i-sense members from the McKendry group at UCL and the Peeling group at LSHTM attended the week-long Advanced Course on Diagnostics (ACDx), which took place at the Fondation Merieux Centre for Global Health in Annecy.
What is the ACDx?
The ACDx has been running for eight years and aims to enhance the knowledge and professional network of policy-makers and scientists.
The course is attended by global experts in the field of diagnostics and offers an opportunity to gain an overview of the social, economic, political and ethical issues of diagnostics.
This year’s course was unique because it was dedicated to antimicrobial resistance and the role that diagnostics can play in reducing inappropriate use of antibiotics, measuring the extent of resistance and assessing the impact of interventions such as stewardship.
Key learnings from the course
- Global networking, public private partnerships, and innovation in diagnostics are pivotal in the control of antimicrobial resistance
- Having a good test is not enough! Developers and manufacturers have to take into account several factors such as quality assurance, regulatory approval, adoption, target market, implementation of the test (centralised or decentralised), and supply chain management
- We need good clinical and laboratory infrastructure in countries to support testing and linkage to care
- Open platform technology is not just a dream; it is becoming a reality
- The road from discovery of proof of principle to regulatory approval and adoption is challenging. There is need for strategies to be put in place to accelerate regulatory approval, assessment of clinical benefit and adoption to incentivise innovation
- Harmonising regional regulatory systems can streamline and accelerate the approval process
- There is currently a need to develop a very good test that can reduce antibiotic misuse by differentiating between bacterial and viral infection. However, there is need to ensure that when such a test is available, the uptake among clinicians is also optimal
- Developers should take into account the property of connectivity in diagnostics from the start. Connectivity is the way forward to ensure real-time start of the art surveillance for antimicrobial resistance and infectious disease outbreaks
- Focusing on the Once Health approach is important; there is huge potential for diagnostics to reduce antibiotic use in animals and farming, not just in humans
How was this course valuable to i-sense work?
As part the work done by i-sense Flagship 1 (end-user needs), our researchers seek to identify the adoption and implementation challenges of point-of-care diagnostics and propose strategies that can streamline and accelerate the regulatory approval for diagnostics. This slow regulatory approval can be a disincentive to innovation.
This work involves understanding the barriers ranging from technical issues in product manufacturing to approvals and implementation in the field. While only reviewing literature provides a theoretical insight about the processes involved, attending ACDx allowed an opportunity to interact and listen to the industry and country representatives on their experiences about the real-life challenges and the way forward for point-of-care implementation.
Furthermore, the course itself involved many discussions and panel sessions which invited participation of industry leaders and policy makers to share their suggestions for tackling issues related to antimicrobial resistance and creating diagnostic solutions. These sessions were not exclusive to diagnostics; they also integrated topics such as public health emergency preparedness, health system strengthening, laboratory systems and biosafety as well as post-market surveillance that are vital for implementing diagnostics. Practical suggestions given throughout these discussion could be useful if adapted in the context of the UK.