By Emmanuel Ssekyanzi
When I was younger and still finding my footing as an entrepreneur, I was impulsive. Like many young founders, I was fascinated by big ideas, visible projects and the excitement of building something new. I rarely paused long enough to examine the deeper problems affecting our continent – especially those facing Uganda and the wider sub-Saharan African region.
With time, however, I have come to understand that development is not measured only by the size of the buildings we commission.
Whenever a new specialised hospital is announced, we celebrate – and rightly so. Modern hospitals, advanced theatres and specialist centres are important. But we often forget that a strong healthcare system is built from the ground up. Its foundation is primary healthcare.
If people cannot access basic screening, reliable testing and timely medical advice within their communities, investment in specialised hospitals alone risks becoming an illusion. We will continue constructing impressive facilities while patients arrive when their diseases are already advanced, complicated and expensive to treat.
The future of African healthcare will therefore not be determined only by what happens inside operating theatres. It will also depend on what happens before a patient ever reaches the hospital. At the centre of that future is diagnostics.
The first prescription should be the right diagnosis
A diagnosis is the bridge between symptoms and treatment. When that bridge is weak, the entire patient journey becomes uncertain.
A wrong diagnosis can lead to the wrong medicine. A delayed diagnosis can allow a manageable condition to become life-threatening. A missing diagnosis may force a patient to move from clinic to clinic, paying repeatedly without receiving a clear answer.
The World Health Organisation estimates that approximately 70 per cent of healthcare decisions are influenced by diagnostic results, yet diagnostic services receive only about 3-5 per cent of healthcare budgets. WHO has also reported that, in a study covering ten low- and middle-income countries – including Uganda – only 2 per cent of health facilities could perform eight basic diagnostic tests.
These figures reveal a contradiction: diagnostics influence most medical decisions, but we invest comparatively little in making them accessible.
We have been taught since primary school that prevention is better than cure. But prevention cannot remain a slogan. Prevention requires screening. It requires reliable tests, understandable results and a clear pathway for follow-up care.
A person whose diabetes, hypertension, cancer or kidney disease is identified early may need counselling, monitoring and affordable treatment. The same person diagnosed years later may require admission, surgery, dialysis or prolonged specialist care. Early diagnosis is therefore not simply a medical intervention. It is also an economic intervention for families and national health systems.
From patient needs to patient experience
Medicine has traditionally been organised around patient needs: What test does the doctor require? What treatment should be prescribed? Which department should receive the patient?
Those questions remain important, but modern healthcare is increasingly concerned with the entire patient experience.
Patient experience asks different questions: How far did the patient travel? How long did the patient wait? Was the process explained clearly? Could the patient afford the test? Were the results delivered securely and on time? Did someone help the patient understand what to do next?
A patient may receive a technically accurate service and still have a poor healthcare experience. Imagine a mother who travels several hours for a blood test, waits all day and is then asked to return days later simply to collect a paper result. The laboratory may have completed the test correctly, but the system has still failed to respect her time, circumstances and dignity.
The future of diagnostics must therefore combine scientific accuracy with convenience, speed, communication and continuity of care.
Diagnostics are leaving the hospital walls
Healthcare is becoming increasingly decentralised. This does not mean hospitals will disappear. It means that not every health service must begin inside a hospital building.
A sample can be collected from a patient’s home, workplace, school or community and transported safely to a central laboratory. Rapid point-of-care devices can support essential testing at lower-level health facilities. A radiological image captured in a rural district can be reviewed remotely by a specialist in Kampala – or even outside Uganda. Digital pathology can allow properly prepared and scanned tissue slides to be assessed or discussed by experts who are not physically in the same laboratory.
This creates a hub-and-spoke model: specialised laboratories and hospitals maintain quality, equipment and expert oversight, while smaller facilities and mobile teams bring access closer to the population.
For a pregnant woman in a rural community, an elderly patient with limited mobility or an employee who cannot spend an entire working day at a health facility, this shift is not merely technological. It can determine whether that person gets tested at all.
Home sample collection, when supported by trained professionals, correct patient identification, proper transport conditions and strong quality systems, can remove one of healthcare’s greatest barriers: distance.
The hospital of the future may therefore not be one enormous building. It may be a connected network that reaches the patient wherever that patient lives.
Information must move as efficiently as the sample
In the old diagnostic model, the patient moved to the laboratory, the sample moved between departments and the printed result moved back to the patient. In the emerging model, the sample may still travel, but information can move instantly.
A digitally connected diagnostic system can register a patient, track a sample from collection to processing, reduce identification errors, notify the laboratory of delays and securely deliver results to the patient and authorised clinician. More importantly, it can help ensure that an abnormal result does not simply disappear into a filing cabinet.
This is the thinking behind DiagnoTrack, a technology being introduced at Nuviva Diagnostics. The goal is to connect the diagnostic journey – from booking and home sample collection to sample tracking, laboratory processing, result delivery and follow-up.
Instead of repeatedly asking, ‘Where is my sample?’ or ‘Are my results ready?’, patients should receive timely updates. Clinicians should be able to access authorised information quickly, while the laboratory maintains a clear record of how the sample was handled.
This is especially important in our setting, where patients frequently move between different clinics, laboratories and hospitals. Too often, every new provider starts the patient’s story again. Previous results may be lost, repeated unnecessarily or presented without sufficient context.
The future should allow health information to follow the patient – with appropriate consent, confidentiality and security.
Artificial intelligence should support, not replace, professionals
Artificial intelligence is also beginning to change diagnostics.
AI-supported systems can help identify patterns in large sets of laboratory information, flag potentially abnormal results, support quality-control processes and help clinicians prioritise urgent cases. In imaging, algorithms can assist trained professionals in reviewing X-rays, CT scans and other medical images. In pathology, digital tools can help specialists examine and classify complex tissue patterns.
For countries facing shortages of radiologists, pathologists and other specialised professionals, these technologies may help experts serve more facilities and reach more patients.
But we must resist exaggeration. AI should not become an excuse to remove trained professionals, bypass clinical judgement or lower regulatory standards. An algorithm can support a decision, but it does not understand a patient’s complete social, clinical and emotional circumstances.
Technology must remain a tool in the hands of qualified professionals – not an unaccountable replacement for them.
Uganda must also address questions of data protection, informed consent, algorithmic bias, cybersecurity and accountability. If a digital system makes an error, who is responsible? Where is the patient’s information stored? Who is permitted to access it? Was the technology validated using populations that reflect African patients?
Innovation without governance can create new risks. Our responsibility is to build technology that is not only fast, but also safe, ethical and appropriate for our realities.
The future is already arriving
The future of diagnostics in Uganda will be smaller, faster, more connected and closer to the patient.
It will include home sample collection, community screening, point-of-care testing, digitally connected laboratories, remotely interpreted medical images, digital pathology and AI-supported decision-making. It will also require something less glamorous but equally important: trained health workers, dependable supply chains, quality-assurance systems and strong primary healthcare facilities.
Technology cannot compensate for poor-quality sample collection, unreliable equipment or weak professional oversight. Digitalising a broken process does not automatically repair it.
Government, private healthcare providers, universities, innovators and development partners must therefore build this future together. We need greater investment in primary healthcare laboratories, national diagnostic standards, workforce development, interoperable digital systems and affordable screening programmes.
Most importantly, we must stop treating diagnostics as a supporting department at the edge of healthcare. Diagnostics are the starting point of effective healthcare.
The most important medical breakthrough for an ordinary Ugandan may not be a robot inside a specialised hospital. It may be a trained professional arriving at their home, collecting a sample safely, having it processed by a quality-assured laboratory and delivering a clear result to the patient and doctor before the condition becomes an emergency.
That future is not approaching from a distant horizon. Parts of it are already here. Our task now is to ensure that it reaches everyone – not only those who can afford it.
About the author
Emmanuel Ssekyanzi is an entrepreneur and the founder of Nuviva Diagnostics. He writes about healthcare innovation, diagnostics and technology in Africa.
