which the organisation hopes to begin as soon as possible.
However, it is not yet known whether Ervebo can protect humans against Bundibugyo virus disease.
Mr Ghebreyesus said the Phase III trial would help establish whether the vaccine is safe and effective and could provide evidence needed to make it available for the current outbreak and future outbreaks.
No licensed vaccines
The development comes as the Bundibugyo virus outbreak in the DRC has become the second-largest Ebola outbreak on record.
As of Thursday, the country had recorded 4,449 confirmed cases and 2,061 deaths across five provinces and 53 health zones, according to the WHO.
The health agency said the outbreak was spreading faster than any previous Ebola outbreak at the same stage and could surpass the 2014–2016 West African outbreak, which remains the largest on record, with more than 28,000 cases and 11,000 deaths reported in Guinea, Liberia and Sierra Leone.
Bundibugyo virus is one of the viruses in the Ebola family that can cause severe and often fatal disease in humans.
Unlike Ebola virus disease caused by the Ebola virus, there is currently no licensed vaccine specifically approved for the prevention of Bundibugyo virus disease.
WHO said in June that Ervebo, the only licensed and WHO-prequalified Ebola vaccine, is approved for Ebola virus disease but not for Bundibugyo virus disease.
The current outbreak was first detected in the DRC in May, following an unexplained cluster of deaths in Ituri Province that was investigated. Laboratory testing confirmed Bundibugyo virus disease, prompting the DRC government to declare its 17th Ebola outbreak.
Uganda also confirmed imported cases linked to the outbreak in the DRC. WHO subsequently determined that the outbreak in the two countries constituted a Public Health Emergency of International Concern.
Previous Bundibugyo virus outbreaks have had case fatality rates between 30 and 50 per cent, according to the WHO.
PREMIUM TIMES reported on 9 August that WHO had already recommended Ervebo for evaluation in a randomised clinical trial after reviewing evidence suggesting that it could provide some protection against Bundibugyo virus.
Treatment advancement
Mr Ghebreyesus also disclosed progress in research into treatments for Bundibugyo virus disease.
He said a WHO-sponsored partners trial had reached 100 patients.
The trial is assessing potential treatments for the disease and is intended to generate evidence on which therapies can improve outcomes for infected patients.
READ ALSO: DRC Ebola outbreak becomes second-largest on record WHO
Mr Ghebreyesus said the milestone showed that research could be mobilised rapidly and responsibly even during a difficult outbreak.
He called on partners to support and accelerate the vaccine trial, while emphasising that the response requires collaboration among the DRC government, WHO, Africa Centres for Disease Control and Prevention (CDC) and other partners.
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