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Drug-Resistant Infections Targeted by FIND's New Diagnostics Initiative

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NEW YORK (360Dx) – The Foundation for Innovative New Diagnostics, a Swiss nonprofit, has launched a new initiative to address antimicrobial resistance, particularly in developing countries.

Backed by the UK and Swiss governments, FIND's Diagnostics Use Accelerator will support studies that could lead to improved use of antibiotics, as well as new diagnostics.

FIND has appointed Piero Olliaro, a University of Oxford professor who most recently led research at the World Health Organization's Special Program for Research & Training in Tropical Diseases, to lead the Geneva-based organization's new Diagnostics Use Accelerator.

According to Olliaro, the Accelerator should help pave the way for new drugs, new diagnostics, and better use of existing tests and therapies for infectious diseases, ultimately restoring confidence in the health sector.

"We are using this platform as a conduit to introduce new innovation in the system," Olliaro said. "We aim not only to give patients better treatment and better care, but to rationalize antibiotic drug use and put a dent in resistance."

The UK government will provide £3 million ($3.8 million) to fund the Accelerator, part of a larger £10 million pledge to support antimicrobial resistance research. The Swiss government will back the Accelerator with CHF1.5 million ($1.5 million) until the end of 2020. The investment is in line with the government's goals to work toward universal global health coverage.

FIND in a statement described its new Diagnostics Use Accelerator as a "demonstration study platform" that would improve data generation in various in-country projects. The data gleaned from these studies would in turn inform policymakers about the best diagnostics to use and would change the way healthcare providers prescribe treatment.

Olliaro said that the current model, where patients are often prescribed general antibiotics has not only led to antimicrobial resistance, but eroded trust among patients in the healthcare sector, who feel they are neither being properly diagnosed nor treated.

"Patients in these places have to travel to come to the health sector, they deal with transportation issues, and queue for hours just to be seen for five minutes, and so the [healthcare providers] feel they have to give them something," said Olliaro. "Sometimes there isn't even a diagnosis."

Olliaro said that a "major component" of the new FIND initiative, therefore, is to "find ways for a more rational use of antibiotics" that would get more people to trust healthcare providers and make the effort to see doctors. "Confidence in the health sector is paramount," Olliaro stressed.  "If we can restore confidence … that healthcare works, it would be a major advance."

The UK Department for International Development and the Swiss Agency for Development and Cooperation will fund the first wave of activities at the Accelerator, according to FIND. The initiative will initially focus on improving antibiotic treatment via the use of point-of-care diagnostics.

FIND announced the program at the Call to Action on AMR meeting, held in Accra, Ghana, earlier this month, and Olliaro said that the Accelerator is already in discussions with partners in Ghana to discuss potential cooperation. Moving forward, he said the Accelerator will interact with multiple countries to develop new policies and approaches that are tailored to domestic need.

"We will start the discussions at different levels in different countries," said Olliaro. "An essential component is that the local bodies will be involved in the design of the studies, so that when the studies are done, there will be a seamless process for policy uptake." FIND is also partnering with the WHO, he noted, meaning that its findings could also be considered for revising policy recommendations by the agency.

There is no technology or approach at the core of the new initiative, though Olliaro did suggest that panels might be run relevant to common infectious diseases such as malaria, influenza, and dengue. "What can be used of course would depend on [the] health system in different countries;" said Olliaro. "The choice of the system may  or may not be the same across different places."

In its studies, FIND will be looking at where patients are being seen, monitoring how current therapies and tests are being administered, as well as any impact from any new changes introduced. This includes gathering data on point-of-care tests, diagnostic algorithms, and the way they are used. It also includes surveilling any changes once these tools and treatments are optimized.

"If we do these studies as a platform, we can pave the way for introducing new diagnostics, new algorithms, and changes in behavior," said Olliaro. "We can also take out things that don't work, and add things that do work," he said. "At the same time, we can monitor the incremental benefits of adding the new approaches."

According to Olliaro, FIND expects the selection and preparation of study sites to begin next year. It will take at least a year to collect data because FIND and its partners will monitor high and low seasons for the infectious diseases in question. He anticipated that it might take two years before the new initiative produced any results.

Olliaro added that if FIND is able to develop the Accelerator into an operating system capable of introducing and modifying diagnostic testing in partner countries, as well as changing the way treatments and tests are used, it will be deemed a success.

The new Accelerator is just one part of FIND's efforts related to AMR. The organization published a report in October 2017 in which it estimated FIND would require $72 million to realize its goals related to AMR over the next six years.

A spokesperson said this week that delivering on that strategy, though, will require investments in initiatives for pathogens not already addressed by existing programs, which also means they might fall outside of regular funding mechanisms.

"Leadership from key governments such as the UK and Switzerland is critical," the spokesperson said, "but more is needed to complement this project-specific funding and we welcome further engagement from the whole donor community."

FIND is therefore counting on institutional donors, corporations, foundations, and philanthropists to reach its goals. The spokesperson added that FIND continues to "build partnerships with industry to drive innovation." Last month, for instance, the organization announced a $3.8 million program to evaluate a new, urine-based test made in partnership with Fujifilm for detecting tuberculosis in patients co-infected with HIV.