Wie wir jedes Jahr 400.000 Babies retten können
Dylan Matthews schreibt auf vox.com:
It’s called NeoTest.
The program targets an extremely common and preventable cause of death in young infants: neonatal sepsis. Sepsis is a catch-all term for infections that provoke an overwhelming immune response, damaging internal organs, and in the worst cases, leading to death. Sepsis can in principle be caused by anything — a virus, a fungus, a protozoa — but in practice, most infants who get it get it from a bacterial infection.
So our targeting of antibiotics to babies is currently bad, with the result that hundreds of thousands of babies die every year from sepsis. The estimates we have on the toll of neonatal sepsis aren’t precise, but the best figure I’ve seen, from the World Health Organization (WHO), is a range of 400,000 to 700,000 deaths a year. That’s in the same ballpark as malaria (600 to 700,000 a year) and HIV/AIDS (630,000 deaths in 2023).
The NeoTest team does not, itself, consist of medical test manufacturers. But in Glennerster and Kremer, it includes two of the inventors of a tool called an “advance market commitment” (AMC).
AMCs are a way to communicate to companies that there’s a big market for a product which doesn’t yet exist. The participants, which can include governments or other businesses or philanthropists, commit to buying a set amount of the new product, at a set price, from any manufacturers who meet the deal’s specifications.
The hope is that this provides an incentive for manufacturers to develop the product, because they know for a fact there will be demand for it.
It’s worked before. The first AMC, for better vaccines against pneumococcal bacteria at a time when that disease was killing as many as 1 million children a year, resulted in three new vaccines being developed, and in the number of vaccine doses growing from just 3 million in 2010 to around 150 million in 2016. By one estimate from Kremer and co-authors, the new vaccines enabled by the AMC saved some 700,000 lives between 2010 and 2020.
More famously, Operation Warp Speed, the US effort that got effective vaccines against Covid-19 on the market less than a year after the pandemic began, used a purchasing mechanism that worked quite a bit like an AMC. The government purchased hundreds of millions of dosesfrom vaccine manufacturers months beforethe vaccines were in fact approved — giving the pharma firms confidence to start producing doses in large numbers, and encouraging them to keep up their R&D work.
NeoTest is an attempt to put together funds — about $120 million in total — for an advance market commitment for a better neonatal sepsis test. Test manufacturers who are willing to sell for $8 per test ($5 funded by the AMC, $3 by the government of the country receiving the tests) would be guaranteed at least 24 million subsidized orders. Ideally, the test will settle at around $3 as a final price, with the initial subsidy helping fund initial costs associated with developing the tests and setting up manufacturing.