Global health organization Unitaid last week called for a "concerted global effort" to introduce accurate and affordable diagnostic tests in low-resource countries to address the rising number of gonorrhea infections and antimicrobial resistance (AMR).

In a report released ahead of the United Nations High-Level Meeting on AMR, Unitaid highlights the diagnostic access gaps that results in both undertreatment and overtreatment of gonorrhea infections in low- and middle-income countries (LMICs) with a high burden of gonorrhea. Because of the lack of affordable, rapid point-of-care (POC) diagnostic tests in these settings, treatment decisions are based on observed signs and reported symptoms. Yet more than half of gonorrhea cases are asymptomatic, resulting in a high number of untreated, missed infections. Conversely, lack of gonorrhea-specific diagnostics means patients with symptoms often receive several treatments.

Tests are in development, but may remain inaccessible

The report provides an overview of the 75 POC and near-POC tests currently in development that have the potential to turn test results around in less than 30 minutes and improve antibiotic selection, including three that have already been cleared by the US Food and Drug Administration. It also lays out the barriers in LMICs that are preventing these tests from reaching those who need them, such as affordability, limited resources and healthcare infrastructure, and prioritization of higher mortality diseases by policymakers.

"Despite the need and the promise of new technologies, significant market challenges impede test accessibility in LMICs," the report states. "There is a high risk that products will become readily available in well-resourced settings and remain largely inaccessible in LMICs."

To address these barriers, the report highlights opportunities for intervention, including market-shaping strategies, product development support, and integrating gonorrhea and other sexually transmitted infection testing into reproductive, maternal, and HIV healthcare services. 

“Early work to implement testing will provide valuable evidence and experience to build demand and guide countries on feasible and cost-effective ways to introduce gonorrhea testing and improve health outcomes, particularly for vulnerable populations," Kelsey Barrett, Unitaid’s Technical Manager for Maternal and Child Health, said in a press release.

The US Department of Health and Human Services (HHS) last week announced funding for a project that will use artificial intelligence (AI) to accelerate the discovery and development of new antibiotics.

To speed up the lengthy and laborious process of screening and testing molecular compounds for antibacterial activity, the Transforming Antibiotic R&D with Generative AI to stop Emerging Threats (TARGET) project will use generative AI to broaden the pool of candidate molecules for screening and deep learning to assess each candidate's effectiveness as an antibiotic. The aim of the project, which is being funded through the Advanced Research Projects Agency for Health (ARPA-H), is to identify 15 promising leads for new antibiotics.

"The rise of antibiotic resistance threatens to turn once-treatable infections into life-threatening ones, but with AI, we can accelerate the discovery of new antibiotics to address this threat like never before," ARPA-H Director Renee Wegrzyn, PhD, said in a press release. "With TARGET, ARPA-H is bringing together experts across antibiotic discovery, AI, and clinical testing to ensure we can refill the global pipeline of antibiotics and stop people from becoming seriously ill due to treatable infections."

The project will be led by Phare Bio, in collaboration with the Collins Lab at the Massachusetts Institute of Technology and Harvard University's Wyss Institute, with a budget of up to $27 million.

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