Only one in seven COVID-19 infections are being detected in Africa because of inadequate testing, the WHO said in an assessment released alongside the announcement of a rapid testing pilot programme in the region.
Since the onset of the pandemic, Africa has reported more than 70 million COVID-19 test results, whereas the United Kingdom with less than 10 per cent of Africa’s population has administered 280 million tests as of this month (10 October).
“Now is the time to go [on the] offensive against COVID-19 to address these testing challenges,” Matshidiso Moeti, WHO Regional director for Africa, told a press conference last week (14 October).
“[The] WHO’s new community testing initiative is radically new approach which shifts from passive to active surveillance through working with communities.”
The initiative will boost community-based screening using rapid diagnostic tests (RDTs) for COVID-19 in eight African countries.
Countries participating in the pilot programme are Burundi, Côte d’Ivoire, Congo, Democratic Republic of the Congo, Guinea-Bissau, Mozambique, Senegal and Zambia.
Moeti explained that more than a third of African countries do not meet WHO recommendations of ten tests per 1,000 people each week and that there is a need to rethink testing strategies.
“With limited testing we’re still flying blind in far too many communities in Africa,” she said.
According to Moeti, most tests are carried out on people with symptoms, whereas much of the transmission is driven by those who do not show symptoms, representing 65 to 85 per cent of COVID-19 cases.
She said the initiative will involve local authorities in hotspots or highly affected districts using RDTs which are fast, reliable, affordable and easy to use.
“Using a ring-based testing strategy, all individuals living within a 100-metre radius of a case will be eligible for voluntary testing,” she explained.
Ngozi Erondu, a senior scholar at the Global Health Policy and Politics Initiative of the O’Neill Institute at Georgetown University in the United States, said that having RDTs closer to the community means more individuals tested and traced.
According to Erondu, at the inception of COVID-19, many African countries had poor quality RDTs, resulting in a high level of distrust.
“[But] RDTs are the only way to have accessible, reliable and affordable widespread testing of COVID-19,” she warned.
“Testing more people will tell us where the virus has gotten to, and community data will help us to detect specific districts or villages that are having active outbreaks,” Erondu added.
The WHO’s Moeti added that vaccination is an important weapon in winning the fight against the COVID-19 pandemic by reducing the chain of transmission to others who are not infected.
“Being vaccinated is a service not only to yourself but your family and the community,” she explained.
But Richard Mihigo, coordinator of the Immunization and Vaccines Development Programme at the WHO Regional Office for Africa, added that there are not enough vaccines available on the continent and advised and called for Africa to start building capacity to have its own vaccines locally produced to prevent vaccine shortages and delays.
Moeti said there is a need for collaborations and support by African governments, manufacturers and researchers to ensure vaccine independence in the continent, a movement which is already underway in many low- and middle-income regions.
“With the kind of delays we’ve seen and differences in coverage with the second dose in Africa compared to other regions, the continent has suffered a significant delay with response to getting vaccines,” Moeti said.
“Africa should look for long-term solutions including collaborating and building capacity to produce [vaccines] locally.”
*Nelson Mandela Ogema is one of SciDev.Net’s Sub-Saharan Africa English Edition correspondents with keen interest on science and technology issues. He is passionate about Science journalism. This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.