This is Mark Perkins.
I am the Chief Scientific
Officer of FIND, the Foundation
for Innovative New Diagnostics
here in Geneva, Switzerland.
Today we're going to be talking
about the development, testing,
and introduction of a new
diagnostic tools for tuberculosis,
an area in which there has been
considerable change in the last few years.
Over the past two decades there have been
remarkable improvements and changes
in biotechnology, specifically in
diagnostic testing; everything
from whole genome
to handheld quantitative assays.
However, none of these changes
have led to diagnostic solutions
for communicable diseases for people
living in impoverished conditions.
Diseases linked to poverty
are still, basically,
insufficiently equipped, in too many settings.
A good example of this is
tuberculosis, a disease, which
for many years has relied on the same
fundamental diagnostic test -
Here is a picture of, in fact,
the microscope of Robert Koch.
And that microscope he used in 1882
to define TB in the first place
would look very much at home in a
modern laboratory in many countries
in the world.
This view through a
at a Ziehl-Neelsen stain
preparation is similar to what Koch
may have seen more
than 100 years ago.
The trouble with microscopy not
only is it relatively awkward,
burdensome to do and requires
a substantial training,
but it gives no
information about drug
susceptibility results or about the
species of the bacteria you see.
The result of this relative
poverty of the diagnostic test
is long delays in the
process of diagnosis itself.
Here's a picture at a routine
clinic, a diagnostic clinic,
in India where patients would
see to wait for the diagnosis
of the cause of their
True diagnostic delays often
runs to the three to nine months
period, resulting, of course,
in the ongoing transmission,
ongoing disease accrual.
What you see the
top of the slide are
numbers from the global
epidemiology of tuberculosis showing
in blue the relatively
large number of detected
and notified smear
positives-- 1.9 million--
and smear negative cases--
2.2 million-- and even larger
number of undetected or unreported
cases that don't get to the WHO.
Some of those are
detected and non-reported.
Some are non-detected.
And this adds to the large
number of TB mortality cases.
On the right, is the amount of
spending that we see not only
by patients and direct costs, but
by governments and loss of revenue
from tuberculosis and, specifically,
from the delayed diagnosis.