Prize for TB low-cost point of care rapid diagnostic test
Present TB diagnostic methods leave half of all patients undiagnosed !sputum smear microscopy: sensitivity < 50%, especially not suitable for: children HIV positive patients extra-pulmonary TB
Better diagnostic tools exist
Improved sputum collection and microscopy methods Liquid and solid cultureColorimetric redox indicatorsIGRA’sMolecular techniquesStill lacking sensitivity and specificity Expensive Not suitable for the most peripheral settings: requires highly trained staff and/or highly equipped lab-infrastructure
What do we need?
More needs-driven research for new TB diagnostic tools, taking especially into account the situation at peripheral level
Rapid, low cost, point of Care
Differentiate between active and latent TB especially in high HIV prevalence areasHigh sensitivity especially for smear negatives and EP TB CheapEasy to handle Fast (results within hours)Not sputum based / Usable for childrenSuitable for follow upDetecting Rifampicin resistance….How to facilitate the development of POC:
POC TB test : best candidate for a prize…The low-cost POC TB test is a perfect candidate for testing innovative R&D mechanisms and fundingThis would perfectly be in line with the « Global strategy and plan of action on public health, innovation and intellectual property » the WHA adopted in May 2008 at the end of the IGWG process:« Explore and (…) promote a range of incentive schemes for research and development including addressing (…) the de-linkage of the costs of research and development and the price of health products, for example through the award of prizes (…) »
A promising proposal
Prize Fund for Development of Low-Cost Rapid Diagnostic Test for Tuberculosis, sponsored by Bolivia and Barbados. Presented during the IGWG process and expected to be considered soon by WHO
Grand Prix
Grand Prix of 100 million dollars for a TB test (every 7 years) feasible to manufacture for 1 $ feasible at POC in developing countries results in 3 hours sensitivity = X % specificity = Y % = needs first = innovation + AccessSub-prizes
Awards (1 to 10 millions) for Small technical challenges Best contributions (every 2 years) Incentives to collaboration and access to knowledge = cash flow on short term = rewards incremental advance = rewards collaboration and open accessMonopoly free
“Intellectual Property Rights For Grand Prix”A licensing pool would be created for acquiringneeded rights for the relevant patents and know-how for the diagnostic test—the TB licensingagency (TBLA). In order to claim the Grand Prix, thewinner would have to grant licenses to all patentand know-how needed for competitive supply of thetest, worldwide.”= no monopoly= competition for productionPublic funding
Government would contribute to the prize Participating high-income countries would be expected to contribute 90 percent of the funds Developing countries would be expected to contribute 10 percent = public responsibility = equity