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  • Countries around the world have ramped up testing for Covid-19, but there is fierce competition for these supplies. South Africa does not make these tests and chemicals locally.
  • The National Health Laboratory Services, which aims to perform 36,000 tests a day by the end of the month, plans to navigate supply shortages by using different ways of testing, and so be able to pivot between suppliers if necessary.
  • The service is using extra capacity on the country’s vast testing programme for HIV and TB, to increase its testing ability.
  • For more stories visit Business Insider South Africa. 

Testing and identifying Covid-19 hotspots is at the heart of South Africa’s plans to reopen the economy. “We should be doing 40,000 to 45,000 tests a day,” says Aspen Pharmacare executive Stavros Nicolaou. “Increasing the scale to screen and test will be critical for businesses in terms of managing their staff complement.”

The country has ramped up its testing capacity from under 3,000 a day at the end of March to almost 10,000 a day on 23 April. The National Health Laboratory Service (NHLS) has pledged to significantly increase testing. But the country does not make the test kits and chemicals (called reagents) locally, experts have confirmed.  

This pits South Africa against the rest of the world, and kit and reagent manufacturers are struggling to keep up with demand and nations battle to expand testing. South Africa’s NHLS, which is in charge of public sector testing, pledged to increase its testing capacity to 36,000 tests a day by the end of the month – although this depends on the number of samples sent to it for testing by the state. 

The service was in the process of bringing different testing platforms online, says Dr Sipho Dlamini, acting executive manager for laboratory services for the NHLS. The service started with RT-PCR testing, which is a molecular test that involves isolating parts of the virus and then testing for them. This month, the service expanded to include its TB and HIV viral load testing capacity, he said. The GeneXpert tests will substantially decrease testing time and does not require specially-trained laboratory pathologists. For these tests, cartridges – similar to old-school printer cartridges – are inserted into the machines. 

“More than 40 PCR instruments from more than four different platforms (suppliers) are located at [numerous] testing sites,” Dlamini says. “This excludes the four different versions of GeneXpert instruments at more than 180 testing sites at NHLS labs and PEPFAR-funded testing sites.” PEPFAR, which stands for President's Emergency Plan for AIDS Relief, is the US’s HIV/Aids response programme. 

“The very same instruments for measuring TB and [HIV] viral load have now got test kits that can be used on the same instruments to test for Covid-19,” he said. 

So far, South Africa has not run into kit and reagent shortages, but that is in part because its testing is still relatively low. Dlamini and Nicolaou confirm that South Africa does not currently have reagent shortages. 

“We are dependent on [countries that manufacture the kits and reagents] that have shortages,” Dlamini said. A major way to mitigate this risk is to use a number of platforms, he said. “If supplies from Manufacturer X are low today, we have enough from Manufacturer Y, and we can move our testing to your Y instrument so we can continue meeting our demand.” 

Repeated attempts to contact Lancet, Ampath, and Pathcare were unsuccessful.

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