Source: The Institute
August 24, 2026

Picture a district hospital in sub-Saharan Africa. A child arrives with a high fever, rapid breathing, and the look of a body in crisis. The doctor suspects sepsis — a bloodstream infection that, treated with the wrong antibiotic, can kill within hours. But there is no lab test to identify the bacteria causing it. So the doctor does what doctors in this situation almost always have to do: guess.

That scene plays out constantly across the region. Bacterial infections cause roughly one in five deaths worldwide, yet across 50,000 medical laboratories surveyed in 14 African countries, only about 1% can perform basic bacteriology testing. Without it, physicians prescribe antibiotics blind — endangering patients in the moment and, over time, fueling antimicrobial resistance (AMR), a top global health threat according to the World Health Organization.

A new study published in The Lancet Microbe, led by Dr. Makeda Semret and colleagues at the Research Institute of the McGill University Health Centre (The Institute), tackles a problem long discussed but rarely solved: nobody could say, in concrete terms, what it would cost to fix it.

Putting a price on saving lives

National AMR action plans have long called for expanding bacteriology testing in low-resource hospitals. What they haven't had is a way to budget for it.

The idea for this study grew directly out of the team's field experience. "We had been running a cohort study on healthcare-associated infections and the burden of AMR in Ethiopia, which required strengthening the local bacteriology laboratory," Semret explains. "We kept hitting a wall: there was no transparent, practical tool to work out the volumes of reagents we’d need, let alone the costs of individual items required for our patient population. Building that missing tool for our own project became the starting point for the broader model."

To build that guide, the team first had to agree on the basics: what does a hospital lab need to reliably grow bacteria from a blood sample and determine which antibiotics will work against it? That meant convening experts from Africa, North America, and Europe to build a consensus list of the minimum equipment and supplies required — down to specific reagents and individual antibiotic discs.

From there, the team did something unglamorous but genuinely new: they got real prices. Using actual supplier quotes from Canada and Belgium, they costed every item, then modelled total costs under different scenarios — from a bare-minimum setup to something closer to international standards of care — adjusted for patient volume.

"This study fills a critical planning gap with numbers that funders and hospital administrators can act on directly," explains Dr. Cedric Yansouni, a scientist in the Infectious Diseases and Immunity in Global Health Program at The Institute and the study's senior author.

"It was a tedious labor of love," Semret says, describing a process of gathering multiple real quotes for hundreds of items across at least two countries, then modelling costs against realistic usage patterns, while accounting for how epidemiology varies across a continent as vast as Africa.

The result is more than a spreadsheet buried in a journal's supplement. The team also built a free, adaptable online tool that lets any hospital or ministry of health plug in its own patient volumes and local prices to generate a realistic budget, rather than relying on someone else's assumptions.

Why this is different

Plenty of international efforts over the past decade and a half have flagged weak laboratory systems in resource-limited settings, without specifying how to strengthen them. "What's new here is the focus on labs for individual patient care rather than surveillance," Yansouni notes, "and the level of granularity: a fully itemized list, with real supplier pricing and a transparent method for forecasting how many of each item a hospital will actually need, scaled to its patient volume."

Other initiatives, such as the UK's Fleming Fund or US CDC assessment tools, have produced checklists of what a functioning lab should have. This study pairs that checklist with an adaptable cost model — the difference between knowing what's needed and knowing what it takes to get it.

Who stands to benefit

The most direct audience is national ministries of health and major funders, such as the Global Fund, drafting or revising AMR action plans, along with hospital administrators planning a new or upgraded lab at a district or referral hospital. But the real beneficiaries are the patients with suspected sepsis who, right now, are often treated with a best-guess antibiotic instead of one chosen from an actual lab result.

A partnership more than a decade in the making

The study is also a case study in what sustained international collaboration can produce. It drew on long-standing partnerships between McGill and Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, and between the Institute of Tropical Medicine in Antwerp and the Centre National Hospitalier et Universitaire Hubert Koutoukou Maga in Cotonou, Benin. The McGill–Addis Ababa partnership traces back to 2015, when The Institute and the MUHC Foundation funded its establishment — an investment that has since generated research with influence well beyond the two institutions. Dr. Yansouni and co-author Dr. Jonathon Campbell both hold career awards from the Fonds de recherche du Québec – Santé (FRQS), which supported the work.

Along the way, the process exposed something the researchers weren't necessarily looking for: a broader lack of transparency in how lab costs get calculated everywhere, including in wealthier countries. In low-resource settings, that opacity is compounded by supply chain constraints and limited competition among suppliers, driving real costs higher than a price list alone would suggest.

What comes next

The team sees this data as a foundation, not an endpoint. The next step is using it to pursue large-scale, de-risked purchasing mechanisms at a supra-national level — pooled procurement that could lower costs further and insulate hospitals from the supply chain volatility that plagues the sector. The same numbers also give a realistic benchmark against which next-generation diagnostics, the ones hoping to leapfrog conventional bacteriology, will need to prove their worth.

For a child with a fever and a doctor without answers, none of this arrives fast enough. But for the ministries, funders, and hospital planners now working from an actual budget instead of a guess, the path to changing that outcome just became clearer.

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Source: [The Lancet Microbe] https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(26)00099-6/fulltext