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Health experts warn of a 'diagnostics apartheid' as rich countries hoard testing tools

The People's Vaccine Alliance has condemned test hoarding by rich countries during the COVID-19 pandemic.
The People's Vaccine Alliance has condemned test hoarding by rich countries during the COVID-19 pandemic. Copyright Rich Pedroncelli/AP
Copyright Rich Pedroncelli/AP
By Giulia Carbonaro
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The right to health "has been denied" to many in developing countries as the West hoarded COVID and Mpox tests.


The hoarding of Mpox and COVID-19 tests by wealthy countries have created a “diagnostic apartheid”, a new report by the People’s Vaccine Alliance has warned.

The alliance – a coalition of more than 100 organisations and networks of activists formed in 2020 with the goal of making vaccines freely available to everyone – said that the lack of testing in developing countries is an issue that needs to be addressed if we want to avoid massive inequality in a potential future pandemic.

The report, commissioned by the People’s Vaccine Alliance and authored by health experts from Matahari Global Solution, focused on the availability of Mpox – formerly known as monkeypox – and COVID-19 tests in the past couple of years as “examples of the inequality in access to tests in developing countries".

They found that, while wealthy countries hoarded tests for the two diseases, developing countries were left unable to buy supplies because of high prices and in the case of COVID-19 and “burdensome intellectual property rules” on PCR test components.

In Kenya, according to the alliance’s reports, a COVID-19 PCR test – the most accurate kind available to the public – cost $11 (€10) in 2021. That’s more than five times the daily income of more than a third of the population in Kenya, who live on less than $1.90 (€1.72) a day.

In the Philippines in the same period, a PCR test averaged $55 (€50), more than twice the country’s average daily wage.

In the same year, PCR tests were available free of charge in the UK, while in most European countries they averaged between €10 and €20 - a modest price compared to people’s average daily salaries.

Lack of testing had 'profound consequences'

“While people in rich countries were able to get rapid antigen tests for COVID-19, our families and friends across the world were denied access,” Mohga Kamal-Yanni, policy co-lead for the alliance, said.

“This research clearly lays out the system of diagnostics apartheid that emerged, where people in developing countries could not afford the price of tests when symptomatic – and testing of contacts to monitor disease spread was out of the question.

We know that many cases in Africa went undetected, simply because people in many countries haven’t had the opportunity to test.
Dr Fifa A Rahman
Report co-author

"Unless world leaders act today, the same inequality will be repeated in the next health crisis, with disastrous impacts".

Access to testing is, according to Dr Fifa A Rahman, who worked on the report on behalf of Matahari Global Solutions, "an essential part of the right to health that has been denied to many in low and middle-income countries".

Rahman said that this lack of testing had "profound consequences" on the spread of the two viruses in developing countries.

"We know that many cases in Africa went undetected, simply because people in many countries haven’t had the opportunity to test. In the next pandemic – and in the remainder of this one – testing needs to be made available as a matter of human rights," he said.

"Removing barriers to accessing diagnostics is essential to save lives – and to understand just how widespread a disease is".

WHO pushing for expansion of access

The same type of hoarding was observed with Mpox tests, which continue to be prohibitively priced in many developing countries.

Access to Mpox testing in developing countries can cost anywhere between $4 (€3.64) and $40 (€36.41) – an unaffordable cost for many in low to middle-income countries.

To avoid a similar crisis in the future, the People’s Vaccine Alliance recommends governments and international institutions to “urgently” invest in local production of diagnostic tests, while also ensuring easy access to rapid antigen testing.

The World Health Organization (WHO) is currently meeting to discuss the development of a first draft of a legally binding agreement to protect the world from future pandemics.


Among the resolutions the agency is expected to agree on is an expansion of access to diagnostic tools for all diseases.

"After the collective trauma of the COVID-19 pandemic, we have a glimmer of hope," said Kamal-Yanni.

"This text contains measures to provide everyone, everywhere with access to the tools needed to prevent and combat pandemics. However, this is a draft, not a final text. Governments need to demonstrate their commitment to a treaty based on equity and human rights".

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