A Task Force for Global Health partnership is testing a novel surveillance approach that may fundamentally change how countries monitor diseases that lead to outbreaks, like mpox, COVID, measles, HIV and other infectious diseases. With just a single drop of blood, this “integrated serosurveillance” approach can analyze samples for hundreds of diseases at the same time.
For non-scientists, the word “multiplex” might suggest a movie theater with multiple screens. In science and technology, it refers to a system of transmitting several messages or signals simultaneously on the same circuit or channel. In global health, a multiplex assay kit tests a single biological sample for dozens of disease markers simultaneously (“integrated serosurveillance”) to indicate whether someone has been infected, exposed to a disease, and/or vaccinated.
A team in The Task Force’s Neglected Tropical Disease-Support Center (NTD-SC) is working with the biotechnology firm Tetracore, Inc. and several other partners, with funding from the Gates Foundation, to pilot this approach. This work has been in development for more than a decade, with the aim of scaling it up for use as a public health tool.
“We need to bridge the gap to enable this technology to be used regularly in global health programs,” said Dr. Pat Lammie, Director of NTD-SC. “This information tells us what we are missing – it gives us a history of infections in the community. This technology is a truth-teller, showing what is actually happening in public health – and what isn’t. It allows you to understand the immunity gaps in a community, like an early warning system, and hold our public health systems accountable.”
The Task Force program is led by Dr. Kumar V. Udhayakumar, who served more than 30 years at The Centers for Disease Control and Prevention (CDC), working on malaria and other infectious diseases, and has a PhD in immunology.
“Using a single blood spot specimen, one can detect in a single test up to 100 different signatures of multiple pathogens,” said Dr. Udhayakumar. “The idea here is, if you can use this kind of methodology, then you can capture all that information with a single test. You don’t have to take large volumes of blood.”
Additionally, the technology uses dried blood, which is an important and practical innovation. Using dried blood spots in place of fresh blood allows the samples to be easily transported because it does not need to be refrigerated.
These tests will allow public health professionals to understand immunity gaps in entire communities quickly and cost-effectively. Importantly, this will allow public health practitioners to be more efficient in their health campaigns. For example, it would not be necessary to conduct multiple separate diagnostic tests for different diseases – like mosquito-transmitted diseases or blood-borne infections. Practitioners could use multiplex assay kits to test for multiple diseases at the same time, which would save valuable laboratory time and inform decisions about public health programs and resources needed to address public health challenges.
PILOT TESTING ON MPOX AND EBOLA
The team aims to advance a broad spectrum of public health goals, which is why mpox, Ebola virus disease and Marburg virus disease surveillance test kits were chosen for the initial pilot testing. Outbreaks of Ebola in Uganda and Marburg in Rwanda and Tanzania have raised the importance of these types of kits for outbreak investigations and surveillance, with WHO reporting 130,000 cases of mpox globally between January 2022 and January 2025 – 61% of them in the WHO Africa region.
Late last year, a small pilot test was done during the mpox outbreak in DRC, and The Task Force, Tetracore, Africa CDC and other public health partners intend to deploy additional kits to support current outbreak investigations.
These types of kits will help to better understand the nature of the spread of these diseases in affected communities and deploy suitable control measures to contain the spread.
HISTORY
Reaching this milestone has been a journey of more than two decades, involving partners with different but complementary skillsets: private sector (Tetracore and others), nonprofit (Task Force for Global Health and others), government (ministries of health and the US CDC), funders (Gates Foundation), academic and research institutions, Pan American Health Organization (PAHO) and the World Health Organization (WHO).
Tetracore, founded in 1999, supplies high-quality animal and human health diagnostic products, diagnostic reagents, and assays for infectious diseases and biological warfare threat agents and provides laboratory services related to those products. Tetracore has a licensing agreement with Luminex (acquired by Diasorin, a specialist in innovative multiplexing technologies) to produce and sell multiplex assay kits based on Tetracore technology. The life science community has been using these kits for many years, but have struggled to break into the health science space.
“We tried for 26 years to bring this technology for public health use but couldn’t get beyond various hurdles to move this idea forward,” said Tetracore Founder Dr. William Nelson. “But with COVID there was a big change. COVID surveillance has been a jump starter.” Following this lead, the current partnership between Tetracore, The Task Force and other partners will enhance adoption of this technology for widespread public health use.
“It’s not just about the test kit,” said Dr. Venkateswaran of Tetracore. “We are trying to provide a total solution.”
Tetracore has developed controls to maintain the quality of testing, including Zoom video-conferencing support for people using them, and works with distributors in Africa, Asia and the Americas.
“We are looking forward to changing the paradigm of the way disease surveillance is done,” said Dr. Lammie of The Task Force, who noted that the chair of the WHO diagnostics technology advisory group for NTD diagnostics has been working to accelerate regulatory pathways to allow countries to procure these tools.
This project received key funding support from the Gates Foundation, which is committed through 2026. The Task Force program team is working on additional long-term funding to advance the work.
WHAT’S NEXT?
Task Force experts are in contact with 20 labs across the globe that will experiment with test kits geared toward detecting COVID-19 and arboviruses. Once the results are validated, more test kits will be distributed to these labs and others so they can test more people for the full panel of diseases. This work is critical for improving the health of communities all over the world, and is also a significant step in achieving a more comprehensive understanding of infectious diseases, how they spread and how they can be eliminated.
