Program areas at FIND
COVID-19 EXPENDITURE USD 103,061,587 FIND's 2022 COVID-19 activities addressed access inequities as well as diagnostics research and development (R&D). FIND led major advances in regional diagnostics manufacturing and evaluated more than 50 COVID-19 tests. Investments led directly to manufacturing capacity based in low- and middle-income countries (LMICs) of 60 million COVID-19 rapid tests (RDTs) and self-tests per month, available to LMICs at US$1-2 per test. FIND's technology transfer programmes enabled Diatropix (Senegal) to manufacture high-quality COVID-19 RDTs and break ground on a new facility for low-cost, high-volume manufacturing for RDTs of regional importance. FIND supported Premier Medical Corporation (India) to expand production capacity to 10 million RDTs/month under global access terms. FIND enabled WAMA Diagnstica (Brazil) in the end-to-end manufacture of RDTs from raw materials. FIND's support enabled Wondfo Biotech (China) and Viatris (South Africa) to achieve WHO Emergency Use Listing (EUL) for their COVID-19 RDTs. Additionally, FIND's provision of independent trial data supported the WHO Emergency Use Listing (EUL) of six COVID-19 tests in 2022, and a seventh in 2023. FIND's assessment of COVID-19 Ag RDT performance included test accuracy and the ability to detect new variants. These studies have now encompassed 54 Ag RDTs, including professional use and self-tests. FIND monitored and mapped both testing and sequencing capacity for COVID-19, as well as tracking the impact of new variants of concern on test performance. FIND supported decentralized community-based testing for COVID-19 and test-and-treat strategies. FIND also generated data that helped in-country policy reviews on the use of Ag RDTs in settings beyond those recommended in the WHO guidelines, including pharmacy channels and non-traditional settings such as taxi ranks. FIND supported the procurement of 1,889,144 diagnostic tests and related consumables, of which 1,853,854 were COVID-19 Ag RDTs, while supporting the introduction of their use in 26 countries.
Access EXPENDITURE USD 6,560,663 FIND and the Indonesian Ministry of Health (MoH) signed a memorandum of understanding (MoU) to expand access to essential diagnostics across 18,000 primary health centres throughout Indonesia, while enhancing pandemic surveillance and advancing diagnostics manufacturing in Indonesia. FIND entered a collaboration with the African Society for Laboratory Medicine (ASLM) and jointly launched the diagnostic network optimization sub-community of practice (DNO subCoP), under the overarching laboratory systems strengthening community of practice (LabCoP) initiative. Out of a target of 15 countries, 12 countries have ongoing or completed analyses using OptiDx-network optimization software co-developed by FIND to support resource planning for national laboratory systems-for TB, TB/HIV, and associated molecular testing. The capacity building of country teams in the use of OptiDx continues in several countries, including Cote d'Ivoire, India, and Zambia. Two strategic DNO analyses are underway, in Kenya and Pakistan, which will likely inform key priorities, including planning for Global Fund support, and integrated disease testing. FIND also developed an online DNO course, aimed at strategic decision-makers, in which 393 participants from 30 countries participated. DNO analyses in countries have focused on identifying gaps in testing capacity and strategies needed to expand testing in hard-to-reach areas.
Tuberculosis (TB) and hepatitis (HCV) EXPENDITURE USD 10,283,492 FIND initiated its first-ever comprehensive involvement of patients in study design, through the Unitaid-funded DriveDx4TB project to seek patient perspectives on novel sample types for TB diagnostics. In the recent development of a WHO target product profile (TPP) for TB, FIND developed an impact model that indicates that new point-of-care (POC) tests for TB that provide results to the patient during the same clinical visit would require minimum sensitivities of 59-70% and 65-71% for non-sputum and sputum samples, respectively, depending on the country and standard of care, to achieve comparable or better case detection than the current standard of care. To maximize value for money of newly developed TB diagnostics, FIND introduced evidence-based target pricing into the forthcoming TPP for TB diagnostics. This work provides a novel framework to guide the future development of TPPs for diagnostics. FIND supported 10 TB products (7 IVDs and 3 digital tools) across various stages of diagnostic product life cycle including 4 IVDs and 1 digital tool in the development phases. FIND also supported 3 HCV tests in the development phases. FIND led the development of targeted next-generation sequencing (tNGS) for use in patients with TB, and the data obtained from this three-country study form the backbone of a new WHO evidence review and guidelines for TB management. FIND identified and demonstrated lot-to-lot variability of the FujiLAM TB rapid test as an unanticipated outcome of a large, seven-country evaluation of the test's accuracy, supporting the WHO decision to cancel a policy review; FIND supported FujiFilm in conducting a root cause analysis and planning a redesigned test. An existing digital global good, developed by MedicMobile, was enhanced to allow for bidirectional TB and COVID-19 screening and NCD screening.