Global health security has become a pressing priority. From the COVID-19 pandemic to the ongoing challenges of antimicrobial resistance, the need for accessible, accurate, and equitable diagnostics has never been more apparent. 

Diagnostics are not just a tool for detecting disease—they are a cornerstone of effective healthcare systems, enabling early intervention, guiding treatment, and preventing the spread of infectious diseases. 

Yet, as highlighted by The Lancet Commission on Diagnostics, nearly half of the world’s population lacks access to even basic diagnostic services. This diagnostic gap disproportionately affects low-income and marginalized communities, exacerbating health inequities and undermining global health security.

Saliva-based diagnostics represent a transformative innovation that can address these challenges. By offering a non-invasive, cost-effective, and versatile testing method, saliva testing has the potential to democratize access to diagnostics and strengthen global health security. In this article, we explore how saliva-based diagnostics can play a pivotal role in advancing equity and preparedness in global healthcare systems.

The Diagnostic Divide and Its Implications for Global Health Security

The diagnostic gap is one of the largest barriers to achieving universal health coverage (UHC) and ensuring global health security. According to The Lancet, 47% of the world’s population has little to no access to diagnostics, with the gap most pronounced in low-income and rural areas. This lack of access delays disease detection, leads to misdiagnoses, and contributes to preventable deaths. For example, conditions like tuberculosis, diabetes, and hypertension often go undiagnosed until they reach advanced stages, resulting in higher mortality rates and increased healthcare costs.

The COVID-19 pandemic underscored the critical role of diagnostics in managing global health crises. Early detection through widespread testing was essential for controlling the virus’s spread. However, many low- and middle-income countries (LMICs) struggled to scale up testing due to limited infrastructure, high costs, and logistical challenges. These disparities highlighted the urgent need for innovative diagnostic solutions that are accessible to all populations.

Saliva-based diagnostics offer a unique opportunity to bridge this gap. Unlike traditional methods such as blood tests or imaging, saliva testing does not require invasive procedures or specialized equipment. This makes it particularly well-suited for use in resource-limited settings where healthcare infrastructure is lacking.

The Advantages of Saliva-Based Diagnostics

Saliva-based diagnostics have several key advantages that make them an ideal tool for promoting equity in global health:

First and foremost, saliva collection is non-invasive and painless. This eliminates the discomfort and fear associated with needles, making it more acceptable to patients across all age groups. It also reduces the need for trained personnel to collect samples, which is a significant barrier in regions with healthcare workforce shortages.

Second, saliva-based tests are highly portable and easy to use. Self-sampling kits allow individuals to collect samples at home or in community settings without requiring visits to healthcare facilities. This is particularly important in rural areas where transportation barriers often prevent people from accessing diagnostic services.

Third, saliva testing is cost-effective. Traditional diagnostic methods often involve expensive equipment and laboratory infrastructure, which are out of reach for many LMICs. In contrast, saliva-based tests can be processed using compact devices or point-of-care technologies that require minimal resources.

Finally, saliva contains a wealth of biomarkers that can be used to detect a wide range of conditions—from infectious diseases like COVID-19 and HIV to chronic illnesses such as diabetes and cardiovascular disease. This versatility makes saliva testing a powerful tool for addressing multiple health challenges simultaneously.

Strengthening Pandemic Preparedness with Saliva Testing

One of the most significant lessons from the COVID-19 pandemic was the importance of rapid mass testing in controlling outbreaks. Saliva-based diagnostics played a crucial role during the pandemic by offering an efficient alternative to nasopharyngeal swabs. Saliva tests were not only easier to administer but also reduced the risk of exposure for healthcare workers by enabling self-sampling.

Looking ahead, saliva testing can enhance pandemic preparedness by enabling early detection of emerging pathogens. Rapid point-of-care tests based on saliva can be deployed in schools, workplaces, airports, and other high-risk settings to identify cases before they lead to widespread transmission. Additionally, saliva samples can be used for genomic surveillance to monitor mutations in pathogens—a critical component of tracking variants during pandemics.

Beyond infectious diseases, saliva testing can also support broader public health initiatives such as vaccination campaigns. For example, saliva-based antibody tests can help assess population immunity levels and guide vaccine distribution strategies.

Addressing Antimicrobial Resistance Through Better Diagnostics

Antimicrobial resistance (AMR) is another major threat to global health security that can be mitigated through improved diagnostics. Misuse and overuse of antibiotics are primary drivers of AMR, often stemming from inaccurate or delayed diagnoses. Saliva-based diagnostics can help address this issue by providing rapid identification of bacterial infections and their susceptibility profiles.

For instance, a saliva test could quickly determine whether a respiratory infection is bacterial or viral, reducing unnecessary antibiotic prescriptions for viral illnesses like colds or influenza. By promoting targeted treatments based on accurate diagnoses, saliva testing can play a vital role in combating AMR.

Promoting Equity Through Democratized Diagnostics

Equity is at the heart of global health security. No diagnostic innovation can succeed unless it reaches those who need it most—particularly marginalized populations who face systemic barriers to care. Saliva-based diagnostics have the potential to democratize access by overcoming many of these barriers.

For example, self-testing kits enable individuals in remote or underserved areas to monitor their health without traveling long distances or incurring high costs. This autonomy empowers patients while reducing strain on overburdened healthcare systems. Additionally, saliva tests are discreet and private—a critical factor for conditions like HIV or STIs that carry stigma.

To ensure equitable adoption of saliva-based diagnostics, it will be essential to address challenges such as affordability and public awareness. Governments and NGOs can play a key role by subsidizing costs and integrating saliva tests into national healthcare programs.

A Vision for Global Health Security

Saliva-based diagnostics represent more than just an innovation—they are a pathway toward achieving equity in healthcare and strengthening global health security. By making testing accessible, affordable, and patient-friendly, these solutions have the potential to transform how diseases are detected and managed worldwide.

At Salignostics, we are committed to advancing this vision by developing cutting-edge saliva-based technologies that prioritize inclusivity and impact. Together with governments, NGOs, and global health organizations, we can build a future where no one is left behind—where every individual has access to life-saving diagnostics regardless of their location or socioeconomic status.