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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.

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US$21-million investment in molecular diagnostic platforms

FIND chooses four firms with promising new platforms for decentralized diagnosis of COVID-19 and other illnesses.

FIND is investing US$21-million to speed the development, manufacturing and launch of affordable, multi-pathogen, molecular diagnostic platforms.

These platforms are specifically aimed at decentralized settings in low- and middle-income countries (LMICs), and will detect different respiratory pathogens, including COVID-19.  

FIND launched the request for proposals in August 2021, in the context of the Access to COVID-19 Tools (ACT) Accelerator diagnostics pillar, which it co-leads. 

The submission deadline was September and the successful firms announced on December 2021.

The four firms are:

The German Federal Ministry of Education and Research (BMBF) is funding the investments through KfW and other donors. 

Read the full report here

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Call to boost access to cheaper rapid diagnostic tests

Key takeaway: RDT agreements boost local manufacturing to supply millions of low-cost, high-quality tests for lower-income nations.

In July 2020 FIND and Unitaid launched a call via the Access to COVID-19 Tools Accelerator Diagnostics Pillar for expressions of interest (EOI) to speed up availability and scale up manufacturing of rapid diagnostic tests (RDTs) for COVID-19.

The EOI was geared towards increasing supply of regulatory approved, fit-for-purpose SARS-CoV-2 Ag RDTs that met WHO criteria of quality, cost and accessibility. This was particularly needed in low- and middle-income countries (LMICs).

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

Interventions included:

  • Accelerating late-stage product development and optimization
  • Facilitating technology transfer activities
  • Conducting performance evaluation studies to support regulatory submissions
  • Increasing production capacity
  • Addressing supply chain challenges
  • Strengthening local capacity for development and deployment of new tests within national testing strategies. 

Driving down prices and supporting the use of less invasive specimens to enable faster LMIC uptake were also critical. 

Over 100 applications were received, with 34 selected for review by a panel of external experts. 

A first collaboration, with Premier Medical Corporation in India, was announced in January 2021. By July that year, additional technology transfer agreements were signed with stakeholders in Africa and Latin America.

These included an agreement with DCN Dx to transfer know-how to WAMA Diagnóstica (Brazil), and with Bionote and Mologic to transfer know-how to DIATROPIX of the Institut Pasteur de Dakar (Senegal). 

There is a separate partnership between Viatris (South Africa) and Guangzhou Wondfo Biotech (China).

These agreements will lead to a dramatic increase in local manufacturing, ultimately making more than 250 million low-cost (US$2–2.50) tests available for LMICs. 

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Outline of WHO’s C-TAP platform

The COVID-19 Technology Access Pool (C-TAP) provides a platform for developers of COVID-19 therapeutics, diagnostics, vaccines and other health products to voluntarily share their intellectual property, knowledge, and data, with quality-assured manufacturers. 

It was launched in May 2020 by WHO, the Government of Costa Rica and other partners to facilitate faster equitable and affordable access to COVID-19 health products for all countries.

Currently endorsed by 45 WHO Member States, it is a response to the global Solidarity Call to Action. Its implementing partners include UNDP, the Medicines Patent Pool, the UN Technology Bank and Unitaid.

C-TAP provides a single global platform that includes public health-driven, transparent, voluntary, non-exclusive and transparent licences. 

Read more on C-TAP here