‘We cannot control what we cannot measure’: experts urge countries to ramp up funding for coronavirus testing

Efforts to control the pandemic in low and middle income countries received a $60 million boost on Monday, but experts said more is needed to help tackle Covid-19 via one underfunded but effective element of the response: testing.

Australia, Germany and Saudi Arabia pledged $60m to the Foundation for Innovative New Diagnostics (FIND) to increase universal access to rapid and reliable coronavirus tests in under-resourced countries.

FIND forms a major part of the World Health Organization’s global Access to COVID-19 Tools (ACT) Accelerator scheme to ensure fair and easy access to tests, vaccines and treatments across the world.

However, while the new round of funding will go towards creating and distributing millions more reliable and rapid coronavirus tests, Dr Catharina Boehme, CEO of FIND, told The Telegraph that there is still much that needs to be done.

“This is very crucial funding that also comes at a critical time point to enable and accelerate  progress in tests and testing capacity for Covid-19. But in total, we need $1 billion over the next 12 months to basically make sure that we get access to the tests we need and to enable their implementation,” she said.

The World Health Organization (WHO) has long stressed that testing is one of the cheapest and most reliable ways to limit the spread of infection, but Dr Boehme suggested that many countries had taken their eye off the ball when it came to investing in this tool.

“We very widely see that people think that the vaccine will be a silver bullet. The fact is, though, that testing will remain critical,” she said. “It's shown to save lives, it's shown to be effective. It's important for surveillance efforts.”

However, while significant diagnostic progress has been made since the start of the pandemic, there still are not reliable tests that can easily enable crucial elements of the global economy, including border crossings, hospitality, or tourism to quickly reopen, Dr Boehme said.

Across the world, molecular tests – or polymerase chain reaction tests known as PCRs – remain the gold standard for producing reliable coronavirus results.

But these types of tests require access to laboratories, reliable infrastructure and highly trained personnel. The process is time consuming – especially when there is a deluge of samples – and costly, which can be a particular barrier for low- and middle-income countries.

Even the UK, with its multi-billion pound testing programme, has in recent weeks struggled to process and turn around tests in the timely manner needed to keep track of the virus.

“We've seen in many countries that the turnaround time to get the results back to patients is way too slow,” Dr Boehme explained. “It's three to four days in many countries, sometimes longer, but by that time patients will have infected others.”

The key to getting the virus under control, says Dr Boehme, is for states to invest in the development and distribution of rapid antigen tests (RDTs) – something that FIND’s latest funding boost will help enable lower and middle income countries to do.

Rapid tests to detect the presence of the virus at the point of care are faster and cheaper than molecular PCR tests – producing results as fast as 15 minutes – but are not quite as accurate and still currently require trained health professionals to conduct them.

In wealthier countries, some private companies have been offering RDTs for months, but the efficacy of many of these tests remains unproven.

“The diagnostic field is a bit of a wild west,” Dr Boehme told The Telegraph. “There's a lot of sub-optimal tests that are on the market.”

Of the 900 registered RDTs, at least two meet WHO standards. However, these tests are not yet as affordable as they could be, Dr Boehme explained.

“At the moment, these types of RDTs cost $5 (£3.84) per test. Our plan is to have the pricing halved by January, right to $2.50 dollars a test.”

With more funding, “the aim is then for coronavirus RDTs to cost only as much as a malaria rapid diagnostic test, which is roughly 16 to 20 cents,” she added.

In the meantime, FIND’s plan is to roll out as many tests as they can with the funding available.

Last month a set of agreements to make 120 million of these affordable and quality Covid-19 antigen rapid tests available to low- and middle-income countries were announced by the ACT-Accelerator scheme.

The plan has been described as a “game changer” for regions like Africa, where demand for coronavirus testing has often outstripped supply.

However, FIND warns that if lower and middle income countries begin testing at the same rate as high income countries, then the 120 million tests would last just eight days.

Without further investment in coronavirus testing, the global fight against Covid-19 will only stall, Dr Boehme warned.

“With the financial support of several countries, we have made great progress, but to ensure we reach all those who need testing and bring the prices down, we urgently need substantial funding from public, philanthropic, and multilateral sources,” Dr Boehme said.

“It is clear we will be living with Covid-19 for some time; we cannot afford not to invest in testing, for the health of our populations and our economies.”

She added: “We cannot control what we cannot measure.”

Protect yourself and your family by learning more about Global Health Security