A decentralised point-of-care testing model to address inequities in the COVID-19 response

Belinda Hengel*, Louise Causer, Susan Matthews, Kirsty Smith, Kelly Andrewartha, Steven Badman, Brooke Spaeth, Annie Tangey, Phillip Cunningham, Amit Saha, Emily Phillips, James Ward, Caroline Watts, Jonathan King, Tanya Applegate, Mark Shephard, Rebecca Guy

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

22 Citations (Scopus)


The COVID-19 pandemic is growing rapidly, with over 37 million cases and more than 1 million deaths reported by mid-October, 2020, with true numbers likely to be much higher in the many countries with low testing rates. Many communities are highly vulnerable to the devastating effects of COVID-19 because of overcrowding in domestic settings, high burden of comorbidities, and scarce access to health care. Access to testing is crucial to globally recommended control strategies, but many communities do not have adequate access to timely laboratory services. Geographic dispersion of small populations across islands and other rural and remote settings presents a key barrier to testing access. In this Personal View, we describe a model for the implementation of decentralised COVID-19 point-of-care testing in remote locations by use of the GeneXpert platform, which has been successfully scaled up in remote Aboriginal and Torres Strait Islander communities across Australia. Implementation of the decentralised point-of-care testing model should be considered for communities in need, especially those that are undertested and socially vulnerable. The decentralised testing model should be part of the core global response towards suppressing COVID-19.

Original languageEnglish
Pages (from-to)e183-e190
JournalThe Lancet Infectious Diseases
Issue number7
Publication statusPublished - Jul 2021
Externally publishedYes

Bibliographical note

Funding Information:
We would like to acknowledge collaborators from the following organisations for their input into the programme's design and implementation. In WA, Australia: The Aboriginal Health Council of WA, Kimberley Aboriginal Medical Services, Ngaanyatjarra Health Service, WA Department of Health, WA Country Health Services, and Path West. In SA, Australia: Aboriginal Health Council of SA, SA Pathology, and Nganampa Health Council. In NSW, Australia: Aboriginal Health and Medical Research Council of NSW; NSW Ministry of Health and NSW Pathology. In NT, Australia: Aboriginal Medical Services Alliance Northern Territory, Central Australian Aboriginal Congress, Katherine West Health Board, Top End Health Service, Central Australian Health Service, and Territory Pathology. In VIC, Australia: Victorian Aboriginal Community Controlled Health Organisation, and Department of Health and Human Services. In QLD, Australia: Queensland Aboriginal and Islander Health Council, Queensland Health, Apunipima Cape York Health Council, and Pathology Queensland. Additionally, we would like to acknowledge the National Aboriginal and Torres Strait Islander COVID-19 Advisory Group, the Aboriginal and Torres Strait Islander COVID-19 POC Testing Program Clinical Advisory Group, Communicable Disease Network of Australia, Public Health Laboratory Network, and the National Aboriginal Community Controlled Health Organisation. The programme was funded by the Australian Government Department of Health.

Funding Information:
The programme is funded by the Australian Government, with non-financial support from Cepheid. All authors declare no other competing interests.

Publisher Copyright:
© 2020 Elsevier Ltd


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