COVID-19 undermines control of other infectious diseases. Diagnostics are critical in health care. This opinion paper explores approaches for leveraging diagnostics for COVID-19 while retaining diagnostics for other infectious diseases including tuberculosis (TB) and HIV. We reflect on experiences with GeneXpert technology for TB detection and opportunities for integration with other diseases. We also reflect on benefits and risks of integration. Placement of diagnostics in laboratory networks is largely non-integrated and designated for specific diseases. Restricting the use of diagnostics leaves gaps in detection of TB, HIV, malaria and COVID-19. Integrated laboratory systems can lead to more efficient testing while increasing access to critical diagnostics. However, we have observed that HIV diagnosis within the TB diagnostic network displaced TB diagnosis. Subsequently, COVID-19 disrupted both TB and HIV diagnosis. WHO-recommended rapid molecular diagnostic networks for infectious diseases need more investment to achieve diagnostic capacity for TB, HIV, COVID-19 and other emerging infectious diseases. Integrated laboratory systems require mapping laboratory networks, assessing needs for each infectious disease, and identifying resources. Otherwise, diagnostic capacity for one infectious disease may displace another. Further, not all aspects of optimal diagnostic networks fit all infectious diseases, but many efficiencies can be gained where integration is possible.
Copyright © 2022. Published by Elsevier Inc.

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