The future of diagnostics with a sustainable twist
The pandemic has taught the world how testing can be done easily, reliably, affordable and at-home. Although the technology has existed since the 1960s, “lateral flow assay (LFA)” meant little to anyone outside the scientific community. However, before 2020, millions of antigen tests were already being used to detect infectious diseases, such as malaria and HIV. Also, the concept of rapid tests is widely known as a tool for women to detect pregnancy in the comfort of their homes. Thanks to COVID-19 the term has entered the public consciousness again.
The future of LFAs now suddenly looks very promising. Outside of infectious diseases, LFA’s can also bring affordable diagnostics to large numbers of people, opening up and democratizing healthcare. People worldwide are now familiar with the technology and more importantly with the ease of use of testing themselves and its implications. There are multiple advantages of self-testing with LFAs compared to regular forms testing body fluid samples: visiting a doctor, getting a sample from the lab, waiting for the results to come back, and seeing a doctor again. Every test taken at home saves public money and puts people in control of their own health. Also, it gives people their results back fast, mostly within 15 minutes. Lastly, the convenience of testing at home is important and would reduce the barrier to getting tested.
LFAs played an important role in African countries before and during the pandemic. Central lab testing cannot be easily rolled out in most settings across Africa. A recent study showed that a majority of Nigerians agree with the concept of COVID-19 self-testing and would act to protect public health by self-testing positive.[1] However, the number of studies done on self-testing in Africa during the pandemic is limited. Also, there is a promising future for point-of-care testing in Africa.
The former Nigerian Minister of Health, Dr. Osagie Ehanire recently emphasized the importance of diagnostic testing. He stated: “Over the past few years, there has been increased recognition of the importance of diagnostic testing in healthcare, and especially in achieving the goal of Universal Health Coverage (UHC), but until recently, there have been few strategic efforts designed to develop the evidence base on which policymakers can rationally increase and improve access to diagnostic testing”.[2]
There is an alarming downside to this trend of self-testing, that no longer can be overlooked. It is estimated that during the pandemic tens of billions of rapid tests were being used. Every COVID antigen test contains over ten grams of plastic and is meant for single use. Unfortunately, a proportion of these rapid tests end up in landfills and in oceans. This adds up to the plastic soup problem the world is already dealing with. It is estimated that plastics will outweigh fish in our oceans by 2050.[3] Although plastic waste is a global concern, plastic waste is spiraling out of control across Africa, a new analysis has shown.[4] The burning and dumping of plastic waste, particularly single-use plastics and microplastics, is harming people’s health. With about 2.5 million tonnes of plastic waste annually, Nigeria ranks ninth globally among countries with the highest contribution to plastic pollution. Unfortunately, over 88% of the plastic waste generated in Nigeria is not recycled. Instead, much of it ends up in water bodies – rivers, lakes, drains, lagoons and the ocean.[5]
Just like how a lot of other segments are exploring ways to become more sustainable and reduce waste, in-vitro diagnostic manufacturers have the challenging task of doing the same. Recently, the first biodegradable LFA prototype was introduced by Dutch start-up Okos Diagnostics. It has the potential to tackle the plastic waste coming from the diagnostic sector worldwide. Okos has multiple patented prototypes to replace the plastic housing of LFAs with bio-based and biodegradable materials. The cassettes could be used to test for all different lateral flow assay use cases, such as hormones, tumor markers, and infectious diseases. Given the fact that the plastic waste concern is global, Okos is partnering with a Nigerian-based Helix. Helix Biogen Institute is a fast-growing organization in the field of technology in Biomedical Sciences based in Nigeria. Its vision is to be one of the world’s leading translational research institutions in biomedical sciences.
Okos and Helix decided to collaborate, raise awareness, and are planning to organize a pilot with biodegradable LFA's for different use cases.
[1] https://bmjopen.bmj.com/content/13/1/e063323 [2] https://www.afro.who.int/countries/nigeria/news/nigeria-flags-policy-document-boost-diagnostic-testing [3] https://www.wwf.org.uk/myfootprint/challenges/will-there-be-more-plastic-fish-sea [4] https://www.theguardian.com/environment/2023/nov/08/plastic-waste-spiralling-out-of-control-across-africa-analysis-shows [5] https://theconversation.com/plastic-pollution-in-nigeria-is-poorly-studied-but-enough-is-known-to-urge-action-184591