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A £10m voyage of discovery

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Health Tech World finds out more about the Longitude Prize – a race lasting six years and counting to create a rapid diagnostic test that reduces unnecessary use of antibiotics.

In 2012, David Cameron announced a scientific endeavour drawing on the spirit of an 18th century project that sought to develop a way to pinpoint the location of a ship based on its longitude.

This 21st century version of the Longitude Prize seeks to solve a different challenge…

The World Health Organisation estimates that antibiotics add an average 20 years to all our lives. But in the 80 years since the discovery of penicillin, our overuse of such medicines has caused bacteria to resist, leading to the emergence of untreatable superbugs. The WHO believes that, by 2050, this resistance could result in over 10 million worldwide deaths.

One reason for this overuse is that clinicians often prescribe broad spectrum antibiotics while waiting for a diagnosis, because of the pressure to act quickly on imperfect information.

The £10 million Longitude Prize fund, which offers an £8 million payout to the winner, aims to solve this life-or-death problem, by creating a rapid diagnostic test, meaning antibiotics will be prescribed only when appropriate. The importance of a rapid turnaround has also been highlighted by this year’s Covid outbreak, where the spread of the virus was aided in large part by the number of asymptomatic cases.

The ever-present threat of a global pandemic, such as we have seen in 2020, will have been at the forefront of the scientific community’s mind in 2014 – the year of the Ebola outbreak – when 250 teams embarked on their Longitude Prize journey.

The competition has since narrowed, with only 54 teams remaining. Judges review submissions every three months and, so far, only one team has come close to winning by achieving five out of the seven mandatory requirements.

These requirements include accuracy and affordability, as well as meeting the rapid time frame of 30 minutes from sample collection to results.

Daniel Berman, director of the Longitude Prize, told us: “To win the top prize you need to come up with a test that is rapid, safe to use and sensitive. There are different ways that you can win the prize, as long as you fulfil these criteria.

“So, some of the tests are viral versus bacterial tests. Quite a few are urinary tract infection tests, with others look for are blood stream infection and prediction of sepsis. The last category is tests that identify pathogens and look at susceptibility.

“The holy grail in this area is a quick test that would tell the doctor and the nurse what the pathogen is and which antibiotics are susceptible to it.”

Further to the race for a rapid diagnostic tool, Daniel also has a vision for what he terms ‘pharmerging’, a rethinking of the responsibilities of medtech companies and multinational generic makers.

He advocates that self-paying middle-income countries and low-income countries (supported by donor subsidies) consolidate demand for new antibiotics and related diagnostics, offering a global response to the worldwide crisis that is antimicrobial resistance (AMR).

Daniel added: “Without an innovative pooling mechanism, new products in the pipeline will not reach those that need them most. It will also be impossible to respect stewardship principles, that is, only using new antibiotics when there is no older drug that would be effective.

“The Covid-19 response has created space for new approaches to be taken to solve old problems.

“Now is the time to try something different to fix the broken market, which is limiting a global response to the AMR crisis.”

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