Table 2

Key challenges to diagnostic preparedness and potential solutions

ChallengesProposed solutions
Research and development
 Lack of diagnostics in a format adapted for field use
  • Develop comprehensive diagnostic platforms that can rapidly adopt new assays to build sustainable capacity at country level.

  • Develop diagnostics with limited sample preparation and training needs.

 Insufficient funding and lack of coordination between donors leading to duplication of effort
  • Establish coordinating body for diagnostics funding.

  • Match small start-up companies/academia with larger diagnostics or vaccine/pharmaceutical manufacturers with greater capacity.

 Poor commercial viability of diagnostics during non-outbreak periods
  • Provide market incentives for manufacturers and establish sustainable business models to offset losses during non-outbreak years.

  • Provide funding for stockpiling of tests.

 Limited access to samples leading to further delays in diagnostic development
  • Establish a specimen sample bank, open to both the diagnostics and vaccines industries, including storage locations and processes for access.

 Limited collaboration between experts and laboratories with pathogen-specific expertise
  • Expand networks of expert personnel and laboratories to allow more rapid responses during outbreaks and maximise knowledge sharing.

  • Partner diagnostics and vaccine developers to find novel diagnostic targets.

 Delays in sharing of diagnostic data affecting response and containment times
  • Create connectivity solutions enabling real-time data reporting.

Logistical and healthcare system preparedness
 Shortages of diagnostic materials and supply chain interruptions during outbreaks
  • Preselect suppliers to ensure appropriate capacity for outbreak situations.

  • Establish manufacturing lines for diagnostic production during outbreaks.

 Poor diagnostic and surveillance capacity at national level in many countries
  • Reinforce surveillance capacities through implementation of surveillance laboratory networks, adapted to specific country needs, or transformation of surveillance laboratories for routine testing.

  • Educate healthcare workers on the importance of real-time reporting.

  • Link diagnostics and vaccines in a common health programme.

  • Adopt a ‘One Health’ surveillance approach that integrates human, animal and ecological health.