A fever pitch

Sep 1st, 2011 11:15 AM UTC
By ONE Partners

Melinda Moree from BIO Ventures for Global Health urges innovators and decision-makers to develop ways to take the guesswork out of diagnosing the sick in developing countries.

When I visit health centers in developing countries, too often I see diagnostic laboratories that are almost completely empty. Many times there is no equipment, bare counters, empty drawers, no electricity or running water. All told, this means there is no way to accurately diagnose the many sick people lined up around the clinic grounds seeking care.

Back at home in the US, the opposite occurs. When something doesn’t feel right I go to the doctor to get it checked out. Rarely my doctor may treat me “presumptively,” which means that she determines a course of action based solely on my reported symptoms. Most of the time, a test is ordered to help my doctor figure out what is going on. This is how it works in wealthy countries where 83 percent of treatment decisions involve a diagnostic test.

But in developing countries, an exceptionally perplexing problem is when a child under five comes to the clinic with a fever and other non-specific symptoms. Any number of microorganisms could cause that fever, and most of them require different types of treatment. It is critical for doctors to understand what is causing the fever so that the child can get the right treatment on the spot. But without the appropriate tests, doctors often have to rely on guesswork. Study after study has shown that the accuracy of treatments based solely on symptoms is very poor.

The result is that more than two million children under five die from causes of fever like bacterial pneumonia every year. Clearly, diagnostic tools that are accurate and can be used at the local, village level by health care workers with little training are desperately needed. Data suggests that timely and accurate diagnosis of bacterial infections could reduce child mortality by 15 to 20 percent. That’s 350,000 children’s lives saved each year.

Unfortunately, industry has focused little attention on these types of diagnostic tests because the return on investment is uncertain. Financial support from governments could help bring products to market. But despite the urgent need, governments are feeling pressure to scale back their investments in global health research and development in the face of financial challenges. So what can be done?

Prizes can offer a solution. They bring ambitious new thinking to old problems, and unlike grants and product development partnerships, prizes are results-driven — the funder only pays if competitors reach the end goal.

A significant proportion of innovation in the development of new medical tools for diseases, including neglected diseases, stems from the biotechnology industry. Biopharmaceutical companies have the expertise and proven track record to produce new drugs, vaccines and diagnostics for neglected diseases. These companies have been at the forefront of medical innovation.

However, because poor countries cannot pay a high price for this tool, industry is unlikely to invest resources into development without a meaningful incentive. That’s why my organization, BIO Ventures for Global Health, has proposed the pay-for-success Global Health Innovation Quotient Prize. The prize is designed to stimulate development of a tool that can diagnose the most common causes of fever in children under age five, and be used at the local level by health care workers with little training.

The lives of millions of children cannot depend on guesswork. Now is the time for policymakers to put frameworks in place that will support the development of an effective fever diagnostic for developing countries. Now is the time for the global health community to call for new tools and renewed efforts. Now is the time to create a fevered pitch for fever diagnostics.

TAGS: From Our Partners, Global Health, ONE App