Neonatal sepsis, a bloodstream infection in babies in the first 90 days of life, affects 1.3 to 3.9 million newborns annually and causes 400,000 to 700,000 deaths per year, primarily in low- and middle-income countries (LMICs). While treatable with antibiotics if identified early, current diagnostic methods—which take 48 to 72 hours—cannot guide crucial and life-saving initial treatment decisions. This leads to both preventable deaths from missed diagnoses and unnecessary antibiotic use that drives antimicrobial resistance (AMR). Despite the likely technical feasibility of developing rapid diagnostics, firms may be reluctant to invest in breakthrough innovations given the risk that potential profits may be eroded by competition from copycat rivals and pressures to keep prices low once a test is developed, especially in LMICs where the need is greatest.
CGD, in partnership with the Market Shaping Accelerator (MSA), is launching a working group to develop an advance market commitment (AMC) for rapid diagnostic tests for neonatal sepsis in LMICs—we call it, “NeoTest.” An AMC would involve funders committing in advance to make top-up payments when healthcare providers procure and use qualifying diagnostic tests, providing sufficient market returns to incentivize private companies to develop these essential tools. The working group will bring together experts in health, economics, policy, and industry to design market incentives that accelerate both innovation and adoption of point-of-care diagnostics. This design builds on CGD's successful track record with AMCs, including the $1.5 billion pneumococcal vaccine AMC.
The working group will develop a detailed, implementable proposal for NeoTest's design and structure, build partnerships with healthcare providers in LMICs to ensure the program meets their needs, and work to secure commitments from funders to establish the AMC fund. The goal is to launch NeoTest by the end of 2026, creating a sustainable market for affordable diagnostics that can significantly reduce preventable newborn deaths and also reduce the burden of AMR.
“NeoTest” was a winner of the University of Chicago’s year-long Market Shaping Accelerator’s (MSA) Innovation Challenge, and it was pitched at the CGD and MSA’s Accelerating Innovation event. For more details, please see our memo here.
Working group members
- Chair- Lord Jim O’Neill
- Chris Avery, Professor of Public Policy, Harvard Medical School
- Edwine Barasa, Director, KEMRI-Wellcome Trust Research Programme, Nairobi
- Rachel Bonnifield, Senior Fellow and Director of Global Health Policy, Center for Global Development
- James Cross, Assistant Professor and head of NEST360 infection, London School of Hygiene and Tropical Medicine
- Chinyere Ezeaka, Professor of Paediatrics, University of Lagos
- Birgitta Gleeson, Senior AMR Scientist, FIND
- Gillian Leitch, Head of HIV, TB & AMR, MedAcces
- David McAdams, Professor of Economics, Duke University
- Mirfin Mpundu, Director, ReAct Africa
- Kevin Outterson, Executive Director, CARB-X; Professor of Law, Boston University
- David Ripin, Chief Science Officer, Clinton Health Access Initiative
- Chris Snyder, Joel Z. and Susan Hyatt Professor of Economics, Dartmouth College
- Neeraj Sood, Professor of Public Policy, University of Southern California
- Kamini Walia, Head of AMR, Senior Scientist, Indian Council of Medical Research
Secretariat members
- Technical Lead - Akhil Bansal, MD, Policy Fellow, Center for Global Development
- Economics Lead - Neeraj Sood, Professor of Public Policy, University of Southern California
- Arthur Baker, Chief of Staff, Development Innovation Lab
- Georgia Bradley, Research Professional, Market Shaping Accelerator
- Siddhartha Haria, Senior Policy Lead, Market Shaping Accelerator
- Anthony McDonnell, Policy Fellow, Center for Global Development
- Claire McMahon, Research Professional, Market Shaping Accelerator
- Rebecca Rolapp, Operations Associate, Market Shaping Accelerator
- Leah Rosenzweig, PhD, Senior Fellow, Center for Global Development