In the second of our AMR guest blog double bill, this piece courtesy of the Longitude Prize, written by Professor Dame Sally Davies, discusses the Prize at its one year anniversary, the ongoing battle against AMR,and the important role that diagnostic testing can play in the fight.
Announcing the results of our last submissions as we celebrate our first anniversary
On the 30th September the second application deadline for the £10m Longitude Prize closed, and we were delighted to see new and interesting entries.
The new Longitude Prize, launched a year ago, celebrates the original Longitude Act of 1714 that used an incentive of £20,000 to entice new innovators to solve a big global problem: determining a ship’s position at sea. I am personally delighted that the UK public voted in their thousands last year for antibiotics to be the topic of this new Prize, following the BBC Horizon’s 50th anniversary episode. More specifically the public want us to solve the problem of drug resistant infections (often called AMR) that render our antibiotics less useful, and less able to prolong and, even save our lives. When I was first working as a doctor we had a plethora of available and effective antibiotics, but we know now that bugs are developing more and more resistance to them, and that the medicine cabinet is getting more and more empty.
The challenge - with a £10million prize fund - opened a year ago and we have been working hard to challenge inventors and innovators from across the UK, and around the world, to put their minds to solving it. We are now one year in, with four years left to go. The challenge remains tough but it is crucial for our health that it is met. To win, teams need to develop a transformative, accurate, affordable, rapid diagnostic test that can be used anywhere in the world. It needs to help doctors, pharmacists, dentists, patients and even vets use the right antibiotics at the right time.
At the moment at least 25,000 people die each year in Europe because of drug-resistant infections, and there is a risk that this could affect more every-day interventions and conditions such as surgery including caesarean sections, knee replacements and cancer treatment. We need a solution now. Since last year the UK has led the way in this area - inclusion of antimicrobial resistance in the UK’s risk register, launching the £195m Fleming Fund to help us improve laboratory capacity and surveillance across the world. The Review on Antimicrobial Resistance launched by the Prime Minister, chaired by economist and Government Minister Lord Jim O’Neill, estimates that drug-resistant infections could kill an additional 10 million people per year, and in its most recent report called for new rapid diagnostics to stop unnecessary use of antibiotics and tackle superbugs.
In September, four new teams from the UK, the US and Sweden put forward their ideas for a test that could win. As a member of the Committee and also co-Chair of the Prize Advisory Panel, who judge the entries, I was delighted to see these new teams take up the mantel with new approaches. Their diagnostics took us into new areas of technology and were also focused on new types of infection. This is welcome, as we actively seek out novel approaches. After review by the Panel, it was decided that none were ready to move to the next stage of assessment. Having said that, at least half of these entrants have said they will continue to work on their ideas and will submit an entry at a future submission deadline.
These four entries come from a total of 114 registered teams from 26 countries, currently working on their ideas. With so much talent working on this difficult problem I am looking forward to seeing entries getting closer and closer to where we need them to be. The challenge was set to be solved within five years, reflecting the fact that meeting all of the criteria in a novel way will take time for organisations of all types and sizes.
It is important to remember why we are asking people, those working in this area, and also those approaching it with a new perspective, to do this. A test that can tell us, with accuracy, in less than 30 minutes whether we have a bacterial, rather than viral, infection is in itself extremely useful. Having that certainty would help us to better look after existing antibiotics, only using them when we really need them – because antibiotics are not effective against viral infections such as the common cold. It would also help us to take better care of new antibiotics once they are discovered. This year we repeated our survey of the awareness and behaviour of the UK public with respect to antibiotics. Almost 90% of respondents told us that a test to determine whether antibiotics are needed or not, would influence their decision to encourage their doctor whether or not to prescribe them. A winning diagnostic is so important for communities all over the world.
To win the Longitude Prize teams must develop a test that enables us to confidently make targeted antibiotic treatment decisions, reducing misuse and overuse. The test must also be accessible to everyone who needs it, across the whole spectrum of health settings. The onus is on the teams to demonstrate how it could be affordable, in hospital settings, for healthworkers, and also in some pharmacies where antibiotics can be bought over the counter. The time to result is also crucially important. One of the only objective areas of criteria is that the test must deliver a result within 30 minutes of the sample being taken, a fine balance if we consider the average time it takes to receive results in hospitals, against the time we may be willing to wait to buy antibiotics from a chemist or pharmacy. Finally the team must demonstrate to the expert panel that the use of the test would impact decisions about whether to patients are treated with antibiotics. The infection being targeted by the test must be one that is commonly treated with antibiotics.
These are some of the areas where the entries need further work.
Once again the entries were varied, and we were pleased to see some new areas of technology being applied, and some new areas of infections being targeted, such as urinary tract infections. Again we have a mix of organisations, from industry and academia, and large and small teams. Not all of the teams have working prototypes, and some are in the process of working on some of the areas we’re most concerned about, such as price and breadth of application.
Again we see some great early applications and it is very feasible that the majority of these teams will apply again, meeting more of the criteria, or with more robust evidence to support their accuracy claims. We certainly think this is the case, adding to a number from the first round who will also do this.
We expected to see only a handful of entries at these early submission deadlines in the first year of the Prize. We hope that these teams, brave enough to put their heads above the parapet so early on, will take on board such early feedback on their approach and provide some great competition to the many teams we know are still working on their submissions.
Our job remains to encourage innovators and teams from all disciplines to come forward. For this to be effective we need to do more to support them, to find new collaborators, to embrace cross discipline working, and to tap into other support they may need to get to the stage of having a prototype.
The teams that entered in September have had feedback and we hope they will incorporate this and re-apply at a future submission date, the next one is 31st January.
Please get your innovative juices working!