Supply Chain and Workforce Capacity Development for Diagnostic Services in Low‑and Lower Middle‑Income Sub‑Saharan Countries

The diagnosis of communicable and noncommunicable diseases cannot be made without radiology/imaging and pathology and laboratory medicine (PALM) services. These diagnostic services are often an under‑recognized vital component of health care systems. Supply chain challenges and limited human resource capacity and capability are major impediments to delivering accurate, timely, and comprehensive diagnostic services in low‑income and lower‑middle‑income countries (LMICs) in sub‑Saharan Africa (SSA) and other low‑resource regions. This viewpoint provides a current assessment of these supply chain and human resource challenges and addresses possible solutions. Chronic underfunding, lack of transparency, and an over‑dependence on inadequate or obsolete methods of supply chain management at all levels are common in many low‑resource regions. Furthermore, overdependence on high‑income countries for basic diagnostic supplies jeopardizes diagnostic and health care services. Resource limitations impede attaining laboratory accreditation and certification. The scarcity of training programs at all levels of laboratory medicine and pathology as well as imaging and the serious problem of brain drain to high‑income countries are major problems in many, if not all LMICs. Training in supply chain management is generally vastly underdeveloped in many low‑resource countries. Diagnostic services in rural and remote low‑resource settings are often very limited. Stakeholder engagement and the adoption of needs‑based solutions to gaps in supply chain management and human resource capacity are essential, as well as political will, public–private partnerships, and adequate funding. Development of effective, sustainable local and regional policies and governance is essential to strengthen diagnostic supply chains and workforce training in SSA and other LMIC areas. Diagnostic services in rural and remote areas in many LMICs need to be vastly improved.