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Antimicrobial Resistance Test Makers Maneuver to Compete for Nesta's £10M Longitude Prize

NEW YORK – Companies that make tests to determine the best therapies for infectious diseases can take part in a new program related to Nesta's £10 million ($13 million) Longitude Prize. The prize, organized by the British innovation foundation Nesta, has assembled a series of workshops and support sessions to help prize competitors. Called Longitude Prize Sprint, the workshop and support package is set to run through March 2021.

The Longitude Prize commenced in 2014 and its current focus is on diagnostics that can mediate the problem of antimicrobial resistance. The total value of the prize is £10 million, but the payout to the winner is £8 million. Nesta will accept entries from the prize through September 2022.

Daniel Berman, head of global health at Nesta Challenges, the arm of Nesta that is responsible for designing and administering the prize, said there will be three upcoming workshops for participants. The first, to be held Aug. 7, is focused on navigating regulatory pathways in developed and emerging markets. A second, focused on investment in funding, will occur in September, followed by a third focused on manufacturing and distribution, will be held in October. Interested parties can register to attend the workshops on the program's website.

"I think what is different about this program is that not only are we offering webinars with experts, but for those teams that are registered with the prize, there is the follow-up one-on-one with mentors," said Berman. "Also, in the COVID-19 world where everything is virtual, it creates opportunities," he noted. "We never would have been able to bring such diverse people together physically for these workshops."

According to Berman, there are currently 54 teams competing for the prize representing 12 different countries. The bulk are from North America, the UK, and India, he said. They include Astrego Diagnostics, an Uppsala, Sweden-based company developing a rapid test for urinary tract infections to stem antibiotic overprescription; Phast Diagnostics, a Boston-based firm that relies on AI imaging to combat antibiotic resistance; and Pune, India's Module Innovation, which is building a diagnostic platform based on color changing polymers for microbial detection.

There is no specific profile for the ideal test, Berman noted, nor is there a fixed deadline for when it will be announced. "It's a first-past-the-post system," he said. "We are asking for an affordable product, asking that it be point-of-care, and asking the team to demonstrate through modeling and smaller studies the potential clinical impact."

The winning test itself might be a lateral flow assay, similar to a pregnancy test, or be based on a microfluidics device. Such "circuit board-like" tests are typically cheap to manufacture and use limited amounts of reagents, he said.

Teams taking part are working in the areas of sepsis, urinary tract infections, and pathogen identification, he said. Over all, Berman said he has been impressed by the technology platforms of participating teams, many of which have taken decades to build.

"It's a pretty exciting time in the diagnostics space," said Berman. "A lot of technologies have been around a number of years, but there is a tipping point where they are becoming commercially available," he said.

Berman noted that the new technical webinars being rolled out this week are not only open to prize seekers but to anybody – individual, organization, or business – that is developing tests in the field of antimicrobial resistance. In general, Nesta is looking to foster innovation in the AMR field, even as teams jockey to eventually win the £8 million payout from Longitude Prize.

"We are focusing companies on a particular challenge, meaning addressing AMR, and a lot of teams have told us that they wouldn't be working on it if it wasn't for the prize," said Berman. "So, our project is feeding the ecosystem." He also noted that Nesta at times makes smaller grants to companies, which is another reason companies wish to interact with the organization.

"A lot of companies have said [winning the prize] would give them a huge marketing boost and that's what motivates them, but we also have small, high-profile grants," Berman said. "When someone wins them, it's like getting our seal of approval [and it] helps them get other grants and investments," he said.

One company that is also taking part in the Longitude Prize competition is Mologic, a UK-based developer of rapid and lateral flow tests. The company has experience in infectious disease testing, and last year partnered with the Institut Pasteur of Dakar in Senegal to develop rapid tests for tropical diseases. The company has also been developing a lateral flow test for sepsis.

According to CEO Mark Davis, the sepsis test has reached an "advanced stage of development," including a trial carried out in cooperation with University College London Hospital with other randomized controlled trials planned in "communities in sub-Saharan Africa and other communities where healthcare spend is low."

Davis said that support from the Longitude Prize could make the final randomized controlled trials possible, "enabling the trials to be conducted independently of commercial preferences, capture the unique challenges of communities that are beyond the customary Western obsession, and deliver reliable rapid diagnostic technology to this unsatisfied corner of acute healthcare."

The availability of such a low-cost, quick test for sepsis should allow the more-informed prescription of therapies, rather than using antimicrobial therapy as a first pass at treatment while waiting for results to come in. "Knowing which patients do not require antimicrobial treatment on a timescale that is actionable within the short period of initial presentation offers tangible results from stratification alone, from cost savings to outcomes," noted Davis.

In general, Davis credited the Longitude Prize with making an "important contribution to diagnostics development," especially in the field of AMR, where he said failed attempts in the past had led to doubts among investors, who are more wary of investing in such tests.

"Without well-considered technical advances reentering the area, the continued clinical unmet need will remain, and patients will continue to succumb unnecessarily," noted Davis. "This complex clinical condition, often complicated by other underlying factors, lacking a reliable gold standard reference assay, requires a wide cross functional team of experts to combine forces and see through to a goal that has evaded science for too long," he said. "The Longitude Prize is ideally placed to facilitate this."

The Longitude Prize might play a similar role in other areas of diagnostics in years to come. Berman said that there are no plans for a follow-on prize related to AMR but noted that the prize is "looking seriously at a Longitude Prize on dementia," that might lead to new tools for managing neurodegenerative conditions. He added that no decision has been made in that area.