1. Improving Access To Diagnostics in the Developing World Rosanna Peeling Professor and Chair, Diagnostics Research London School of Hygiene & Tropical Medicine

2. Improving Access To Diagnostics in the Developing World Global landscape of diagnostics Improving access to diagnostic innovation Fast-tracking the translation of evidence to policy

4. Diagnostics are Under-valued In the US, while diagnostics comprise - less than 5% of hospital costs - about 1.6% of all Medicare costs, their findings influence as much as 60-70% of health care decision-making The Value of Diagnostics, Lewin Report, 2005

7. How Good are Dengue Rapid Tests? WHO Evaluation (%) SensSpec 23 99 18 98 63 69 9 100 65 98 22 99 6 99 Test Claimed Accuracy (%) Sens Spec Test 1 100 100 Test 2 NS NS Test 3 80 >99 Test 4 NS NS Test 5 70 100 Test 6 93 100 Test 7 100 100 NS = not stated Blacksell et al. Clin Infect Dis 2006;42:1127

8. Product Development and Adoption Pathway for Diagnostics Regulatory Approval Diagnostic Targets Proof of Principle Product Prototype Lab & field evaluations Test adoption Policy & Guidelines Product Specifications Technology platform Shared Resources Shared Risks Shared Rewards

9. Lab on a Chip Platform: Integrated specimen processing, amplification, and detection of MTB and Rif resistance in sputum In < 2 hrs In 1,730 patients with suspected drug-sensitive or multi drug-resistant pulmonary TB at centers in Peru, Azerbaijan, South Africa, and India, Xpert detected 98% of smear +, 90% of smear – ; 98% of RIF resist. and 98% of RIF sens. TB. Boehme et al NJEM Sept 6 2010

11. 9.27 million new cases in 2007

12. 1.9 million deaths a year

14. Fast-tracking the translation of evidence to policy