COVID-19: diagnostics in the global spotlight

These are challenging times, and I’d like to open this message with a sincere wish that you and your loved ones are well.

The COVID-19 pandemic has changed the game for global public health. Never before have diagnostics had the attention of the whole world. It is crystal clear that controlling the outbreak by flattening the curve and reducing transmission – while maintaining functioning societies – depends on improved test production capacity and mitigation of supply chain interruptions, at a time when unprecedented diagnostic demand is coming from every corner of the world.

The challenges around diagnosis for COVID-19 are of course magnified in low- and middle-income countries. These countries have the lowest rates of testing reported to WHO. There is also evidence that the pandemic is impacting access to diagnosis for essential care, particularly for women and girls. The consequences are significant, both for mounting an effective public health response to reduce transmission as well as providing care to patients when infections do occur.

While the private sector has rallied to develop new diagnostics, FIND is working to channel these innovations into prioritized areas of activity; facilitating international collaboration and coordination, and addressing the issues of access and equity for low- and middle- income countries at a time where high demand and panic have caused shortages and barriers for sharing of tests, components, and technology.

The Global Preparedness Monitoring Board (GPMB), an independent body convened by WHO and the World Bank, has identified an $8 billion funding gap for COVID-19 that must be urgently filled. Wellcome recently announced the launch of their COVID-Zero initiative to fill this gap, and FIND is coordinating the diagnostic needs. We are very grateful for new COVID-19 funding already received from Unitaid as well as UK aid from the British people, and we are also working with others who stand ready to support us. I am hopeful that more engagement will follow, to enable us to address today’s pandemic and ensure it comes to an end – and that we can be prepared for the next one.

There are now over 500 tests for SARS-CoV-2 (the causative agent of COVID-19) listed in the diagnostic pipeline we are collating. Understanding which of these tests should be used when, where and how is critical and high priority for us. There is a chronic lack of data across the board that is compromising decision making and frankly putting lives at risk. We are working with WHO and in partnership with the University Hospitals of Geneva (HUG), among others, to conduct independent evaluations of tests meeting our criteria. We published our first data this week. We’d love to move more quickly with these evaluations, but getting hold of the tests is challenging; as an example, we’re working hard to obtain tests even for study purposes as nearly every country has restricted COVID-19-related exports, notably on key diagnostics supplies.

In parallel, we have an open call for SARS-CoV-2 test performance data generated from assessment in any independent laboratory. We are centralizing these data and making them openly accessible on our website.

Together with WHO, we are driving access to diagnostics for LMICs in a supply chain consortium. We have mapped supply chains to be able to address bottlenecks through innovative solutions that include know-how sharing.

Providing technical assistance to labs is of course crucial and among other initiatives we have teamed up with the African Society for Laboratory Medicine (ASLM) and the London School of Hygiene and Tropical Medicine to develop an open-access online training course (MOOC) that will be launching on Monday (20 April).

We also have a range of other tools online, including an interactive test tracker that maps the number of tests reported to have been performed in each country, which is updated daily. More data tools are on the way, such as a diagnostic implementation simulator that uses modeling data to simulate the outcomes of different testing strategies. Do check in regularly to our COVID-19 diagnostics resource centre.

Of course, against this backdrop we are also trying hard to mitigate the impact on our ongoing programmes, exploring new (virtual) approaches to traditional activities such as clinical trial monitoring. COVID-19 is not just a global health tragedy in its own right, it also threatens the end-game for many other deadly diseases, including TB and malaria. The repercussions will be felt for a very long time.

I will keep you updated but please don’t hesitate to reach out to me or the team if you have any queries or need specific information on any of our work.