Efforts to modernise the national laboratory system are being stepped up, with the Government moving to expand diagnostic services closer to communities, strengthen disease surveillance and improve the reliability and turnaround time of laboratory results. Our reporter RUMBIDZAYI ZINYUKE recently interviewed the director of Laboratory Services in the Ministry of Health and Child Care, DR RAIVA SIMBI, who outlined the state of Zimbabwe’s diagnostic capacity, efforts to expand services in rural and hard-to-reach areas, the growing use of digital laboratory systems, investments in quality assurance and accreditation, and the role of national laboratories in detecting emerging infectious diseases.
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Q: What is the current state of Zimbabwe’s national laboratory services and how would you describe the country’s diagnostic capacity across the different levels of the health system?
A: Laboratory services are the bedrock of Zimbabwe’s healthcare system — essential for accurate diagnosis, effective treatment and robust disease surveillance. Our national laboratory network operates across all levels, from primary care clinics to the National Microbiology Reference Laboratory, our pinnacle facility. While we have a solid foundation, our services are not static; we are in a significant process of modernisation and expansion.
Historically, our central and provincial laboratories have held more capacity, but the Government is making concerted efforts to strengthen the district and primary levels.
The recently revised National Health Laboratory Strategic Plan (2025-2030), developed with support from the Africa Centres for Disease Control and Prevention (Africa CDC), serves as our blueprint to build a more resilient, integrated system capable of meeting both current and future public health needs.
We have a laboratory network where each level of the health system plays a clear, complementary role:
At the primary healthcare and community interface, the emphasis is on early case detection, proper specimen collection and timely referral for tests not done on site. Our goal is that no patient should be left waiting for diagnosis simply because a facility is remote.
At the district and provincial levels, we are strengthening diagnostic services for priority diseases so that testing can happen closer to communities. This reduces the travel burden for patients, improves turnaround time and ensures that care is delivered swiftly and equitably.
At the national level, our specialised and reference laboratories provide confirmatory testing, reference services, advanced diagnostics and critical support for surveillance and outbreak response.
They also standardise methods and offer technical guidance to lower-level laboratories, ensuring consistency across the network.
This integrated, stepped approach is how we turn our strategic plan into tangible health outcomes for every Zimbabwean.
Q: What are some of the major gaps currently affecting laboratory services, particularly in terms of equipment, reagents, infrastructure, staffing and maintenance?
A: Like many developing nations, we have faced, and continue to face, significant systemic challenges that affect the reliability and reach of our laboratory services.
Some laboratories have machines, but not all equipment is consistently functional.
Reasons include ageing instruments, limited spare parts or weak access to timely repairs.
When instruments go down, testing stops or is reduced, which directly affects patients and undermines confidence in the system.
Laboratory testing depends on a continuous supply of reagents, test kits and consumables.
Stockouts, even when laboratories are otherwise capable, cause service interruptions.
This is why supply planning, forecasting and robust procurement systems are central to our work.
Laboratories need more than a building. They require reliable electricity or power backup, adequate ventilation, correct temperature storage for reagents, safe biosafety systems, appropriate waste management and sufficient space for proper workflow.
Where infrastructure is weak, particularly in rural areas, maintaining high standards becomes extremely difficult.
We experience shortages and uneven distribution of trained laboratory scientists and technicians, especially in rural and hard-to-reach areas. This affects testing volumes, turnaround times and quality when workloads become excessive.
Historically, we have also faced a skills gap due to the migration of trained professionals. Since 2018, the public health sector has lost over 8 000 workers across various specialties, including a significant number of laboratory scientists. However, we are actively addressing this through new recruitments, which will help replenish and redistribute our workforce. Preventive maintenance and calibration are critical to ensure tests remain accurate over time.
Without strong maintenance systems, plus access to repairs and qualified technicians, instrument performance may drift, increasing the risk of unreliable results.
This has historically been an overlooked area, but it is now receiving focused attention. These gaps are well-recognised, and they are being targeted through comprehensive system strengthening, not by addressing one issue in isolation.
Our National Health Laboratory Strategic Plan (2025-2030) provides the framework to tackle these interconnected challenges systematically so that we build a laboratory network that is not only equipped but also sustained, staffed and supported to deliver dependable results for every Zimbabwean, regardless of where they live.
Q: What steps is the Government taking to expand access to quality diagnostic services, especially for patients in rural and hard-to-reach areas?
A: Our strategy is to ensure that access to diagnostics is not determined by distance from major cities. We are taking a multi-pronged approach to make testing accessible, functional and trusted so that rural patients can benefit equally from evidence-based care.
First, we are strengthening laboratory capacity at district and provincial levels so fewer tests need to be referred far away.
A key part of this is the nationwide digitalisation of public laboratories through the electronic Laboratory Information Management System (LIMS), a game-changer that allows remote clinics to request tests and receive results instantly via SMS. Second, we are improving specimen logistics.
Diagnostics succeed when specimens are collected correctly, transported safely and delivered on time. We have rolled out an integrated sample transportation system to support sample referral in areas where testing is not available at lower-level facilities, achieving over 90 percent coverage nationwide so that patients and clinicians are not paying the price of delays.
Third, we focus on commodity availability, ensuring reagents, rapid test kits and multi-disease point-of-care testing devices reach rural sites consistently.
These devices are simple to use yet highly advanced, capable of testing for TB, HIV, HPV and PSA screening, while rapid test kits are already being utilised at the primary healthcare level to enable early disease detection.
Fourth, we support training and supportive supervision.
People in rural areas need confidence that tests are done correctly and that results are interpreted appropriately, which is why we are investing in the people who deliver these services.
Fifth, we strengthen referral networks so that when advanced testing is needed, the pathway is clear, functional and timely.
Q: How is the ministry strengthening the availability and reliability of essential laboratory tests?
A: When we speak of essential tests, we mean those that address high-burden diseases and conditions where correct diagnosis changes outcomes, whether it’s initiating the right treatment, guiding clinical management or monitoring disease progression . . .
Q: What role are national laboratories playing in the early detection and confirmation of emerging infectious diseases?
A: National laboratories are the backbone of early detection and confirmation, and they are now at the forefront of our national security.
When outbreaks start, the key question becomes: What is it and how quickly can we confirm and respond? They ensure that surveillance is not only detecting signals but verifying them, because a response based on confirmation reduces unnecessary panic and improves resource targeting.
We have significantly enhanced our capacity for early detection. A prime example is our new Environmental Surveillance laboratory unit for polio, established in January 2026 with support from WHO (World Health Organisation) and the Gates Foundation.
This facility allows us to test wastewater for poliovirus, enabling us to detect potential outbreaks even before clinical cases appear, a critical proactive measure.
Furthermore, we have strengthened our ability to test for emerging threats like Ebola by developing and disseminating in-country testing guidelines.
This capability builds on investments made during the Covid-19 pandemic, where the same equipment is now repurposed for any upcoming epidemic.
Our labs are now fully integrated into the One Health approach, recognising the vital connection between human, animal and environmental health.
In short, national laboratories help us move from suspected outbreaks to verified action, and that is essential for safeguarding communities.
Q: How is the ministry addressing the shortage and retention of skilled laboratory scientists, technicians and other laboratory personnel in the public health sector?
A: Human resources are the foundation of diagnostic quality. Without skilled laboratory personnel, machines and reagents cannot deliver reliable results. We recognise that our modern equipment is only as good as the people operating it, which is why we have taken firm steps to build, support and retain our laboratory workforce.
Our actions include:
Retention strategies: We have taken firm steps to address the exodus of health professionals. Our initiatives to enhance working conditions and remuneration have begun to pay off. The attrition rate in the public health sector has declined from 8 percent in 2021 to 3 percent in 2024. We also provide the necessary tools, functional equipment and supplies so staff can deliver effectively and feel valued.
Career pathways and institutional support: Retention improves when people can grow professionally. We are working towards clearer career progression and stronger institutional management within the laboratory system. Additionally, we are actively addressing workforce gaps through new recruitments — the Health Service Commission has availed over 8 000 posts within the health sector, including scientists and technicians, which will help replenish and redistribute our workforce . . .
Q: What progress has been made in modernising laboratories through automation, digital technologies and improved laboratory information systems?
A: We are undergoing a significant digital revolution. The nationwide rollout of the Laboratory Information Management System has replaced cumbersome paper-based processes, with operational LIMS now installed at 117 main laboratories linked to lower-level laboratories.
This electronic platform is improving data management and accelerating result communication; patients and clinicians receive results instantly via SMS. The new National Health Laboratory Strategic Plan (2025-2030) explicitly sets a target of expanding LIMS to 80 percent of our facilities.
The system has also been interfaced with key conventional high-throughput equipment deployed across our laboratories, meaning that test results are directly transmitted into LIMS, where verification is completed before results are sent electronically to requesting sites. Looking ahead, we are exploring the use of artificial intelligence (AI) and other digital tools to further enhance efficiency and accuracy . . .
Q: What partnerships or investments are supporting the strengthening of Zimbabwe’s laboratory system, and how important are these partnerships to improving diagnostic capacity?
A: Partnerships are indispensable to our goal of building a world-class laboratory system. Laboratory system strengthening is broad; it requires investments in equipment and infrastructure upgrades, reagents and consumables, workforce training, quality assurance systems, laboratory information systems, and surveillance and outbreak response capacity.
No single partner can cover all of this, which is why we work with multiple partners who support different aspects of the strengthening agenda, including technical assistance, funding, procurement support and capacity building.
Our progress would be impossible without the invaluable contributions of the Africa CDC, the UK Fleming Fund, WHO, CLSI, as well as the Global Fund and USG through PEPFAR.
Partnerships help us accelerate progress, but we also emphasise sustainability, so improvements become embedded into Government systems and can continue over time.
Ultimately, these partnerships are important because they help Zimbabwe deliver better diagnostics for people with HIV, TB, malaria, maternal and child health needs, and many other priority conditions.
Q: What are the key priorities for strengthening national laboratory services and what improvements can Zimbabweans expect to see in the coming years?
A: Our vision is clear and ambitious. We are committed to building a resilient laboratory network that is the envy of the region. Looking ahead, our priorities remain anchored in one objective: dependable diagnostic services for priority diseases across Zimbabwe, including HIV, TB, malaria, maternal and child health, and other high-burden illnesses.
In the coming years, Zimbabweans should expect:
Improved access: Continued expansion of LIMS and diagnostic equipment to bring services closer to communities, dramatically reducing wait times. This includes improved availability of essential tests with reduced interruptions from stockouts, and expanded access through strengthened district and provincial capacity and improved specimen transport.
Enhanced quality: More laboratories achieving international ISO 15189 accreditation, guaranteeing the reliability of test results. This will be supported by more consistent quality assurance, strengthening confidence in laboratory results.
Better turnaround times: Clinicians will receive results quickly, so treatment decisions are timely, supported by stronger equipment reliability through preventive maintenance and quicker repair support.
Strengthened security: A more robust and self-reliant system for detecting and responding to disease outbreaks, protecting our people from health threats. Further modernisation through digital reporting will improve the speed and transparency of results.
A stable workforce: A retained and motivated cadre of highly skilled laboratory professionals who are the backbone of our health system, supported by continued workforce strengthening and retention of skilled personnel.
The new National Health Laboratory Strategic Plan (2025–2030) provides a clear path forward. If we deliver these priorities, the benefits to citizens will be clear: correct diagnoses, improved treatment outcomes and a health system that responds faster to disease trends and outbreaks. We are working tirelessly to ensure that every Zimbabwean, no matter where they live, has access to the timely, accurate diagnostics they deserve.
