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COVID Testing Equity: A Reflection Based on 1.5 Years in the ACT-Accelerator

Dr. Fifa Rahman, Prof Brook Baker, and Dr. Carolyn Gomes, ACT-A CSO Representatives for the Diagnostics and Therapeutics Pillars, have come together to author an op-ed on the need to accelerate testing equity for diagnostics and other COVID-19 tools. 

At the time of writing, access to rapid diagnostic tests (RDTs) and self-tests for COVID-19 were widely accessible in the Global North, but access in the Global South was far more constrained. The authors urgently call upon global health actors within the ACT-Accelerator to take action, including calling on WHO to accelerate development of guidelines for self-testing.

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Resource Centre - Media & Press

Vaccines Alone Won’t Defeat the Variants

Why do we not use antibody tests to diagnose COVID-19 infections?

Checking for antibodies is not the most accurate indicator of the presence of a SARS-COV-2 infection.

What are antibody tests?

This article explains the role antibody tests are playing in fighting the pandemic. 

Antibodies neutralize foreign cells the body sees as a threat. Most COVID-19 vaccines trigger the body to produce antibodies against the spike protein in the SARS-COV-2 virus. 

The spike protein is a molecule found on the surface of the virus, and it helps the virus to enter the host cells and spread from there. 

Why can’t we use antibody testing to measure vaccine efficacy?

COVID-19 serology tests were designed early in the pandemic to detect only a few antibodies generated by natural infection, not vaccine-induced immunity.

They detect antibodies produced to fight the protein capsule around the virus and not the spike protein, while most COVID-19 vaccines introduce the body to small amounts of the genetic material in the spike protein to elicit an immune reaction.

Can antibody testing determine if a vaccine worked?

Not precisely. It takes around two weeks for the body to generate antibodies after COVID-19 vaccination, so even tests to detect the “right” antibody could be negative in the first few weeks after vaccination. 

Can antibody tests be wrong?

The United States Food and Drug Administration (FDA) has recommended that antibody testing not be used to evaluate either immunity levels or protection levels from SARS-COV-2.

Why still do antibody tests?

Data from antibody tests are helpful for surveillance studies. In these studies, large numbers of people in a community are tested. These studies estimate how many people were infected in the past and how fast the virus spreads. 

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Resource Centre - Media & Press

COVID-19: why we can’t use antibody tests to show that vaccines are working

Why do we not use antibody tests to diagnose COVID-19 infections?

Checking for antibodies is not the most accurate indicator of the presence of a SARS-COV-2 infection.

What are antibody tests?

This article explains the role antibody tests are playing in fighting the pandemic. 

Antibodies neutralize foreign cells the body sees as a threat. Most COVID-19 vaccines trigger the body to produce antibodies against the spike protein in the SARS-COV-2 virus. 

The spike protein is a molecule found on the surface of the virus, and it helps the virus to enter the host cells and spread from there. 

Why can’t we use antibody testing to measure vaccine efficacy?

COVID-19 serology tests were designed early in the pandemic to detect only a few antibodies generated by natural infection, not vaccine-induced immunity.

They detect antibodies produced to fight the protein capsule around the virus and not the spike protein, while most COVID-19 vaccines introduce the body to small amounts of the genetic material in the spike protein to elicit an immune reaction.

Can antibody testing determine if a vaccine worked?

Not precisely. It takes around two weeks for the body to generate antibodies after COVID-19 vaccination, so even tests to detect the “right” antibody could be negative in the first few weeks after vaccination. 

Can antibody tests be wrong?

The United States Food and Drug Administration (FDA) has recommended that antibody testing not be used to evaluate either immunity levels or protection levels from SARS-COV-2.

Why still do antibody tests?

Data from antibody tests are helpful for surveillance studies. In these studies, large numbers of people in a community are tested. These studies estimate how many people were infected in the past and how fast the virus spreads. 

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Add Resources - Awareness & Advocacy Resource Centre - Media & Press

Low testing rates and constrained access to vaccines – a deadly combination?

Diagnostics constitutes the most significant funding gap within the ACT Accelerator”

Low testing rates and constrained access to vaccines – a deadly combination?


In this opinion piece Peter Sands, Director of the Global Fund to Fight AIDS, tuberculosis, and malaria, and Emma Hannay, Find’s Chief Access Officer, argue for a global refocus on testing to fight the COVID-19 pandemic.

They highlight the stark inequalities in COVID-19 testing between high-, middle- and low-income countries, saying that this can create conditions for a more severe and contagious mutation of SARS-COV-2 to emerge unnoticed.

The authors add that diagnostics constitutes the most significant funding gap within the ACT Accelerator.


The statistics:

  • Germany offers a free test a week
  • England offers two free tests a week
  • Lower-income countries can only test 7 people for every 100 000
  • For every test done in lower-income countries, high-income countries test 86 people
  • According to a survey of 24 African countries, only 11% could offer rapid COVID-19 tests, and only 8% could provide PCR tests
  • Globally, there is an $8.7-billion shortfall in testing and lab capacity. Box ends

“The low availability of testing, coupled with constrained access to vaccines, create a perfect environment for new, more contagious, and perhaps more deadly strains of the COVID-19 virus to emerge without initial notice, putting even vaccinated populations at risk” – Peter Sands and Emma Hannay.

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Add Resources - Awareness & Advocacy Resource Centre - Media & Press

One year into the Covid-19 pandemic, testing is as vital as ever

Why do we not use antibody tests to diagnose COVID-19 infections?

Checking for antibodies is not the most accurate indicator of the presence of a SARS-COV-2 infection.

What are antibody tests?

This article explains the role antibody tests are playing in fighting the pandemic. 

Antibodies neutralize foreign cells the body sees as a threat. Most COVID-19 vaccines trigger the body to produce antibodies against the spike protein in the SARS-COV-2 virus. 

The spike protein is a molecule found on the surface of the virus, and it helps the virus to enter the host cells and spread from there. 

Why can’t we use antibody testing to measure vaccine efficacy?

COVID-19 serology tests were designed early in the pandemic to detect only a few antibodies generated by natural infection, not vaccine-induced immunity.

They detect antibodies produced to fight the protein capsule around the virus and not the spike protein, while most COVID-19 vaccines introduce the body to small amounts of the genetic material in the spike protein to elicit an immune reaction.

Can antibody testing determine if a vaccine worked?

Not precisely. It takes around two weeks for the body to generate antibodies after COVID-19 vaccination, so even tests to detect the “right” antibody could be negative in the first few weeks after vaccination. 

Can antibody tests be wrong?

The United States Food and Drug Administration (FDA) has recommended that antibody testing not be used to evaluate either immunity levels or protection levels from SARS-COV-2.

Why still do antibody tests?

Data from antibody tests are helpful for surveillance studies. In these studies, large numbers of people in a community are tested. These studies estimate how many people were infected in the past and how fast the virus spreads.