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BMJ Glob Health . Rapid establishment of public sector COVID-19 test-and-treatment programmes across seven low- and middle-income countries: implem

tetano

Editor, Senior Moderator
BMJ Glob Health


. 2025 Dec 10;10(12):e019040.
doi: 10.1136/bmjgh-2025-019040. Rapid establishment of public sector COVID-19 test-and-treatment programmes across seven low- and middle-income countries: implementation strategies and program monitoring results

Caroline E Boeke[SUP] 1 [/SUP], Nervine Hamza[SUP] 2 [/SUP], Chukwuemeka Agwuocha[SUP] 3 [/SUP], Okechukwu Amako[SUP] 2 [/SUP], Khamsay Detleuxay[SUP] 4 [/SUP], Michelle Gao[SUP] 2 [/SUP], Bridget C Griffith[SUP] 2 [/SUP], Yamikani Gumulira[SUP] 5 [/SUP], Elina Urli Hodges[SUP] 6 [/SUP], Jessica Joseph[SUP] 2 [/SUP], Norman Lufesi[SUP] 7 [/SUP], Emily Macharia[SUP] 6 [/SUP], Nyuma Mbewe[SUP] 8 [/SUP], Elizabeth McCarthy[SUP] 2 [/SUP], Faustina O Mintah[SUP] 9 [/SUP], Moses Mukiibi[SUP] 10 [/SUP], Mwaba Mulenga[SUP] 11 [/SUP], Alida Ngwije[SUP] 12 [/SUP], Lawrence Ofori-Boadu[SUP] 13 [/SUP], Ijeoma Uzondu Okoli[SUP] 14 [/SUP], Sompasong Phongphila[SUP] 15 [/SUP], Christian Ramers[SUP] 2 [/SUP], Sean Regan[SUP] 2 [/SUP], Evarist Twinomujuni[SUP] 16 [/SUP], Edison Rwagasore[SUP] 17 [/SUP], Jessica Tebor[SUP] 2 [/SUP], Krishna Udayakumar[SUP] 6 [/SUP]; COVID-19 Treatment QuickStart Consortium



Collaborators, Affiliations
Free article Abstract

The COVID-19 Treatment QuickStart Consortium worked with governments in seven low- and middle-income countries (LMICs), Ghana, Laos, Malawi, Nigeria, Rwanda, Uganda and Zambia, to implement COVID-19 test-and-treat programmes at 776 health facilities, including training over 5000 staff and facilitating a donation of 11 300 courses of the oral antiviral nirmatrelvir/ritonavir for treatment. This paper describes the process of implementing COVID-19 test-and-treat programmes in each country, provides aggregate programme monitoring data on numbers tested and treated and analyzes programme enablers and challenges. Between country-level programme initiation (Ghana, May 2023; Laos and Malawi, July 2023; Nigeria, June 2023; Rwanda, March 2023; Uganda, September 2023; Zambia, December 2022) and June 2024, a total of 731 970 SARS-CoV-2 tests were conducted. Of 6724 positive tests, a subset were documented to meet eligibility criteria for nirmatrelvir/ritonavir initiation, and 3041 patients were prescribed nirmatrelvir/ritonavir. The largest number of prescriptions was in Zambia. Programme enablers included decentralisation of services; task-shifting from higher to lower health worker cadres; increased access to point of care antigen tests, including self-tests; and the integration of COVID-19 with other health services. Challenges included COVID-19 de-prioritisation at the time of programme rollout, test commodity stockouts and expiries, and dwindling national surveillance efforts. Learnings from rapid initiation and scale-up of COVID-19 test-and-treat programmes in these seven countries can be used to inform future pandemic preparedness strategies in LMICs.

Keywords: Africa; COVID-19; Pandemic Preparedness.

 
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