Dr John Nkengasong, Director of the Africa Centres for Disease Control and Prevention (Africa CDC) has told Health Policy Watch that the continent is not in short supply of COVID-19 test kits. According to him, every African country that is in need of the test supplies can get it if they want.

An open letter dated 31 January that was written by concerned members of civil society, clinicians, advocates, and communities affected by COVID-19, to the World Health Organization (WHO) urged it to rapidly recommend self-testing for COVID-19.

While calling on the global health body to expedite the finalisation and release of a self-testing guideline for SARS-CoV-2 infection that includes a strong recommendation in favour of widespread access to self-testing, they noted that low- and middle-income countries (LMICs) represent nearly 85% of the global population but that only 40% of tests for COVID-19 have been used in LMICs. 

“As a result, the reported average daily testing rate of high-income countries is, per capita, nearly 10 times higher than that of middle-income countries and close to 100 times higher than that of low-income countries,” the letter stated.

In Africa, according to the experts, citing WHO AFRO region, said 85% of COVID-19 infections are going undetected. 

“This inequity in access to the diagnostic tools that trigger life-saving individual and public health measures is part of the same ‘medical apartheid’ that has plagued the rollout of COVID-19 vaccines,” the experts noted.

But on Thursday, Nkengasong noted that Africa has seen a remarkable change and improvement in access to testing. 

“We are here in the middle of the African Union (AU) Summit and we are characterizing it as a COVID-free summit, which means every day we conduct testing on all the delegates, and those are thousands of people that are tested. We have not run out of tests,” Nkengasong said.

He said if countries follow the guidelines that the Africa CDC has given them, they will be able to access testing. 

Prioritising testing at the country level

He argued that the major determining factor for closing the COVID-19 testing gap in Africa is at the country level — enjoining governments to prioritise testing as a major cornerstone of their pandemic response.

While the continent’s testing data fluctuates from one week to another, it does not suggest that the continent is in short supply of testing kits, he added, describing the trend as a reflection of the priorities of the governments concerned.

“Testing will continue to be key. We see the test numbers fluctuate. Some weeks you have a very high increase in testing and then the following week you see a decrease. But that doesn’t necessarily reflect a lack of tests. 

Instead, he said the trend could suggest that countries actually engaged in testing or they are doing selective tests — “which most of the cases is about people who have symptoms or people that are trying to travel, not really systematic testing going on”.

In May 2020, the WHO published criteria in which it described a positive rate of less than 5% as an indicator that the epidemic is under control in a country. While this data for several African countries is not available, available data showed positive rates on the African continent ranging from 0.64% in Rwanda to 37.4% in Tunisia.