EXPANDIA: African lab network project for diagnostics

EXPANDIA is the extension of the African laboratory network projects COVID-19 and COVID19+ that involve testing and transferring cost-effective technologies suited to the needs of diagnostic laboratories in limited resource settings.

The EXPANDIA project (“Expanding Access to Sustainable Diagnosis in Africa”), funded by the Bill & Melinda Gates Foundation, is shared by the Regulatory Science, Molecular Virology and Biomanufacturing Groups and is a one-year project aiming at providing African clinical centres and laboratories with reliable, economic and rapid tests for the various types of viral infections that are currently under-diagnosed or mis-diagnosed.

The project is attempting to address critical elements, such as the weakness of supply chains, which limits rapid access to reagents and critical equipment for diagnostic and surveillance of diseases; the lack of in-country local manufacturing capabilities for reagents and/or diagnostic assays, and fragmented regulatory landscapes, especially with respect to the authorisation of laboratory diagnostic tests (LDT) in Africa.

The EXPANDIA project will address these issues by utilising recently adopted technology transfer approaches for rapid scale-up and introduction of novel and tailored diagnostics, involving a network of experts to create suitable sustainable approaches to establish local manufacturing.

The network created under the projects previously funded (COVID-19 and COVID19+) involved multiple actors such as technology owners, regulatory consultants, African reference laboratories and ICGEB scientific teams, enabling technology transfer to take place in different ways according to the needs of end-users.

Similarly, the network will adopt light touch, downstream approaches (where technologies and protocols will be transferred from tech owners to end users), or will be optimised by means of shared Research and Development (R&D) processes, transferred according to the needs and priorities of end users. This workflow can be replicated for different diseases and diagnostic needs and, therefore, will be further expanded to new actors to build capacities at the local and pan-African level, and to meet policy objectives related to the diagnostics and surveillance of infectious diseases.  

“This strategy worked well with SARS-CoV-2, and prior to the declaration of the end of the COVID-19 pandemic by the WHO in May 2023, the network was able to extend activities towards the development of an assay for the detection of diseases prioritised in public health emergency contexts,” confirms scientific project leader, Dr. Alessandro Marcello, who continues: “positive results have already been obtained from these efforts in optimising an RT-LAMP-based assay for the detection of Zika virus”. 

“Multiple activities will concur to achieve the main objective, which is to strengthen the diagnostic and surveillance capacities of Public Health systems across sub-Saharan Africa (SSA)”, states Dr. Wendy Craig, Project Manager of EXPANDIA, “Namely, by facilitating south-south collaborations between technology providers and reference laboratories, with the aim to introduce new and cost-effective diagnostic solutions for overcoming issues common to the Public Health of this part of the globe.”

EXPANDIA network members from LabGene – Angola; IRSS-NIRLS – Burkina Faso; CIRCB – Cameroon; Pasteur Institut Cote d’Ivoire – Ivory Coast; BETin – Ethiopia; KEMRI – Kenya; UMTH – Nigeria; IRESSEF – Senegal; NMRL - Zimbabwe with the team from ICGEB.

EXPANDIA network members from LabGene – Angola; IRSS-NIRLS – Burkina Faso; CIRCB – Cameroon; Pasteur Institut Cote d’Ivoire – Ivory Coast; BETin – Ethiopia; KEMRI – Kenya; UMTH – Nigeria; IRESSEF – Senegal; NMRL – Zimbabwe with the team from ICGEB.

To address the challenges common to many African diagnostic and surveillance laboratories, the partners are promoting the establishment of local production of reagents through in-house protein purification and master mix lyophilisation; expansion of genomic sequencing capacities by establishing and transferring to SSA reference laboratories new protocols for the sequencing of endemic diseases, and the development of a decision tool to guide African reference laboratories in selecting optimal diagnostic testing modalities for specific use-cases, tailored to their local context resources and clinical needs.

The EXPANDIA network will include Technology providers based in Low and Middle Income Countries, reference laboratories in SSA, responsible for field trials, and technology promotors at the country level.

The project commenced in late October 2023 and will end on 31 October 2024, lasting 12 Months.

EXPANDIA Network members in Cape Town, South Africa