Inequities in access to diagnostics threatens global public health security

In 2014, an approximately 3-month delay in the detection of Ebola virus allowed the virus to infect thousands of people in west Africa, contributing to the largest outbreak of Ebola virus in history, with over 28 600 infections and more than 11 000 deaths.1 According to a case study of the 2014 Ebola virus disease epidemic, conducted by the Foundation for Innovative New Diagnostics, improved detection of Ebola virus coupled with rapid patient isolation and contact tracing could have prevented 30–70% of infections, saving thousands of lives and billions of dollars.2 Diagnostic tests exist for Ebola virus, but these tests are expensive, require advanced technical expertise, necessitate high-level infrastructure for infection control, or are in a format that is not adapted for field use. The next generation of field-ready diagnostics, in addition to improved accuracy, need to be easy to use with minimal training, able to withstand the temperature and humidity that are typical in regions that are prone to outbreaks of Ebola virus disease, and priced and sourced to be available and sustainable during the entire course of an outbreak and beyond. [...]the inequity in diagnostics should not be considered only when infectious diseases threaten to transcend borders to become epidemics and pandemics.