Janet Ogundepo
A new report has found that four in five patients across Africa do not get appropriate diagnostic tests at primary health care facilities.
The report, published by global health non-profits PATH and Impact Global Health ahead of the African Union Extraordinary Health Summit in Ghana, found that only 19 per cent of people seeking care at primary health facilities across the continent could access diagnostic tools, leaving 81 per cent without any means of being accurately tested before treatment decisions were made.
It analysed six priority diseases for which the Africa CDC recommends faster diagnosis because of the high number of epidemics they cause, including mpox, dengue, cholera, meningitis, malaria, and Ebola, and found that cost, importation barriers, regulatory hurdles, and declining international funding were collectively preventing diagnostic tools from reaching the clinics and communities that needed them most.
The report warned that declining funding for diagnostic research and development, which fell by 56 per cent between 2015 and 2024, was moving in the opposite direction to the growing threat of disease outbreaks, and called for sustained investment to ensure countries had the tools they needed before the next epidemic struck.
The report noted that when tests were available, many African countries still struggled to access and use them because they were expensive and often manufactured and imported from abroad, with different regulatory requirements and the inability of countries to validate equipment locally adding further barriers to access.
It said only 577 diagnostics had been approved and found safe for use by various regulatory authorities, with another 59 remaining in development.
The Senior Director of the Centre for Advocacy and Policy at PATH, Bernard Aryeetey, said the problem was not the existence of diagnostic tools but whether they could reach clinics and communities when they were most needed.
He said, “It is not whether the diagnostics exist, but mainly whether they can reach the clinics and surveillance systems when they are needed the most, like during outbreaks, and whether communities can afford and access them.”
The report specifically highlighted Nigeria as a country that had experienced severe consequences from diagnostic failures, especially for cholera.
“Nigeria has experienced these diagnostic challenges, especially for Cholera. The country has recorded major outbreaks in 1991, 2010, and 2021.
“In 2026 alone, Nigeria has recorded 6,860 cases and 80 deaths, with a case fatality above the World Health Organisation threshold of one per cent, with most cases in Borno State.
“Researchers have cited a lack of rapid diagnostic test kits and weak laboratory diagnostics, which have undermined effective treatment. If the challenge of access, affordability, deployment, and manufacturing readiness is not solved, more will die, yet innovative diagnostic tools exist,” it stated.
The report also pointed to the recent 2026 Ebola outbreak as a stark illustration of what happens when diagnostic gaps are not addressed, noting that initial samples tested negative because the assays available were designed to detect only the Zaire ebolavirus and could not specifically detect Bundibugyo ebolavirus, the species responsible for the current outbreak.
It said, “Without accurate results, health care workers cannot provide treatment or prescribe medicine on time, leading to deaths.”
On funding, the report said its analysis of data from G-FINDER, the research and development funding portal, found that funding for the six diseases had decreased by nearly $4m a year since 2015, falling by 56 per cent from $55m in 2015 to $24m in 2024.
The Director of Research at Impact Global Health, Sabastine Wakdok, said investment in diagnostic research and development was moving in the opposite direction.
He said, “While outbreaks continue to emerge and disease threats evolve, funding remains driven by crisis cycles rather than long-term preparedness.”
The global health organisations said sustained investment is essential to ensure that countries have the diagnostic tools they need before the next outbreak occurs.
The report was published ahead of the African Union Extraordinary Health Summit in Ghana, where African heads of government were meeting to discuss strategies for reducing preventable deaths on the continent.
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