Read the French version of the blog here.
When a patient with sudden paralysis arrived at a hospital in Siguiri, Guinea, health workers knew they were racing against time. Confirming polio would depend on how quickly a stool sample could travel more than 700 kilometres to the regional laboratory in Dakar, Senegal.
“We knew immediately what was at stake,” recalled a surveillance officer. “Without rapid sample transport, we were working in the dark.”
Guinea has made remarkable progress toward polio eradication. Certified as part of the World Health Organization’s Africa Region polio-free declaration in August 2020, the country has eliminated both wild poliovirus and circulating vaccine-derived strains. To maintain this hard-won status, Guinea strengthened environmental surveillance by systematically collecting wastewater samples from its more than 1,300 rivers and water sources (these water sources have earned Guinea its well-known title as the “Water Tower of West Africa).
Yet even with robust sample collection in line with WHO protocols, the country still faced a critical bottleneck: getting those samples to the laboratory fast enough to ensure a fast response.
Building an Integrated Sample-Transport System
Before 2022, Guinea’s disease surveillance systems operated in silos. Each program: polio, measles, Ebola and others, managed its own sample transport, with speed dictated largely by available funding. For polio surveillance, stool samples routinely took more than three weeks to reach coordination centres in Conakry, far exceeding the recommended 72-hour transport window. In addition, without a certified national laboratory, Guinea relied on regional labs in Dakar, Senegal.
In response, the Guinea Ministry of Health and Public Hygiene, with support from partners including FHI 360 and VillageReach, began strengthening an integrated sample-transport system in 2022. The system was initially piloted in four districts. Early success led to additional support, allowing the initiative to integrate polio surveillance and expand geographically. Building on the pilot, VillageReach partnered with FHI 360 to expand sample tracking from 15 districts to all 33 health districts and the five communes of Conakry. The system now connects approximately 99% of health facilities nationwide.
To reach remote and hard-to-reach areas, implementers adapted to Guinea’s challenging geography: motorcycle taxis navigated rugged terrain, while boats linked island communities to the mainland network. By pooling financial and material resources across disease programs, the initiative created a more efficient, cost-effective logistics chain that strengthens detection and response for polio and other epidemic-prone diseases alike.
A courier departs from the Conakry transport station to deliver samples to the Expanded Program on Immunization (EPI) and the national reference laboratory. Photo credit: Ebi Bile
Smart Technology + Local Partnerships
In early 2022, partners collaborated with local engineers to develop an Android application for real-time sample tracking. Adopted by the Ministry of Health, the app supports a “One Health” approach, enabling monitoring of samples across diseases. Surveillance focal points across the country use GPS-equipped smartphones with temperature monitoring to ensure safe and timely transport. The system captures sample type, timestamps and other key data, automatically sending SMS alerts to laboratories and health teams.
Equally important was the integration of local transport networks. By partnering with community-based transporters and unions (and later signing contractual agreements with airlines for commercial flights to Dakar), the system built a reliable logistics chain capable of moving samples from the most remote health facilities to the regional lab.
Measurable Impact: Faster Detection, Stronger Response
The results speak for themselves. The integrated system has reduced sample transport time to Dakar by more than four days. In Siguiri, what once took weeks now happens within days. Samples arrive faster, laboratory results come sooner and response teams can act before outbreaks spread.
“We used to worry whether samples would arrive at all,” a laboratory staff member shared. “Now we track them in real time. That changes everything.”
The strengthened system not only improves speed but also reliability by ensuring suspected cases of poliovirus and other epidemic-prone diseases are detected and confirmed in time to trigger a rapid response.
A courier hands over samples at the reference laboratory in Conakry, supporting timely disease detection and response in Guinea. Photo credit: Ebi Bile
Sustainability Through Government Ownership and Private-Sector Integration
As the system has matured, attention has shifted to long-term sustainability. Following changes in donor funding, continued support from new partners helped maintain operations and prevent disruption to surveillance activities.
“We’ve built something that works,” the program lead noted. “The priority now is ensuring sustainability through government ownership, private-sector engagement and increased domestic investment.”
Efforts are now underway to secure long-term financing through increased government ownership and diversified funding sources. Planned cost analyses will demonstrate both the investment required and the efficiencies gained through integration. At the same time, the system is beginning a gradual transition toward handing over logistics operations to private-sector transport companies. This shift aims to strengthen efficiency, accountability and resilience while reducing reliance on external partners.
Together, these steps position Guinea not only to sustain its polio-free status but also to maintain a resilient public health infrastructure capable of responding to future threats.