Anafi Mataka, Head of Division ASLM.
Sylvester Moyo, Project Manager ASLM
Diagnostics are often seen as routine tools, tests that confirm a clinician’s suspicions before treatment begins. But in reality, they do far more. Diagnostics shape every step of care, from guiding treatment decisions to enabling outbreak response and strengthening entire health systems. When early and accurate testing is available, it saves lives, reduces costs, and turns reactive health systems into proactive, resilient ones.

Across Africa, real-world examples show just how transformative diagnostics can be. Decentralizing early infant diagnosis (EID) from central labs to district facilities cut result turnaround times from months to just hours. The impact was dramatic: same-day care linkage jumped from under 20% to over 80%, and infant mortality at 12 months was halved.

Similarly, rolling out Xpert MTB/RIF testing for tuberculosis at peripheral sites shifted diagnosis from weeks of waiting to just days, leading to a 25% increase in timely treatment and significantly lowering community transmission. Rapid antigen testing during COVID-19 identified asymptomatic carriers early, preserving critical care capacity during surges. Diagnostics also drive better management of chronic diseases.

Portable lipid and glucose analyzers deployed in rural clinics improved risk-factor control among hypertensive and diabetic patients by 30%, reducing hospital admissions. These successes highlight a simple truth: when diagnostics are brought closer to patients, outcomes improve, transmissions drop, and health systems become more responsive and efficient.

Beyond individual patient care, diagnostics create ripple effects across entire systems. They optimize treatment by guiding clinicians to the right therapies quickly, reducing unnecessary drug use and slowing antimicrobial resistance. They generate real-time data that power public health intelligence, enabling early warning systems, better resource allocation, and predictive modeling for disease trends. When integrated with digital health platforms, diagnostics provide seamless reporting, patient tracking, and data-driven decision-making.

Diagnostics also make systems more efficient. Pooled procurement and coordinated supply chains reduce per-test costs and prevent stockouts, while training nurses and community health workers to perform point-of-care testing extends services into underserved areas. This combination brings care closer to those who need it most, shortens turnaround times, and eases the burden on centralized laboratories.

Investing in diagnostics is not just good medicine-it’s smart economics. In Europe, diagnostics account for less than 1% of health spending yet inform over 60% of clinical decisions. In Africa, though data is sparse, the return on investment is clear. Every $1 spent on TB diagnosis and treatment yields $43 in avoided costs, improved productivity, and reduced drug resistance. During the COVID-19 pandemic, widespread rapid testing led to a 43% drop in hospital admissions, preserving scarce resources.

To unlock these benefits, countries need coordinated strategies. The National Essential Diagnostics List (NEDL) serves as a blueprint, guiding which tests should be prioritized, where they should be delivered, and how they can be financed sustainably. By focusing on high-impact tests like HIV viral load, malaria RDTs, and blood glucose monitoring and ensuring access even in rural clinics, NEDLs help create equitable, cost-effective systems.

ASLM plays a critical role in this transformation. Through initiatives like the NEDL, the Africa Collaborative to Advance Diagnostics (AFCAD), and LabMap, ASLM helps countries align policy, build capacity, and scale innovations such as molecular diagnostics, multi-disease platforms, and decentralized testing. These efforts reflect a global shift as outlined by Pai et al. in Nature Medicine-toward replacing outdated tools with modern, accessible diagnostics, prioritizing affordability, and moving toward integrated, disease-agnostic systems.

Diagnostics are no longer optional; they are foundational. They guide life-saving treatment, enable real time surveillance, and unlock system-wide efficiencies. As Africa strives toward universal health coverage and pandemic preparedness, investing in diagnostics is not just a technical requirement-it’s a strategic imperative. With leadership from organizations like ASLM and Africa CDC, and with tools like the NEDL, Africa is well-positioned to build resilient, equitable diagnostic systems that can transform health outcomes at scale. Because without diagnostics, there is no diagnosis and without diagnosis, there is no health.