Neonatal sepsis, a bloodstream infection in babies in the first 90 days of life, affects 1.3–3.9 million newborns annually and causes 400,000–700,000 deaths per year, primarily in low- and middle-income countries. While treatable with antibiotics if identified early, current diagnostic methods—which take 48–72 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 low- and middle-income countries (LMICs) where the need is greatest.
CGD 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 our work on 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.
Associated organizations
While the working group membership is still being finalized, the following organizations have advised on the development of this project, all of which have given expressions of interest in supporting the working group as it moves forward:
Secretariat members
- Akhil Bansal, MD, incoming fellow, Center for Global Development
- Siddh Haria, senior policy lead, Market Shaping Accelerator
- Anthony McDonnell, 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