Grant: Operating Grant: Joint Programming Initiative on Antimicrobial Resistance

Greater availability of fast and accurate diagnostics for infections would greatly reduce the over-prescription of antibiotics and slow the growth of antibiotic resistance which limits treatment options. It would also help prescribe the right drug at the right time, thus reducing suffering and increasing survival. However, despite advances in technology, few useful diagnostics for bacterial infections have come to market and we are seeing a downward trend in innovation. This study proposes to identify the key barriers that remain once a new diagnostic has been developed, looking at recent technological advances that ultimately failed to be authorized, adopted, or able to change prescribing. It will also look at technologies that have helped in the fight against antimicrobial resistance. Are there any features or particularities that seem to have improved their chance of success? Lessons from the failures and few successes will be used to assess chances for products in the pipeline, examining how regulation, reimbursement, technology transfer, and organizational characteristics might be improved to make them succeed within the clinical setting. The work will focus on each of these themes in developed world settings but also use them as a lens (in addition to diagnostic technical characteristics) to examine determinants of uptake in rural parts of South Africa, which are to some extent a proxy for LMIC.