The global plastic pollution crisis and the fallout from the COVID-19 pandemic – where billions of single-use diagnostic tests were discarded – is prompting businesses and researchers to develop new and more sustainable rapid diagnostic tests.

Some companies have designed biodegradable tests for flu and COVID-19, while researchers are finding new and creative ways of making tests out of recycled materials.

But these innovations mostly come from companies and institutions in the global North. Low- and middle-income countries, where plastic pollution is most severe and local production of diagnostics is rare, will need a big push from investors and regulatory bodies to become sustainable, experts say.

Last month, Dutch company Okos Diagnostics started selling what it says is the first fully biodegradable test kit for COVID-19, Influenza A and B and Respiratory Syncytial Virus, after three years of prototyping and testing various materials and designs.

The test case is made of a plant-based material resulting from agricultural discard. The complete test, which is ready for users to buy and swab themselves, is now being sold worldwide for EUR 4.99 (US$ 5.5).

The company made it a point that the test be biodegradable and not just recycled, so that it  could address the issue of used tests ending up in landfills, especially in low- and middle-income countries, co-founder Sander Julian Brus told SciDev.Net.

Okos calculated that its test kit could biodegrade in 10 to 30 months and is now partnering with the Helix Biogen Institute in Nigeria to test biodegradability in real-world conditions.

While environmental concerns might not have been front of mind in the early stages of the pandemic, “I think now is the right time,” said Brus.

“Since we entered an endemic phase [of the pandemic], now it’s the right time to switch and for the industry to change and to make sure that if the next thing breaks out, it can be done differently,” he added.

The waste issue

In a 2022 report, the World Health Organization estimated that over 140 million test kits used around the world during the first phase of the pandemic could have generated as much as 2,600 tonnes of waste — most of it plastic.

The United Nations is poised to sign a legally binding agreement to curb plastic pollution by the end of this year.

Across Sub-Saharan Africa, where rates of HIV and many other diseases are higher than elsewhere, self-testing has become a lifeline for people in recent years. That is also contributing to pollution in an area of the world where appropriate waste disposal is lagging, says Collins Odhiambo, portfolio lead at the African Society for Laboratory Medicine.

An OECD projection sees global plastic use almost tripling by 2060 from 2019 levels and growing more than sixfold in Sub-Saharan Africa.

“People just throw waste anywhere. If it is collected, it’s just taken somewhere and dumped,” Odhiambo, who is based in Kenya, told SciDev.Net.

Producing more sustainable materials instead of plastic could be part of the solution, but Odhiambo is not convinced that the continent’s manufacturing sector can currently support such a shift.

“I think the landscape in Africa for local manufacturing is not yet there,” he explained. Neither for sustainable diagnostics, nor for plastic diagnostics.

Most diagnostic or pharmaceutical products reach Africa via technology transfer from rich countries.

“We need to first change the practice up [in the global North], so that if they use sustainable materials in the North, then when they do the technology transfer to Africa it’s actually technology that includes the use of biodegradable material,” Odhiambo said.

Chewing gum and fridge parts    

Besides Netherlands-based Okos, more and more companies and research institutions are starting to take up the challenge. British diagnostic company Abingdon Health recently partnered with London-based sustainable design consultancy Morrama to come up with plant fibre test cases for various types of rapid testing. The test should be launched on the market by the spring of 2025.

At Heriot-Watt University in Scotland, a group of researchers earlier this year designed tests made of recycled materials, using pellets that originated from objects as diverse as chewing gum and old fridge parts.

“It’s not written anywhere that it has to be in virgin plastic,” said Maïwenn Kersaudy-Kerhoas, professor in microfluidic engineering in the School of Engineering and Physical Sciences at Heriot-Watt University, who has been leading the test prototyping.

However, using recycled materials is just an intermediate solution and in the long run more investment is needed in manufacturing lines for non-plastic materials, Kersaudy-Kerhoas told SciDev.Net.

Elijah Kolawole Oladipo, director of science at Helix Biogen Institute, is optimistic that sustainable diagnostics manufacturing can come to Africa soon enough, if sufficient investment can be attracted.

The Nigerian research institute is partnering with test-makers Okos on a study to check biodegradability of test kits in soil. The idea is eventually to replicate the test’s production locally and make it available in Nigeria and beyond.

Instead of continuing to accept transfers of technology coming from the global North, Oladipo believes, African nations should leverage their abundance of raw materials to build local manufacturing plants for sustainable products.