Experts sound alarm over lack of Covid-19 test kits in Africa

Emmanuel Akinwotu West Africa correspondent
Photograph: Akintunde Akinleye/EPA

Public health experts have warned about the risks of low supplies of coronavirus test kits as lockdowns in African countries begin to ease and urban populations become more mobile.

Different countries on the continent have adopted a range of testing strategies, but international competition for test kits and a lack of global coordination of resources have meant many African countries are testing with significantly limited reach.

More than half of African countries are experiencing community transmission as lockdown measures relax.

Kate Dooley, the director for West Africa at the Tony Blair Institute, said: “Most governments are currently rationing their use of test kits given limited supplies. We are aware of some cases where African governments who placed orders in early March are still yet to receive the supply, six to eight weeks later.”

Testing capacity, logistics and staffing challenges posed structural constraints to the ability of many countries to increase testing even when supplies became available, she said. Some countries, such as Nigeria, had been waiting months for deliveries of test kits.

There are 112,000 confirmed cases of Covid-19 in Africa, and 3,000 people are confirmed to have died from the virus.

Total infections are lower than in most other continents, owing in part to the effectiveness of lockdown and control measures, adopted early by several countries when cases were in their low dozens.

According to the World Health Organization, 1.5m Covid-19 tests have been conducted in Africaover the last 6 weeks. South Africa and Ghana account for half of the tests, and just eight African countries have administered more than 3,000 tests per million people.

The Africa Centre for Disease Control and Prevention has set up a digital purchasing platform, being piloted this week, to let African governments bulk order test supplies and protective equipment. It is hoped the platform will improve the continent’s negotiating position when bidding for supplies.

The ACDC director, Dr John Nkengasong, said last month that “a collapse of global cooperation and a failure of international solidarity have shoved Africa out of the diagnostics market”.

“African countries have funds to pay for reagents but cannot buy them,” he added.

According to Dr Iruka Okeke, the editor of the African Journal of Laboratory Medicine, gains made by African countries in the early stages of the outbreak could be at risk from a lack of test supplies.

“Unless we can vastly ramp up testing we risk entering a stage where it spreads through communities where there isn’t the capability to test them,” she said.

The prevalence of virus response measures and detection systems in countries that have already experienced deadly viruses has been vital, according to Okeke.

“Responses to Ebola, HIV and Lassa fever have improved the level of molecular biology in Africa, which countries have leveraged well.

“The problem is countries were preparing for an epidemic not a pandemic, so now African countries are competing for the same consumable resources as the other countries.”

Parts of Ghana’s virus response have emerged as a model in the region. With a population of 29 million, the country has tested almost 200,000 people, one of the highest rates in Africa. The country has registered 6,800 infections with over 2,000 recoveries, while 32 people have died.

Ghana has just five laboratories that can test for Covid-19 but has innovated to improve test levels, running laboratories for 24 hours, using drones to deliver samples from rural areas, and testing multiple samples at the same time.

Improving the level of testing in Africa’s most populous country has been difficult. Nigeria has 7,800 confirmed infections, with a third recovered and 226 deaths.

But according to Dr Casmir Ifeanyi, the president of the Association of Medical and Laboratory Scientists of Nigeria, a medical union, confirmed cases were “an underestimation of Covid-19 mobility.

“We have conducted fewer than 40,000 tests. For a country of 200 million where we have community transmission across the country, that is not the sample size to make any deduction about the spread of the virus.” Mass deaths in Kano have put pressure on authorities to increase testing.

There are now 25 laboratories that can test for Covid-19, up from five before the first confirmed case in February. But despite a capacity for 2,500 tests a day, Nigeria often administers less than half, hampered by personnel and logistical constraints, particularly in rural and insecure areas.

“We’re in a very severe situation especially now the government is talking about further easing the lockdown,” Ifeanyi said. “Without testing this will create problems.”