@uchi-msa.bsky.social
UChicago's Market Shaping Accelerator aims to catalyze market shaping tools to accelerate innovation to solve the world’s most pressing challenges. https://marketshaping.uchicago.edu/
CARB-X Executive Director @koutterson.bsky.social joined a working group convened by @cgdev.org and @uchi-msa.bsky.social that aims to develop an advance market commitment for a rapid diagnostic test for neonatal sepsis in LMICs. 🧪 #IDSky
🔗 Read here: bit.ly/44ku4xJ
More in our blog post series with @cgdev.org:
🔗 www.cgdev.org/blog/why-exp...
@siddhharia.bsky.social
Done right, we believe this AMC can help bring a game-changing diagnostic to market that tackles neonatal sepsis and antibiotic resistance at once.
If you’re interested in shaping this work—whether as a funder, policymaker, developer, or implementer—we’d love to hear from you.
The working group’s efforts will also create valuable public goods.
Clear TPPs and evidence requirements, market assessments, and health economic modeling can aid broader diagnostics efforts.
It can also inform how to de-risk other valuable global health innovations.
🤝 Mobilizing funding
An AMC is only as strong as the coalition behind it.
We’re generating evidence on cost-effectiveness and AMR impact to show countries, donors, and implementers why this is a high-value, neglected opportunity worth investing in.
🌍 Country engagement
The AMC would provide a demand signal, but clear regulatory pathways and procurement plans from LMICs are needed to make such signals credible.
As such, we’re mapping what’s needed to get diagnostics widely implemented across different health systems.
🔧AMC design means answering questions such as:
- What kind of test should we target?
- How will we validate its quality and use?
- What should we pay, and how should payments be structured?
These questions are deeply technical and interdependent, and thus require interdisciplinary expertise.
We’re convening global health leaders, industrial organization economists, diagnostics experts, and policymakers—chaired by Lord Jim O’Neill—to tackle three tasks:
🔧 AMC design
🌍 Country engagement
🤝 Mobilizing funding
In our earlier posts, we outlined the scale of the problem and why market failures have stalled innovation.
In this one, we turn to how we’re planning to fix it: by launching a working group to design an effective AMC that can deliver results.
An Advance Market Commitment (AMC) for neonatal sepsis diagnostics could save newborn lives and curb antibiotic resistance.
But how should such an AMC actually work? And how will we get it off the ground? 🧵
📖 Read our post to learn more:
🔗 www.cgdev.org/blog/when-ma...
@siddhharia.bsky.social
We're developing the “NeoTest” AMC under a @cgdev.org -led working group. We're defining TPPs, modeling cost-effectiveness and market potential, and laying the foundations for future procurement.
26.06.2025 21:01 — 👍 1 🔁 0 💬 1 📌 0Our AMC proposal specifically targets the market failures we’ve outlined:
✅ Rewards early movers
✅ Pricing commitment dissolves the hold-up problem
✅ Increased payments partially compensate for the social value of reduced AMR
An AMC brings several advantages:
🔬 Tech-agnostic—welcoming biomarkers, metagenomics, machine learning, and more
📋 Tied to real-world needs via a target product profile (TPP)
🌍 Linked to affordability to ensure access where it’s needed most
To overcome these challenges, we propose an advance market commitment (AMC): a pull mechanism in which funders commit upfront to pay for products that meet real-world criteria.
For neonatal sepsis, this could mean top-up payments per qualifying test or guaranteed purchase volumes at a fixed price.
3️⃣ AMR spillovers:
Only ~18% of neonates treated for sepsis in LMICs have a confirmed infection. The rest still receive antibiotics, fueling resistance.
Better diagnostics could change that. But health systems underinvest because AMR reductions help others, not just the payer.
2️⃣ Pricing constraints:
Neonatal sepsis predominantly affects low-resource countries. Here, limited health budgets and concentrated purchasing power often drive prices down to marginal cost, making it hard to recoup R&D investment.
This is a classic case of a hold-up problem.
1️⃣ First-mover disadvantage:
Pioneering a new sepsis diagnostic involves high R&D costs, navigating uncertain regulation, and building demand from scratch.
But weak IP protections and industry-wide spillovers allow later entrants to compete away profits, undermining the incentive to invest.
Despite clear need and promising scientific leads, no rapid, point-of-care neonatal sepsis test has reached the market. Why?
Three overlapping market failures disincentivize investment. 👇
In our last post, we explained why rapid diagnostics for neonatal sepsis are a high-value innovation target: they can catch infections early and reduce unnecessary antibiotic use.
📖 www.cgdev.org/blog/case-pr...
A rapid diagnostic for neonatal sepsis could save newborn lives and reduce antibiotic resistance - but no such test exists yet. What’s blocking progress? 🧵
26.06.2025 21:01 — 👍 1 🔁 0 💬 1 📌 0
📖 Learn more in our blog post—the first in a new series on how an AMC could unlock progress on this critical front:
www.cgdev.org/blog/case-pr...
@siddhharia.bsky.social @rrolapp.bsky.social @cgdev.org
Neonatal sepsis diagnostics are a promising solution to prevent newborn deaths and reduce the incidence of antimicrobial resistance.
Our working group with @CGDev is building the incentives to bring them to market.
Nonetheless, diagnostics remain underfunded. Just 8% of AMR R&D funding goes to diagnostics.
And yet, promising solutions are advancing—biomarkers, molecular tests, metagenomics, and AI-based tools are already in development.
Sensitive, specific rapid diagnostics would save lives by catching infections early and reducing antibiotic overuse.
They’re a recognized global priority: the WHO has outlined needs for neonatal sepsis diagnostics, and frontline providers in LMICs have emphasized their importance.
Already, over 30% of neonatal sepsis deaths are attributable to first-line antibiotic-resistant infections.
Antimicrobial resistance (AMR) more broadly is linked to nearly five million deaths globally each year. The need for better tools to guide antibiotic use is urgent.
As a result, clinicians must act based on ambiguous symptoms.
This leads to preventable deaths from missed diagnoses and unnecessary antibiotic use that drives antimicrobial resistance (AMR).
Neonatal sepsis kills 400-700k newborns every year.
It’s treatable with antibiotics—if diagnosed in time. But current tests take 48–72 hours, too long to guide life-saving initial treatment decisions.
In collaboration with @CGDev, we’re establishing a working group to design an Advance Market Commitment (AMC) for a rapid diagnostic for neonatal sepsis—a devastating and neglected cause of child mortality.
Here’s why this is our focus. 🧵👇
Developing a rapid diagnostic could save thousands of newborn lives and slow AMR.
Read the full series to learn more: www.cgdev.org/blog/case-pr...
@siddhharia.bsky.social @cgdev.org @rrolapp.bsky.social
