A laboratory-focussed desk review of health systems in Uganda, Kenya, and the UK to respond to current and future pandemics

Background Laboratory systems play a crucial role in managing diseases
effectively, and the COVID-19 pandemic serves as a prime example. The
pandemic underscored the need to make laboratory health systems more
resilient and robust to respond to future pandemics.

Methods We conducted a desk review guided by the six World Health Organization health system building blocks (health service delivery, health
financing, medical products, vaccines, and technologies, human resources for health, governance, and health information systems).

Results The three countries’ strengths include health information systems, well-established reference laboratories, mobile and community-level testing, a vibrant private laboratory sector in Uganda and Kenya, and a
growing private sector in the UK. In Uganda and Kenya, there are laboratory connectivity solutions for molecular diagnostics, multi-disease testing
platforms and specimen referral systems, while in the UK, there are hub-and-spoke networks. Weaknesses in Uganda and Kenya include vertical
laboratory systems strengthening, ill-equipped laboratories, constrained
and inequitable distribution of laboratory human resources, and limited
data use. In the UK, there is chronic underfunding and undervaluing of
disciplines supporting infection testing, microbiology and virology.

Conclusions The growing contribution of the private sector in the three
countries and the deployment of multi-disease testing platforms should
be supported, given the advantage of shared financial costs in the face of
chronic underfunding for laboratory systems.