Featured Work - Awareness & Advocacy

Understanding barriers to diagnostics access in Madagascar

Communities in Madagascar face numerous barriers in accessing diagnostics services. In this rapid assessment, led by Matahari Global Solutions, in partnership with the community-based organisation Ankizy Gasy, and supported by FIND, 43 individuals living in rural and semi-rural communities in Madagascar were interviewed to understand availability of diagnostics, and to understand barriers to accessing diagnostics.

This rapid assessment found a complex diagnostics environment marked by high out-of-pocket spending for diagnostics relative to income, relatively long distances to get to primary healthcare centres, doctors prescribing antibiotics with incomplete diagnostics regimens or no diagnostics at all, poor clinical practices on diagnostics (such as use of inaccurate terminology), and insufficient data about stockouts. Because rapid malaria tests are provided for free, doctors offer these more regularly, but upon a negative result are unable to recommend additional tests because of the cost barrier. The assessment also found that rural communities overwhelmingly wanted more accessible and affordable testing – and perceived that people they knew were dying from ‘unknown diseases’.

To learn more about the results of the assessment, and recommendations to address the barriers revealed, click below.

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RFP: Community-Based Applications of SARS-CoV-2 Antigen Rapid Diagnostic Tests (Ag RDTs) for Timely and Effective Public Health Response

Testing for SARS-CoV-2 infection is essential for the control of COVID-19, enabling epidemiological surveillance and implementation of public health measures. At the community level, swift identification and isolation of new cases, combined with contact tracing, are important tools for controlling virus transmission.

In December 2021, FIND’s Global Health Security (GHS) Operational Research (OR) team commissioned 17 community-based SARS-CoV-2 testing approaches in low-and middle-income countries (LMICs). The selection process was highly competitive as it became widely recognized among public health specialists that a health center-based approach was insufficient with regards to reducing SARS-CoV-2 transmission within communities. The proposals selected all demonstrated a clear community-based strategy for using SARS-CoV-2 antigen diagnostic tests for a timely and effective public health response.

The studies commissioned took place in 13 countries: Uganda, Malawi, Zimbabwe, Jamaica, Cameroon, Zambia, Kenya, Thailand, Suriname, Mozambique, South Africa, Mali, and Tanzania. More information on the outcomes of these research studies will be available in 2023. 

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RFP: Innovations in COVID-19 Antigen RDT Rollout in Underserved Populations

Searching for innovative ways to implement screening programmes for SARS-CoV-2 in underserved communities,  the ACT-Accelerator, FIND and IRD Global issued this request for proposals in May 2021.

The focus of the programmes was low- and middle-income countries. Globally stark inequities exist, with these countries not having adequate access to diagnostics during the COVID-19 pandemic.

The Access to COVID-19 Tools (ACT) Accelerator is a global collaboration focused on accelerating the development, production, and equitable access to COVID-19 tests, treatments, and vaccines. 

FIND is a global non-profit organization focusing on diagnostics for major diseases, and IRD Global is a global health delivery and research organization.

The project was projected to involve customizing training materials, conducting training and proficiency assessment of trainees, and implementing and monitoring testing programmes within local policies and guidelines. 

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WHO Public Health Labs Webinar – Accelerating community access to SARS-CoV-2 testing

In this webinar, co-hosted by WHO and FIND, speakers discussed efforts undertaken through the Access to COVID-19 Tools (ACT)-Accelerator to enable countries to improve their community-based testing for SARS-CoV-2 through the development of testing protocols and training of health-care workers, with experience sharing from Somalia and Zimbabwe.

Participants also discussed the newly published interim guidance on Use of SARS-CoV-2 antigen-detection rapid diagnostic tests for COVID-19 self-testing.

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Update on global access to testing survey

This webinar, delivered in February 2022 by FIND via the ACT-A CSO Platform, captures data on perceptions on access to COVID-19. The webinar covers approach and methodologies for the survey as well as preliminary findings. 

The survey recorded over 12,000 responses in 10 countries: Brazil, India, Egypt, Indonesia, Kenya, Peru, South Africa, Tunisia, Uganda, and Viet Nam. Over 50% of respondents reported difficulty in accessing a test when needed, with key contribung factors being lack of testing facilities, prohibitive costs, and the difficulty traveling to testing facilities.

Resource Centre - Media & Press

Democratizing Access to Testing

FIND, alongside the Global Fund, was named co-convener of the diagnostics pillar of the Access to COVID-19 Tools Accelerator (ACT-Accelerator) in 2020.

Traditional models of diagnostic testing are often characterized by a centralized approach, particularly true in low- and middle-income countries (LMICs). However, there are several common barriers to centralized testing.

FIND is part of the process to remedy this, and this includes how the ACT-Accelerator has, since inception, worked to transform access to decentralized testing.

This FIND case study explores the process and partnerships that have driven progress across four stages:

  1. Accelerating innovation in research and development
  2. Ensuring efficient and sustainable test supplies
  3. Supporting robust national policy development
  4. Mobilizing community-based and self-testing strategies.

The study also highlights learning, impact and recommendations from a decentralized approach in response to the COVID-19 pandemic.

Read the case study here

Resource Centre - Media & Press

Redesigning systems to focus on people, not pathogens: A conversation with Dr Fifa Rahman and Dr Bill Rodriguez

Focus on the humans, not the virus: Better diagnostics are crucial for more robust, pandemic-proof primary healthcare

In this podcast, Dr. Bill Rodriguez and Dr. Fifa Rahman discuss why it is vital to improve access to Covid-19 diagnostics and strengthen primary healthcare systems to make humans, rather than the SARS-COV-2 virus, the focus of the global pandemic response. 

Creating human-centered health systems

“It has been about the virus and not about the people for a very long time,” Rodriguez said.

Rodriquez and Rahman both highlight that globally there must be a shift in focus from the SARS-COV-2 virus to the humans affected by it. 

They agree that the focus must be on strengthening primary healthcare systems and designing diagnostics and digital tools to enable the treatment of people with respiratory symptoms at a community level. 

Fighting paternalism

Rahman emphasized that this would mean fighting paternalism at a global level. She used the example that global health decision-makers raised concerns if people in lower-income countries could read the results of self-tests for Covid-19 and act on it, even though self-tests for HIV and pregnancy have been around for a long time.

Communities must become the focus

Rodriques said decision-makers, primarily male and European, needed more input on what was happening at a community level.

He said a clear example of this was that it took global health organizations two years to finalize a policy recommendation on self-testing. One of the concerns raised was that it would not be possible to collect data on the virus if people self-test. 

At the same time, Rahman pointed out; there was a genuine risk of Covid-19 spreading in a community while people had to wait for days to access test results done at a laboratory.

“We would be negligent if we do not take this opportunity to redesign the system,” Rodriquez said.

He stressed that strengthening public healthcare systems should be a priority in preparing for the next pandemic.

Dr. Bill Rodriguez is the CEO of FIND, the global alliance for diagnostics. Dr. Fifa Rahman is the Principal Consultant at Matahari Global Solutions and a Permanent NGO Representative at the WHO Access to COVID-19 Tools Accelerator.

Add Resources - Research & Development Featured Work - Manufacturing Featured Work - Research & Development

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.