Gavi funding boosts yellow fever diagnostics capacity across Africa
An initiative to boost yellow fever diagnostic capacity across Africa has revolutionised diagnostics on the continent, one of the programme’s coordinating agencies, Gavi, the Vaccine Alliance, said.
The initiative is part of the implementation of the Eliminate Yellow Fever Epidemics (EYE) strategy and brings together different partners including WHO, UNICEF, CDC, the Institut Pasteur Dakar, Centre Pasteur Cameroon, and the Uganda Virus Research Institute. The diagnostic capacity initiative has made significant progress since its launch in 2018:
- The number of laboratories able to confirm yellow fever samples on the continent has risen from one, in Senegal, to four, with Nigeria, Cameroon and Uganda now able to definitively determine if someone has yellow fever, particularly early in the course of illness. This laboratory network has helped save nearly $2 million in unnecessary spending by correctly identifying disease cases and allowing public health authorities to make timely decisions that minimise waste. In addition, data from this network has driven country decisions to protect their populations against yellow fever in the long term, such as Uganda’s decision in 2020 to introduce the yellow fever vaccine into routine immunisation.
- Chronic shortages of laboratory supplies that impeded timely yellow fever testing have been resolved by the establishment of testing bundles that can be readily ordered by national laboratories. The average time for national laboratories to complete the testing of samples initially positive for yellow fever confirming whether a new outbreak has started or an existing one has expanded, has declined by 70%, from over three and a half months in 2017 to 39 days in 2020.
- A new commercial PCR test kit validated by the EYE laboratory technical working group is now available for use in national laboratories that are part of the WHO yellow fever laboratory network.
“Prior to this investment in diagnostic capacity, it was a huge challenge for countries across Africa to accurately ascertain where yellow fever outbreaks were at risk of breaking out,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “This lack of capacity not only meant outbreaks, such as the 2015 epidemic that hit Angola and DRC, were able to spread rapidly before containment measures could be put in place, it also meant expensive precautionary, yet unnecessary, vaccination campaigns may have taken place in areas where cases were in fact low. In just a few years this investment has revolutionised capacity in a number of countries, putting them in a far better position to tackle this terrible disease.”
This progress is in part due to a new pooled procurement mechanism to buy yellow fever test kits and obtain critical testing supplies, helping to shape a commercial market for these crucial diagnostic tools. UNICEF Supply Division created new supply routes and relationships with manufacturers to improve the availability and distribution of testing supplies, while the EYE laboratory technical working group developed specifications and evaluated commercial test kits to identify which ones were accurate and reliable enough to be worth using.