Transportation challenges limited the utility of the
hub-and-spoke model during the COVID-19 pandemic, taking 3-6 months to
move samples between countries in EMR.
Complex emergency countries such as Yemen, Syria and Lebanon face
extreme challenges in both importing and exporting reagents and
samples44. It is estimated during the COVID-19
pandemic that, the cost of acquiring reagents and importing them into
these countries was 5-7x higher than those found in other regions5,10. While this is partially due to geographical
challenges with moving samples from conflict zones, it is also likely
partially due to challenges with import and export embargoes imposed by
suppliers and other countries in response to the situations in these
countries11. A lack of courier networks and stable
cold-chain logistics also impacts the time taken to move samples between
countries. Despite the best efforts of UNHAS, WHO/EMRO and other
stakeholders, it took 3-6 months to move samples from each country to
RLID-AD for analysis. Import and export challenges were also faced,
holding the samples up further and impacting the quality of testing that
could be performed downstream. Samples were collected between 07/01/2021
and 10/06/2021, with sequencing and results performed in March and April
2022 upon receipt at RLID-AD, almost 12 months after collection in some
cases. In spite of this, 170 samples were received intact at SKMC for
further analysis.