By AGGREY OMBOKI
ACCRA, Ghana — In May 2026, health responders in Ituri Province, a remote region of the Democratic Republic of Congo (DRC), scrambled to contain a suspected haemorrhagic fever outbreak. Acting swiftly, medical teams carried out standard diagnostic tests for Ebola, but the results came back negative.
For 10 days, the outbreak spread undetected before health officials confirmed the culprit was the Bundibugyo ebolavirus strain, first identified in 2007 in Uganda’s Bundibugyo District near the DRC border. The initial tests failed because the available diagnostic tools had been designed to detect a different Ebola strain, exposing a critical gap in frontline diagnostic capacity across Africa.
The vulnerability is highlighted in a landmark report released by global health non-profits PATH and Impact Global Health.
Titled The Diagnostics Deficit: Funding, Access, and Preparedness Gaps in African Health Systems, the report reveals that half of all approved diagnostic tools for six epidemic-prone diseases prioritised by the Africa Centres for Disease Control and Prevention (Africa CDC)—mpox, dengue, cholera, bacterial meningitis, malaria and Ebola—require specialised laboratory infrastructure that is unavailable in most African primary healthcare facilities.
For Ebola alone, 88 per cent of approved diagnostic tools cannot be used at the frontline. The report was launched ahead of the African Union Extraordinary Health Summit in Accra, where heads of state and government are meeting to discuss strategies for reducing preventable deaths.
Funding shortfall
The report attributes much of the diagnostic gap to a chronic lack of sustained funding. An analysis of G-FINDER data shows that global investment in diagnostic research and development (R&D) for the six priority diseases has declined by nearly US$4 million annually since 2015.
“Our G-FINDER data reveals a system under strain,” said Dr Sabastine Wakdok, Director of Research at Impact Global Health.
“Diagnostic R&D investment for six Africa CDC priority diseases has fallen by nearly US$4 million annually since 2015. More troubling is that this decline has continued despite rising disease incidence and increasing outbreak risks. Instead of sustained investment, funding tends to spike during outbreaks before rapidly declining, leaving Africa perpetually underprepared.”
The report says this inconsistent funding has created major imbalances in healthcare innovation across the continent. Of the 577 approved diagnostics and 59 products currently under development, 84 per cent are focused solely on dengue and mpox.
In contrast, cholera and bacterial meningitis—both identified by Africa CDC as major outbreak threats and drivers of antimicrobial resistance—have only seven approved or pipeline diagnostic products each.
Kenya and the region
The report notes that Eastern African countries, including Kenya, face a particularly acute diagnostic challenge.
Although Kenya has transitioned to the Social Health Authority (SHA) as part of efforts to achieve Universal Health Coverage, national health spending remains heavily weighted towards curative care rather than preventive surveillance and diagnostics.
Rachel Ndirangu, PATH’s Regional Director for Advocacy and Policy, said African governments must adopt home-grown policy solutions to strengthen diagnostic systems.
She noted that Kenya, like many other African countries, has yet to meet the 2001 Abuja Declaration target requiring governments to allocate at least 15 per cent of their national budgets to healthcare.
The report also cites Africa CDC data showing that although Africa bears nearly a quarter of the world’s disease burden, it contributes less than three per cent of global health research output.
More than 90 per cent of medicines and diagnostic products used across the continent are imported, leaving health systems vulnerable to global supply chain disruptions.
“African patients wait far too long for diagnostic tests,” said Dr Esther Anyango, Advocacy and Public Policy Officer at PATH, citing fragmented regulatory systems as a key barrier to timely access.
Infrastructure and regulatory barriers
According to the report, the diagnostics deficit stems from several structural weaknesses, beginning with inadequate infrastructure and a shortage of skilled personnel.
Many frontline health workers in community health facilities lack the training and equipment needed to conduct sophisticated molecular or PCR tests. Diagnostic tools that require uninterrupted electricity, refrigeration or laboratory equipment such as centrifuges remain impractical for large parts of rural Africa.
The report further argues that many diagnostic products are designed for well-resourced laboratories in high-income countries rather than the realities of African primary healthcare settings. Instead of affordable, easy-to-use rapid diagnostic tests, most products require complex laboratory environments.
Regulatory fragmentation also remains a major obstacle. A diagnostic test approved in one African country often has to undergo a separate approval process in neighbouring states, delaying deployment during disease outbreaks.
Policy recommendations
The report outlines several reforms aimed at closing the diagnostic gap.
“It is not solely whether the diagnostics exist, but whether they can reach clinics and surveillance systems when they are needed most, especially during outbreaks,” said Bernard Aryeetey, Senior Director of the Centre for Advocacy and Policy at PATH.
Aryeetey warned that unless governments address challenges related to access, affordability, deployment and local manufacturing, preventable deaths will continue despite advances in diagnostic technology.
Among the report’s recommendations are incentives for regional manufacturing of affordable point-of-care diagnostic tools that do not require laboratory infrastructure.
It also calls on the African Medicines Agency to harmonise regulatory approval processes so that a diagnostic approved in one member state can be fast-tracked across the continent.
In addition, the report urges Africa CDC to make diagnostic preparedness a core pillar of health security planning and recommends that member states legally protect national budget allocations for disease surveillance while working towards the continental target of investing one per cent of GDP in domestic research and development.
The report concludes that the 10-day delay in identifying the Bundibugyo ebolavirus outbreak in the DRC should serve as a wake-up call.
While the science and technology to detect deadly diseases already exist, Africa must now mobilise the political commitment and financial resources needed to place these diagnostic tools in the hands of frontline healthcare workers, where they can save lives before outbreaks spiral out of control.
