Point of Care Antimicrobial Diagnostics in Low- and Middle-Income Countries

Nesta is the UK's innovation agency for social good, which designs, tests and scales new solutions to society’s biggest problems. One of Nesta’s initiatives is the Longitude Prize – a £10m prize fund (with an £8m payout) that currently focuses on the challenges of antimicrobial resistance (AMR) and dementia. The Longitude Prize on AMR rewards innovators who develop a point–of–care diagnostic test that will conserve the efficacy of antibiotics for future generations. The test must be accurate, rapid, affordable and easy to use anywhere in the world. It is Nesta’s belief that without accurate, rapid diagnostic tests and best practice in antibiotic stewardship, modern medicine as we know it is at risk.

The Problem 

The rise of Antimicrobial Resistance (AMR) is a growing concern; AMR accounts for more than 700,000 deaths worldwide. It is estimated that without any intervention, by 2050, AMR will affect 10 million lives and cost about US$100 trillion per year. In Africa, where deaths from AMR are the highest globally, 42.6% of countries are without recent AMR data, and of these, few include surveillance data. The lack of quality data leads to inadequate treatment guidelines that are no longer appropriate for existing local situations.

There is a high level of resistance to commonly used antibiotics in Africa. These include the preferred first line of drugs for urinary tract infections, such as amoxicillin or ceftriaxone for bloodstream infections.

Furthermore, the misuse of antibiotics threatens the effective control and treatment of various bacterial diseases on the continent.

Without accurate, rapid diagnostic tests and best practices in antibiotic stewardship, the efficacy of new antimicrobial medicines will be undermined in the long-term, while current stocks of antibiotics will be compromised in the short-term.

The Solution 

Nesta commissioned Market Access Africa to develop a market landscape report to support the Longitude Prize team’s product commercialization efforts in Africa. This report involved conducting primary and secondary research, including consultation with 30 experts at 21 organizations in Nigeria and South Africa, including policymakers, regulators, health insurers, pharmaceutical distributors and research institutes.  

Our recommendations were informed by a robust assessment of potential channels for entry into the public and private sectors, the clinical evaluation requirements for each product class and key opinion leader engagement strategies, and other contextually relevant factors in each country. 

The Outcome 

Overall, eight actionable recommendations were presented to the Longitude Prize team to support commercialization planning for true and near point-of-care AMR diagnostic tests. These suggestions and recommendations were converted into a resource for future diagnostic developers interested in low- and middle-income countries.