Dr. Kgomosto Makhaola, Senior Science Manager, ASLM
The temporary suspension of United States Government (USG) funding-primarily through the President’s Emergency Plan for AIDS Relief (PEPFAR)-has revealed critical vulnerabilities in Africa’s laboratory systems. A survey conducted by the African Society for Laboratory Medicine (ASLM) across 16 partner countries underscores far-reaching consequences of this funding pause and highlights the urgent need for sustainable solutions. Findings from the ASLM survey show that 80% of participating countries rely on USG funding for more than 25% of their laboratory budgets. This dependency has placed many national laboratory systems at risk, with critical services such as sample transport, equipment maintenance, and quality assurance systems among the most affected.

In fact, 62.5% of countries reported significant disruptions to their sample transport networks, delaying diagnostics and hampering disease surveillance efforts. Half of the respondents also cited challenges in maintaining and repairing essential diagnostic equipment, while 50% experienced setbacks in implementing quality control systems-undermining the reliability of test results. Additionally, many laboratories are facing difficulties in retaining skilled staff due to uncertainty surrounding future funding.

Alarmingly, 62.5% of countries lacked finalized contingency plans, leaving them ill-equipped to respond to the sudden halt in funding. Only 12.5% reported the capacity to maintain essential services for more than a year without USG support. In the face of this challenge, several countries are exploring alternative strategies being domestic funding, diversification of funding sources as well as seeking private sector partnerships for short term gap filling. These efforts, while commendable, highlight the broader issue: Africa must establish long-term solutions to secure its laboratory systems. To guide future resilience, the respondents proposed a Minimum Package of Laboratory Services (MPLS) that must be preserved under any circumstances.

This includes diagnostic testing for priority diseases based on national essential diagnostics lists, basic equipment maintenance and repair, robust quality assurance systems, staff training and retention, and minimal data collection and reporting capacity.

The report issues a clear call to African governments and stakeholders: commit to long-term investment in laboratory systems. This includes not only financial support but also improved accountability, strategic partnerships, and a focus on quality and efficiency. As Africa continues to face emerging health threats including shifts in global funding landscape, resilient laboratory systems are not optional-they are foundational. The current funding crisis presents an opportunity to reimagine and reinforce the continent’s diagnostic backbone.

ASLM CEO, Mr. Ngobile Ndlovu emphasized, “This funding pause is a wake-up call. It’s time for African governments and stakeholders to take ownership of laboratory systems and ensure their sustainability.” And in response, ASLM commits to convening high level consultative meetings with member states to re-emphasize the role of diagnostics and advocate for increased budgetary allocations for laboratory services. ASLM will also develop comprehensive diagnostics business plan and funding models including PPP frameworks that address the unclear real cost and benefit derived from optimization of laboratory networks.