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R&D blueprint expands for COVID-19 epidemic and beyond

The R&D Blueprint is a global strategy and preparedness plan that allows the rapid activation of research and development activities during epidemics. 

It aims to fast-track the availability of effective tests, vaccines and medicines that can be used to save lives and avert large scale crises. 

With WHO as convener, WHO Member States welcomed the development of the Blueprint at the World Health Assembly in May 2016.

As part of WHO’s response to the coronavirus pandemic in 2020, the R&D Blueprint was activated during COVID-19 to accelerate diagnostics, vaccines and therapeutics for the novel virus. 

This aims to improve coordination between scientists and global health professionals, accelerate the research and development process, and develop new norms and standards to inform the global response.

Building on the response to recent outbreaks of Ebola virus disease, SARS-CoV and MERS-CoV, the R&D Blueprint has facilitated a coordinated and accelerated response to COVID-19.

In 202, WHO published the final version of Target Product Profiles (TPP) for priority COVID-19 diagnostics. These TPPs describe the desirable and minimally acceptable profiles for four tests.

  • Read more on the R&D Blueprint here
  • Read more on COVID-19 Blueprint  here
  • Read more on TPP here
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Collaborations lead to apps, toolkits to collect COVID-19 RDT data

Collaboration between organizations is essential to quickly design and develop human-centred health tools to tackle the COVID-19 pandemic. The list below is a collection of various applications and toolkits developed in this way to capture COVID-19 related data.

  1. The COVID-19 Template App, designed by FIND and Dimagi, supports health workers as they administer and record the results of COVID-19 antigen rapid diagnostic tests (RDTs). The application features workflows for patient registration, test initiation, and result capture. 
  1. The RDToolkit: Currently Supported RDTs is a listing of the RDTs that the Rapid Diagnostics Tookit hosts.
  1. FIND and HISP India collaborated to develop a DHIS2-based package for capturing data for RDTs. The resultant COVID-19 RDT Data Capture programme metadata package is available for download.
  1. As part of the ACT-Accelerator, Argusoft added a novel digital health solution to enable RDT capture with FIND. This COVID-19 RDT Data Capture is a MEDplat extension.
  1. ODK partnered with FIND to create a ready-to-use form to help community health workers in collecting data when performing RDTs. Read more on the COVID-19 Antigen RDT form for standards-compliant data.
  1. Medic’s CHT App with COVID-19 RDT Workflows is a community health toolkit to enhance RDT workflows. It also was developed in partnership with FIND. The app is powered by the Community Health Toolkit (CHT).
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Model to improve COVID-19 diagnostic data collection

FIND and PATH have been working together to support the development and implementation of digital tools for the global COVID-19 response.

With more than 400 COVID-19-based digital health tools available, countries need to determine the most appropriate ones for their needs, and how to use them. 

The Digital Square initiative within PATH’s Centre of Digital Excellence has convened a network of global collaborators to streamline a more effective approach to using these tools.

Its goal is to improve COVID-19 diagnostic data and use, which will increase the ability to share and view rapid diagnostic testing data.

To this end, FIND and PATH created a template of data fields relevant to the COVID-19 rapid diagnostic test workflow, called the ACT-A COVID-19 Antigen RDT Data Model.

Aimed at supporting low- and middle-income countries, the common data model is freely available to download.

Read more here

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Assessing COVID-19 digital tools in Kenya

This case study of Machakos and Mombasa counties in Kenya was conducted by the Ministry of Health, Jomo Kenyatta University of Agriculture and Technology, and FIND in 2021.

It mapped the use of digital tools to strengthen COVID-19 screening, testing, contact tracing and case management.

It makes findings on:

  • Management of COVID-19 in Machakos and Mombasa
  • COVID-19 management cascade
  • Use of digital tools
  • Primary and secondary outcomes
  • Epidemiological outcomes.

Key challenges are presented, and recommendations made on:

  • Screening process
  • Testing
  • Contact tracing
  • Management.

It also provides general recommendations to improve the use of digital tools for COVID-19 management in Kenya.

Read full report here

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Call for solution to capture COVID-19 testing data

FIND issues proposals request from digital health solution providers for COVID rapid diagnostic test data capture 

FIND, as co-convener of the ACT-Accelerator (ACT-A) diagnostics pillar, is working towards supporting countries in implementing an effective test-trace-isolate response using digital tools. 

This includes partnering with digital solution providers to speed up development and deployment of a set of minimum functionalities for COVID rapid diagnostic test (RDT) data. 

The idea is to incorporate these functionalities into existing digital tools to be used in low- and middle-income country (LMIC) settings.

FIND therefore issued a Request for Proposals (RFP) to identify and work with developers of existing digital health solutions already in use in LMICs at community level. 

Any organization, institution or entity specializing in developing and implementing digital health solutions for healthcare data collection in LMICs was invited to apply, with potential for further collaboration.

Partners were to be selected through a process which focused on:

  • Current capability to deliver the RFP requirements 
  • Organizational assessment
  • Cost of the project.

This RFP contained three appendixes which provided data points to be captured, target characteristics to be considered, and a response template.

The RFP opened on 7 April 2021, and closed on 28 April 2021. Data collection functionalities and workflows were due to be ready for rollout by the end of June 2021.

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Framework to safeguard personal data in a public health emergency

The Access to COVID-19 Tools Accelerator (ACT-A) was established to respond to the COVID-19 pandemic by scaling up development and equitable distribution of tests, treatments and vaccines, and strengthening underlying health systems infrastructure.

Key takeaway: Protecting individual right to privacy is vital both during and after a pandemic response.

Early on, the Research and Development and Digital Working Group of the ACT-A Diagnostics Pillar recognised that it was essential to collect, link and share timely access to data.

However, during this public health emergency (PHE), government states of emergency were declared, and fundamental human rights, including the right to privacy, were limited as part of national COVID-19 responses. 

As the world’s first pandemic where digital technologies and personal data have been used on such a large scale, this has highlighted the issue of how personal data is used. 

It also raised the related issue of how to ensure that use remains in the public interest.

Proactive response The Framework for the Governance of Personal Data for the Access to COVID-19 Tools Accelerator  was developed as a guide to promoting best practice and responsible use of personal data by all initiatives funded under the ACT-A. 

Published in January 2021, it outlines how using personal data in responding to COVID-19 must safeguard privacy and the rights of vulnerable groups. 

The framework aims to:

  • Promote best practice
  • Support the safeguarding of the rights of vulnerable groups 
  • Complement national laws and policies
  • Guide the development of national regulations on the governance of data for COVID-19 related activities
  • Guide the development of mechanisms for appropriate levels of community reviews and oversight
  • Be a dynamic framework. 

Six substantive principles guide decisions on data and data use:

  • Solidarity
  • Respect for persons and communities
  • Equity
  • Non-exploitation
  • Privacy
  • Data stewardship.

There are also three procedural principles:

  • Transparency
  • Accountability
  • Engagement.

The nine principles provide overarching guidance on both managing personal data and balancing collective interests with individual rights during a COVID-19 response. 

The framework provides detailed guidance on data management, including data collection and storage, retention, access, and the responsibilities of those processing personal data during COVID-19. 

Read more here

Guidelines on equitable access to data and public engagement are included in the framework.

Governance of this personal data must extend to its use in a post-pandemic world; hence it also calls for the establishment of national independent Data Stewardship Oversight Committees for COVID-19. 

During a pandemic, these should monitor the collection and use of personal information in line with public expectations, human rights and clear and accountable processes. 

In a post-COVID-19 world, these national committees should be tasked with determining access to COVID-19 data and conditions for access. 

Importantly, they also should ensure decisions on access continue to be driven by public and not private or commercial interests. link page text ends 

The framework will be updated and refined based on recommendations and experiences, and reviewed every six months. Feedback is encouraged and may be sent to the ACT-Accelerator Diagnostics Pillar at email ACTAdiagnostics@finddx.org

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In-house test development for molecular detection of SARS-CoV-2

Roadmap to create diagnostic tests available in English, French and Portuguese.

This document provides guidance on the development of a new, in-house, real-time RT-PCR test for SARS-CoV-2 aimed at laboratories which have established molecular biology capabilities. 

The information – available in English, French and Portuguese – will also provide a roadmap for the creation of new molecular diagnostic tests for other emerging pathogens. 

It acknowledges the constraints  of resource-limited laboratories, and outlines  requirements for good molecular biology practices, including quality control and quality assurance.

Steps to success
When a new virus such as SARS-CoV-2 emerges, laboratories rely on time-tested methods of developing diagnostic tests when commercial assays are unavailable. 

These LDTs are rarely perfect on the first attempt. 

Ideally, these tests continue to develop and gain validation until formally certified for in vitro diagnostic use by a regulatory body.

Most LDTs do not progress to the point of formal certification for use. However, they should still be held to the highest standard of quality possible to mitigate the health and economic impacts of the emerging disease and help protect vulnerable populations.

Read the report here

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Forum discusses research agenda for SARS-CoV-2 antigen rapid diagnostic tests

Participants identify key questions to take technical and programmatic research forward.

ACT-Accelerator diagnostic pillar partners joined in a virtual forum to discuss the development of a collaborative operational research agenda for SARS-CoV-2 antigen rapid diagnostic tests (Ag-RDTs). 

The forum, held on 29 October 2020, was organized around three breakout groups according to three thematic areas for SARS-CoV-2 Ag-RDTs:

  • Technical research
  • Programmatic research
  • Modelling

Group participants focused on understanding the performance of Ag-RDTs when implemented in real-world settings and across specific populations. 

Priority questions

  • Performance
  • Use cases
  • Samples
  • Bio-safety
  • Quality control
  • Training and delivery
  • Economics and cost.

Participants discussed steps to advance the Ag-RDT research agenda and agreed that there should be multiple future discussions on this. 

Read the report here

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Rapid diagnostic tests for COVID-19

Key takeaway: Both types of RDTs are crucial for effective public health management.

Rapid diagnostic tests (RDTs) for COVID-19 can detect either antigen (Ag) or antibody (Ab), and both types of tests have important roles.

A combination is needed for effective patient management and public health planning.

This May 2020 report outlines general information on Ag- and Ab-detection RDTs for COVID-19, and suggested uses for them.

Polymerase chain reaction (PCR) or Ag

  • Directly detects the virus and should be prioritized for diagnosis and monitoring
  • Prioritize for case management to enable decentralized testing – particularly where PCR testing is limited.

Immune response tests or Ab

  • Tests detecting viral immune response tests can be complementary for clinical care
  • Should be prioritized for seroprevalence and epidemiological purposes
  • Prioritize Ab RDTs for seroprevalence surveys to inform public health measures and testing of contacts to establish previous viral spread.

The value of any test is dependent on factors such as the test performance, or sensitivity/specificity, as well as the epidemiological context, or prevalence in the population where it is used, and timing.

The report also lists unique features of SARS-COV-2 to consider when using RDTs and specifies operational characteristics, such as how to interpret test results. 


Read the report here

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US$7 million investment accelerates availability COVID-19 self-tests in low- and middle-income countries

Key takeaway: Successful applicants to manufacture 240 million low-priced tests a month.

On March 31 2021, FIND launched a request for proposals (RFP) to develop, manufacture, and launch to market COVID-19 self-tests in low- and middle-income countries (LMIC). 

The RFP called for quality-assured and easy-to-use self-tests that were accurate and affordable. It was prepared in the context of the Access to COVID-19 Tools (ACT) Accelerator Diagnostics Pillar, co-convened by FIND and the Global Fund.

Innovators, developers and manufacturers of in vitro diagnostics, and LMIC-based diagnostic stakeholders, were invited to submit proposals.

A package of US$7 million was offered in support, funded via grants to FIND from the German Federal Ministry of Education and through KfW and other donors.

International expertiseFrom 80 applicants, contracts were signed with four companies, and their names announced in February 2022:

Each has committed to manufacturing up to 60 million tests per month, priced from US$1–2 per test.FIND will conduct independent clinical evaluations of test performance, with support dependent on meeting project milestones.