27 July 2020

Given the urgent global need for rapid, point-of-care diagnostic tests to deal with the continuous spread of the COVID-19 pandemic, Doctors Without Borders (MSF) today called on US diagnostics corporation Cepheid to allocate its COVID-19 tests (Xpert Xpress SARS-COV2) equitably and affordably across all countries.

MSF called on Cepheid to refrain from profiteering off of the pandemic, by lowering the price of each test to US$5(R82.23) from the nearly $20 (R328.90) it charges in the world’s poorest countries, in order to ensure much broader access to the test. MSF research shows the tests could be sold at a profit for $5(R82.23) each. 

MSF, Doctors Without Borders, COVID-19 test maker Cepheid
“This is not the time to set the price based on what the market can bear. This critical test must be made accessible to all people
​​​​who urgently need it at $5 per test to tackle this global health emergency.”- Sharonann Lynch, HIV & TB Advisor for MSF’s Access Campaign. © Olmo Calvo/MSF

“As countries are struggling to deal with suspected COVID-19 cases, having an accurate rapid diagnostic test is essential for real-time management of people affected with the virus, in order to tackle this pandemic,” said Dr Greg Elder, Medical Coordinator for MSF's Access Campaign. “So many lives could be saved if corporations like Cepheid made their test available urgently and affordably in all countries.”  

South Africa like many other countries is struggling to secure enough testing tools to test for COVID-19. Despite being one of the first countries to roll out the Cepheid GeneXpert machines it is still struggling to secure enough testing kits to meet local demands.

Candice Sehoma, Access Campaign Advocacy Officer in Advocacy, MSF Southern Africa.

"It is important for Cepheid to do away with profiteering from people’s lives and make these tests available and affordable for countries like South Africa to upscale their testing capacity." Candice Sehoma

Cepheid has set the price for each test at $19.80 (R325.61) in 145 developing countries, including the world’s poorest countries where people live on less than two dollars per day. Cepheid developed the Xpert Xpress SARS-CoV-2 cartridge with $3.7 million in public funding from the US government’s Biomedical Advanced Research and Development Authority (BARDA).

Additionally, MSF and others’ analysis of the cost of manufacturing Cepheid’s tuberculosis (TB) test – which is similar to the COVID-19 cartridge – shows that the cost of goods, including materials, manufacturing, overhead, and other indirect expenses for each cartridge is as low as $3 at high volumes and with relevant royalties expired, and therefore each test could be sold at a profit for $5. The analysis also demonstrates that there was no significant difference between viral and bacterial cartridges that would justify substantial price variances across cartridges for different diseases. MSF called on Cepheid for a significant price reduction of their cartridges to no more than $5, including the COVID-19 test.

MSF, Doctors Without Borders, COVID-19 test maker Cepheid
At a joint mobile testing clinic with Doctors Without Borders(MSF) in Immokalee, Florida, a nurse for the Collier County Department of Health gives a free COVID-19 test to an area resident. Ninety-seven people received free COVID-19 tests at the clinic that day. © Taimy Alvarez/MSF

“It is indefensible for Cepheid to profit in this pandemic,” said Sharonann Lynch, Senior HIV & TB Advisor for MSF’s Access Campaign. “This is not the time to set the price based on what the market can bear. This critical test must be made accessible to all people who urgently need it at $5 per test to tackle this global health emergency.” 

In March 2020, Cepheid received emergency authorisation from the US Food and Drug Administration for its COVID-19 test to detect coronavirus at the near point-of-care, delivering results in less than an hour. The test is designed for use on Cepheid’s GeneXpert testing platforms, which are already being used across the world for diagnosis of TB and other infectious diseases. There are an estimated 11,000 GeneXpert instruments in low- and middle-income countries. 

The World Health Organization (WHO) along with several of its partners set up the ‘Diagnostics Consortium’ in March 2020 to support rapid and equitable access to COVID-19 health products and diagnostics for low- and middle-income countries. The Consortium secured volume commitments from major diagnostic test manufacturers (Abbott, Cepheid, Roche, and Thermo Fisher) for a period of four months. 

MSF, Doctors Without Borders, COVID-19 test maker Cepheid
MSF, in support of the Khayelitsha District Hospital, opens a COVID-19 treatment facility to meet the needs of the local community during the epidemic. © MSF

According to the Consortium, the amounts committed from Cepheid represented only one-third of its COVID-19 cartridge manufacturing capacity. As a result, less than half of the countries’ orders into the Consortium have been fulfilled. The Consortium and corporations, including Cepheid, are set to meet again to negotiate supply volumes and prices for the next four-month period (September-December).

“In this raging pandemic, wealthier countries have a tremendous advantage over others in buying COVID-19 medical tools for their use first,” said Lynch. “We are deeply concerned that people in many resource-limited countries will be deprived of this critical diagnostic test. We need to see Cepheid take the right steps and guarantee a fair allocation and affordable supply of its COVID-19 test to the Diagnostic Consortium to help countries that would otherwise be left behind or left out of bilateral deals.  No one should be denied access based on where they come from or what they earn.”


MSF teams are racing to respond to the COVID-19 pandemic in dozens of countries, either by adapting existing activities to the COVID-19 pandemic or by opening new projects in countries as they become pandemic hotspots. MSF’s response focuses on three main priorities: supporting authorities to provide care for COVID-19 patients; protecting people who are vulnerable and at-risk; keeping essential medical services running.