This year, a partnership between researchers in Uganda and UCSF launched the Uganda Hypoxia Lab, the first independent medical device research and testing facility in Africa. The lab was established to address a persistent global health issue: bias in medical testing, particularly in hypoxia testing.
The lab, based in Kampala, Uganda, is co-led by Ugandan clinicians and researchers and developed in partnership with UCSF’s Center for Health Equity in Surgery and Anesthesia (CHESA), which is part of IGHS; the UCSF Hypoxia Lab; the Association of Anesthesiologists of Uganda (AAU); and faculty from Makerere University.
Historically, many medical devices are designed, tested, and manufactured in wealthier countries that have the financial means or large private companies to fund this type of research. This also means that many of these devices aren’t tested in diverse settings and are often tested on primarily light-skinned populations. This includes devices like pulse oximeters, which measure oxygen levels in blood. Pulse oximeters routinely underperform for people with darker skin tones.
Growing Recognition During the COVID-19 Pandemic
Though this has been known for decades, it wasn’t until the COVID-19 pandemic that the issue got more attention from physicians, researchers, and regulators. Overwhelmed hospitals often relied on pulse oximeters to determine which patients needed immediate care, such as supplemental oxygen. Research from this period shows that some patients, especially those with darker skin tones, who could have required oxygen, were misidentified because of inaccurate pulse oximeters.
The US Food and Drug Administration has made some progress on this issue by recommending that more people with darker skin tones be included in medical device testing and clinical studies, but more work is needed to expand global medical device research and development (R&D) capacity and improve equity in all medical device testing.
“This is an especially important time to ensure that medical devices are safe and accurate across diverse populations. Wearable technology and clinical algorithms are expanding rapidly, but if we don’t validate them across all skin tones, we risk scaling a problem we haven’t yet measured. The Hypoxia Lab Uganda exists to close that gap, right here in Kampala.” Said Cornelius Sendagire, Co-Principal Investigator at the Uganda Hypoxia Lab.
The Uganda Hypoxia Lab
The Uganda Hypoxia Lab, first of its kind in sub-Saharan Africa, was established in February 2026 to ensure that medical devices work well for everyone, everywhere – particularly populations historically excluded from device development and validation. The lab offers high-quality, independent testing of medical devices with a focus on equity and global standards.
By ensuring that diverse populations are represented in how technologies are tested, the lab enables manufacturers to develop safer, more equitable medical devices, address gaps in global testing capacity, and establish a research resource within Africa. The Lab also supports policy change with regionally relevant data and builds research capacity through local training and university partnerships.
The lab emerged from the Open Oximetry Project, which held regulatory discussions on pulse oximetry accuracy and equity. It builds on the legacy of the UCSF Hypoxia Lab, which pioneered many of the seminal technologies and testing protocols that have served as the industry standard for pulse oximeter performance verification for decades.
Plans for the Future
Over the next two years, the Lab aims to transition to a self-sustaining model supported by manufacturer-sponsored studies and independent research grants and subgrants, based on the UCSF Hypoxia Lab’s successful financial model.
The Lab also plans to expand beyond pulse oximetry validation and into R&D for other essential health technologies, including respiratory rate monitors for childhood pneumonia and hemoglobin measurement devices critical for managing postpartum hemorrhage, and malaria.
The Uganda Hypoxia Lab marks an important step toward equitable and effective healthcare innovation.
Photo, from left to right: CHESA Fellow Emmanuel Aporu, Uganda Hypoxia Lab Co-PI Fred Bulamba, and Clinical Research Coordinator Philip Ewoku.
Sources: The Problem with Pulse Oximeters: A Long History of Racial Bias, Racial and Ethnic Discrepancy in Pulse Oximetry and Delayed Identification of Treatment Eligibility Among Patients With COVID-19