Foresight Study on European Stakeholder Appraisal of Diagnostics to Manage Anti-Microbial Resistance

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It is well-documented that there is a desperate need for new antibiotics against established and emergent drug-resistant bacteria - the so called 'superbugs' - but we currently face a thin global pipeline of new agents in this area. Multiple factors drive the development and spread of antimicrobial resistance (AMR). A number of important on-going initiatives are underway to try to address this AMR challenge - but these are primarily focused on new antibiotics. There is a lack of an in-depth analysis in the peer-reviewed literature regarding diagnostics, even though development of bacterial infection diagnostics has been identified as a priority. For this reason, this proposal focuses on the development and use of diagnostics to address the AMR challenge. In theory, diagnostics have the potential to rapidly aid the management of antibiotic resistance as development times are shorter and so diagnostics can be brought into use more quickly in the battle against super bugs. Moreover, there is good evidence that the use of diagnostics can reduce unnecessary antibiotic use, but this has so far failed to translate into the development and use of appropriate technologies.This project provides a foresight study across seven EU nations to facilitate stakeholder appraisals of potential innovation pathways (covering development, validation, introduction and incentives) for a wide range of bacterial infection diagnostics - presented as scenarios that compete for public and/or private resourcing. The project's hypothesis is that some scenarios are attractive to a critical mass of stakeholders, while others will not be supported and are therefore unlikely to be viable in the short to medium term. The project's contribution will be to demonstrate clearly and transparently within and across stakeholder groups and countries, where there is consensus, divergence and uncertainties in relation to scenarios to support particular innovation pathways, as well as detailing the factors that underlie similarities, differences and uncertainties in appraisals. The project will be transformative for a range of stakeholders particularly, in the short term, research funders, researchers and small firms, who are often unable to undertake or access such analysis themselves. The project's impact aim is to drive higher resourcing and policy support towards particular viable pathways and therefore accelerate development of the needed diagnostics. In the short term this would occur through enhanced stakeholder co-ordination and by reducing missteps (investment in poorly supported approaches that do not meet stakeholder needs).SPRU and OHE are active in disseminating their research especially to policy and industry audiences, in addition to academia. Given the great policy and industry, as well as academic, interest in AMR solutions we plan to disseminate the outputs of this research very actively, via different means. The starting point will be the preparation of four academic articles for submission, and a policy brief. We will take advantage of running alongside key on-going initiatives via bilateral discussions, workshops and presentations. Our impact plan includes presentations to these and to policy makers, researchers/ industry/ clinicians, ensuring that UK and international research on AMR is better informed of downstream viewpoints allowing them to move beyond a "science push" approach.