Nqobile Ndlovu, ASLM CEO

Universal Health Coverage (UHC) means that all people and communities can access the health services they need without experiencing financial hardship. The goal is to ensure everyone can obtain the care they need, when and where they need it, without facing financial barriers. Embedding diagnostics in UHC agenda is therefore critical to ensure diagnostic services are available at the primary healthcare level, so patients can receive timely and accurate diagnoses close to home. Diagnostics are essential for effective treatment, prevention, and efficient health spending-reducing missed diagnoses that burden both patients and health systems. Unfortunately, about half (47%) of the world’s population lack adequate access to diagnostic services. The realities of Low-Middle-Income Countries-LMIC (e.g Africa) are worse with about 87% lacking access to testing, 70% of the funding for diagnostics come from outside Africa, diagnostics represent less than 4% of funder budget and less than 2% of national budgets. The cost of diagnostics is often perceived as an unnecessary burden as many people want medicines, and not a test. Without urgent action to prioritize and invest in diagnostics as a core pillar of UHC, millions-especially in LMICs-will continue to face delayed or missed diagnoses, undermining health outcomes, wasting resources, and threatening the very promise of universal health coverage.

To achieve UHC, countries must elevate diagnostics as a core pillar of healthcare delivery. Building on Pai et al.’s “”Seven Transitions”” for TB diagnostics, we propose a framework for scaling access: prioritize equity via point-of-care testing; integrate networks to boost efficiency; embrace innovation; strengthen community-based outreach and screening; focus on public health impact; and ensure cost-effective, sustainable solutions. This shift from outdated approaches to modern, patient-centered technologies can make diagnostics a measurable reality.

To support the diagnostic agenda, it is also important to mention that diagnostic innovation is becoming a key driver for equitable, efficient and scalable testing in Africa-a key to achieving UHC. A lot of this innovation is taking place to bringing diagnostic tools closer to the communities and meet the needs and priorities of the communities and countries. Be it the big platforms that are high throughput, benchtop platforms for less complicated and lower regions, near POC of care devices, true Point of Care devices and self-care test kits. The efforts to leverage digital tools, artificial and mobile health platforms for diagnostics are very promising. The future of evidence-based management, precision medicine is diagnostics and laboratory testing.

Every $1 invested in diagnostics delivers multiple returns-saving lives, reducing disease burdens, and boosting economic productivity. For Africa, investing in diagnostics is not optional but urgent. Governments must embed diagnostics into national health benefit packages, remove user fees, expand insurance coverage, and champion sustained funding and advocacy. Without this, millions will continue to face delayed diagnoses, wasted resources, and avoidable loss of life-undermining the very promise of universal health coverage.