Publication: Strengthening supply chains for pathogen genomic surveillance in Asia (BMJ Global Health, 2026)

Next-generation sequencing (NGS) is a critical tool for infectious disease surveillance, yet its adoption and scale up across Asia are constrained in procurement and supply chain bottlenecks, affecting timely access to equipment, reagents, and related consumables essential for pathogen genomics. 

A study led by the Asia Pathogen Genomics Initiative (Asia PGI) at the Duke-NUS Medical School Centre for Outbreak Preparedness examined the procurement and supply chain landscape of NGS technology for infectious disease surveillance across 13 countries in Asia. By surveying institutional partners, genomics manufacturers, and laboratory personnel, the study identified systemic barriers as well as opportunities and actionable strategies to improve access to pathogen genomic sequencing technology.

The challenge: high costs and long delays

• Prohibitive costs: The high cost of equipment, reagents, and consumables was identified as a near-universal barrier. Low- and middle-income countries often pay significantly more per sequence than high-income nations.
• Extensive lead times: Reagent resupply took an average of eight weeks, with some countries waiting up to three months. These delays are critical when attempting to track rapidly evolving outbreaks.
• Infrastructure & maintenance: Over half of the surveyed countries experienced frequent equipment breakdowns, with repair lead times cited as a major obstacle to continuous surveillance.
• Regulatory red tape: Manufacturers highlighted inconsistent customs procedures, varying import taxes, and a lack of clear regulatory frameworks as major challenges to timely access of NGS related equipment.
  

Strategic opportunities for regional resilience:

To address the identified problems, the authors propose the following key recommendations as a roadmap towards a more resilient and sustainable genomic surveillance ecosystem in Asia: 

1. Pooled procurement & price transparency: Moving away from small, individual laboratory orders toward national or regional pooled forecasting to increase bargaining power and lower costs.
2. Streamlined regulations: Harmonising customs and tax-waiver processes within regional blocs like ASEAN to reduce purchasing lead times.
3. Local capacity & digital solutions: Leveraging innovative digital solutions for demand forecasting and supporting manufacturers in establishing regional logistics and service hubs to reduce shipping and repair times.
4. Multisectoral collaboration: Creating multisectoral platforms—similar to models used in Africa—that bring together policymakers, manufacturers, and scientists to co-develop context-specific solutions for the region.
   
   
   

Conclusion

Pathogen genomics has the power to bridge health equity gaps in early disease detection. However, technology alone is not enough. Without a robust, coordinated regional effort to address the procurement and supply chain challenges, the potential of genomics to enhance health security in the region will remain underutilised.