Although it seems we have weathered the worst of the COVID-19 pandemic, almost 3 years in, the virus is still causing millions of new cases each week (www.COVID19.WHO.int). Living with COVID-19 doesn’t mean pretending it no longer exists. But we can return to a new version of “normal”, as long as we have systems in place to proactively manage and limit its damage. As such, testing remains one of the best tools we have to control the spread of COVID-19 and minimize the impact of outbreaks on people, our communities and our healthcare systems.

The pandemic set off seismic changes around testing. Increased attention and investment accelerated diagnostic innovations: from rapid self-testing, to new diagnostic platforms, and strengthening of genomic surveillance systems around the world. COVID-19 also fundamentally changed how we think about infectious diseases, and our collective personal responsibilities to help keep each other safe.

Moving forward, strategic use of testing for COVID-19 can help us reduce the spread of the virus, particularly during the winter peaks when COVID-19 will coincide with seasonal outbreaks of flu and other respiratory infections. While it may not be feasible or needed to test everyone, as we did at the height of the COVID-19 pandemic, strategic deployment of testing can help lessen the burden on communities and limit the amount of time people have to take off work or school due to illness. Transitioning testing from an emergency response to part of routine healthcare can also help minimize outbreaks, particularly in key settings like schools, hospitals, care homes and prisons.

In this regard, Africa is leading the way, last month kicking off development of a revised COVID-19 testing strategy (https://bit.ly/3Bh2J0i) that focuses on integrating COVID-19 testing into routine healthcare and existing surveillance programs. Building on learnings and gains made as part of the COVID-19 response, laboratory directors, surveillance leads and incident managers for COVID-19 from the 46 African Union Member States are formulating practical approaches and interventions that will foster integration and expansion of COVID-19 testing services and surveillance into routine healthcare services, while leveraging existing structures within other disease programmes. The result will include expansion of robust and integrated surveillance systems, including pathogen genomics surveillance necessary for picking up any surge of COVID-19, and future outbreaks of infectious diseases.

AU Member States intend to use financial investments and innovative service delivery strategies, developed as part of the COVID-19 response, towards building stronger, more resilient health systems across the continent. Key areas identified for action include development of policies to promote multi-disease testing; integrating COVID-19 testing into health service packages that are offered at community level; exploring local diagnostics manufacturing to build more resilient supply chains; use of digital tools to support real-time disease surveillance; and adoption of test-to-treat guidelines where appropriate. Member States are calling on funding agencies to move away from disease-focused investments towards health systems strengthening investments.

Testing has to remain a cornerstone of our defence against COVID-19 – and sustainably embedded into our health systems as a fundamental element of care. Strategically using the testing tools developed during the pandemic can help limit outbreaks, particularly among the most vulnerable. As African leaders gather in Kigali at the second annual international Conference on Public Health in Africa (www.CPHIA2022.com) next week to discuss the future of pandemic preparedness and post-pandemic recovery, and the northern hemisphere readies for winter and the seasonal illnesses that come with it, we may now be facing our first true test of whether we are ready to live with COVID-19.