The Ghana Association of Medical Laboratory Scientists (GAMLS) has since March 2020 offered professional advice on effective ways of expanding laboratory testing in the management of the COIVD-19 pandemic in the country in order to reduce the rate of infection. This includes the use of the GeneXpert equipment for COVID-19 testing.
The GeneXpert is a real-time PCR machine used for tuberculosis tests. The manufacturers of the equipment in responding to the needs to fight the COVID-19 pandemic, have developed reagent packages that can be used to test for COVID-19. The technology only requires the sample mixed with a reagent (buffer) and slotted into the machine. It takes just 45 minutes to give the result of suspected persons. Just like malaria, one can also test for COVID-19 in hospitals that have the equipment. The map inserted into this publication depicts facilities in Ghana that have the GeneXpert equipment already installed and can be used for COVID-19 testing if the reagents are bought. The good news is that compared to the other forms of real-time PCR for COVID-19 costing between $80.00 to $100.00, one pays a maximum of $ 20.00 to get a test done with the GneeXpert and at the same quality but lower turn around time.
Countries that use the equipment for COVID-19 include Nigeria, South Africa, USA and India. In Angola, the use of GeneXpert for testing reduced their time to get results from 72 hours to 24 hours. Is it not surprising to know that even after the President of Ghana has directed since to recalibrate about 100 of these facilities to expand testing, individuals in charge have not seen the urgency to get the necessary reagents to use the equipment? Ghana and Nigeria hatched the idea of adopting the use of the GeneXpert. Sources contacted indicate that Nigeria has received reagents to do about 30000 tests with the game-changer, while in Ghana even after displaying pictures of the arrival if the reagents at our ports, the current updates indicate we are yet to receive the kits hopefully by the end of July 2020. Are these ploys to throw away such a beautiful professional idea used on several global platforms?
In a recent publication, the Deputy Minister of Health is noted to have said that the government had spent a whopping US$34.6 million on Covid-19 testing alone with each test at a cost of US$100. Including the “pooling” strategy? Well, this would be for another day’s discussion. But it is important to assume that, this huge sum noted to have been spent could do only 346,000 tests. This amount could have given us about 1,730,000 tests if our option had been to use the GeneXpert. The cartridges for GeneXpert received Emergency Use Authorization from the United States Food and Drug Administration on 20 March 2020, so no one should deceive us into thinking that we could not have planned right from the onset when the evidence is clear that medical laboratory professional body in Ghana had advised before the 20th March 2020. It is just not the interest of the country to use the equipment which is installed in not less than 130 health facilities.
One other disheartening area in this whole COVID-19 saga is the delay in the validation and recommendations of Rapid Diagnostic test (RDT) kits. On the 4th of July 2020, a release by the Food and Drugs Authority (FDA) indicated that no RDT kit has been approved yet for use in Ghana. When the Minister of Education was discharged after his management for COVID-19, a press release by the ministry made mention of a rapid test which showed the minister had developed antibodies and it was a good indication of his recovery. In a media briefing on the 19th of July 2020, Prof Williams Ampofo, the leader of the group coordinating COVID-19 testing in Ghana, even though reiterated the position of the FDA, further mentioned that antibody tests are being explored on convalescent people after their management for COVID-19.
Noguchi is on record to have received about 10,000 RDTs from Omni Speciality Products. In that publication, it was stated that “the RDT’s donated were being used in thirty-eight (38) countries and that it had been approved by the United States of America Food and Drugs Authority (FDA).” Is that what is being explored on convalescent patients including the Minister of Education?
One of the things I wished the FDA would have published for all to see would have been the rigorous protocol(s) employed in the validation of the RDT kits they receive through applications. When we all received the news of a Ghanaian based medical laboratory scientist and kit developer (CEO, INCAS Diagnostic) in collaboration with the Kwame Nkrumah University of Science and Technology (KNUST) had developed an antibody-based RDT for COVID-19, the desire of the populace to get access to screen themselves by professionals for exposure to the pandemic was heightened. Unfortunately, several months down the lane, no favourable results of approval have been communicated to the public. Information on what processes the kit went through and how it came out would have been helpful and even would have encouraged others to follow. RDTs are widely used across the globe in addition to the molecular-based techniques. I admit it has its place in testing and management of COVID-19 patients but because of its cost-effectiveness and knowing the gains Senegal has made from using RDTs, it is surprising that NO RDT has been approved yet for use in the medical laboratories of Ghana. Is it the case that none of those that qualified by the US regulator are inferior in Ghana?
Ghana has made a lot of gains with the fight against the pandemic. I thought that after the realization by the President of the country and many others that our medical diagnostics have been neglected for far too long, we would have taken steps to improve now and sustain our laboratories for future eventualities. Unfortunately, the woes are deepened day in day out to the extent that with all the $34.6 million pumped into testing, none of our clinical laboratories has benefited to be ready to support with COVID-19 testing of patients for care and management.
I cannot agree more with expert epidemiologists Prof Kwadwo Koram, former director of Noguchi and Prof John Gyapong, Vice-Chancellor of the University of Health and Allied Sciences (UHAS) that we need to resource our clinical laboratories to take up the task of testing for immediate patient care to free our research facilities and universities to concentrate on research to guide on battling the global pandemic (Joynews: Beyond the Lockdown, 19th Jul 2020).
Continuous disregard for professional advice may not end well for us as a country. We must all be involved and think of Ghana first.
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