A policy roadmap for sustainable mass-testing

Abstract

Population-wide mass testing with affordable self-tests can drastically reduce lives lost and minimize economic and societal costs during pandemics, especially if deployed before vaccines. During COVID-19, however, the development of self-test manufacturing and distribution capacity lagged behind vaccine rollout and was dismantled once surges subsided, returning us to a prepandemic state. As no new capacity has since been secured, future mass-testing would again face costly delays. To mitigate this risk, we propose a policy roadmap for an economically viable mass-testing system that can be sustained between crises and rapidly scaled during emergencies. Public investment in R&D to improve the sensitivity of affordable self-tests—not to achieve a single benchmark, but to advance point-of-need technologies across medical and nonmedical applications—is essential. Improved sensitivity would enable new uses in routine health screening, food safety, and environmental monitoring, generating steady demand and production capacity that can expand as needed. This demand would support a robust system anchored by four mutually reinforcing pillars: scalable manufacturing, real-time data infrastructure, predictive analytics, and sustainable financing. Prioritizing sensitivity can transform mass testing from a reactive measure into a durable public health foundation.