Portable Molecular Tests Bring Lab-Grade Accuracy to Remote Areas
The closing panel of the Diagnostics Day. From left to right: Dr Sanjay Sarin
Access division Vice-President, FIND, Dr Fatim Cham-Jallow Technical Advice and Partnerships Department at The Global Fund, Renuka Gadde, Senior Advisor of the Clinton Health Access Initiative, Dr Daniel Townsend, Global Fund Advocates Network and Jan Willem Scheijgrond of the Global Diagnostic Imaging Healthcare IT and Radiation Therapy Trade Association

A new generation of portable molecular testing devices unveiled by the global non-profit FIND on Thursday has achieved accuracy levels previously only attainable in lab testing, a potential game-changer for healthcare in regions with limited access to clinics. 

These compact devices can test for multiple diseases using cartridges that analyze tissue, blood, or other bodily fluid samples to detect the presence of molecules characteristic of a particular illness. The devices can perform tests like the polymerase chain reaction (PCR) test, used for diagnosing COVID-19, influenza, HIV, and Ebola. 

“With these innovations, it’s not necessarily the patients that need to go to the clinic,” said Sara Fröjdö, Senior Technology Officer at FIND. “It’s testing that goes to the patients.”

With shortened development times that cut PCR test times from 60-90 minutes to just 15-30 minutes, patients could receive their results during the same consultation, Fröjdö added.

”All of that is made possible, and still with maintained performance, Fröjdö said. “You can really diagnose the patients where they are, not just screen to then send them to a hospital,” 

While these innovations offer convenience for healthcare systems with a dense network of local facilities, they have the potential to revolutionize access to lab-quality testing in rural regions. In 2020, nearly 9% of the global population lived more than an hour away from their closest healthcare centre by motorized transport, according to Nature Medicine. When considering on-foot travel time, this number skyrockets to 3.16 billion, or 43.3% of the world’s population.

Distance to the nearest healthcare facility with access to a motorised vehicle. Gaps in accessible healthcare clearly visible in many remote areas.

However, the technology still faces hurdles to being truly accessible. Commute time is only one of the many barriers to healthcare access, with others including difficulties in securing transportation and lengthy waiting periods before seeing a doctor.

Affordability remains a key challenge. Test cartridges cost approximately €100, with an additional €5-6 per test. FIND scientists say they are carefully designing cartridges to balance affordability, reliability, and ease of use in remote areas.

Manufacturers  must also address cold chain limitations, which hindered low- and middle-income countries’ access to mRNA vaccines favored by wealthy nations.

“[You need] to ensure you don’t end up having a small device that can be really useful in an outreach setting but you need to store it in -20°C,” Ms. Fröjdö said.

Shortened development times also contribute to the cost-effectiveness of this new technology, as the cost per patient decreases when a large number of tests are conducted.

“The product becomes n-times more efficient,” said Jan Willem Scheijgrond from the Global Diagnostic Imaging Healthcare IT and Radiation Therapy Trade Association. “The cost per patient drops suddenly by 90%.”

While the upgraded cartridges are being used in several countries, including the United States, India, and China, manufacturers are looking to extend their reach to serve a larger number of patients and a larger market.

“It’s difficult to put ‘a small lab’ inside, but also be mindful of keeping the price affordable in low- and middle-income countries,” Fröjdö said.

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