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Addressing the challenges of diagnostics demand and supply: insights from an online global health discussion platform
  1. Nora Engel1,
  2. Keri Wachter2,
  3. Madhukar Pai3,
  4. Jim Gallarda4,
  5. Catharina Boehme5,
  6. Isabelle Celentano6,
  7. Rebecca Weintraub2,6
  1. 1Department of Health, Ethics & Society/CAPHRI, Maastricht University, Maastricht, The Netherlands
  2. 2Harvard Medical School, Global Health Delivery Project at Harvard University, Boston, Massachusetts, USA
  3. 3McGill Global Health Programs & McGill International TB Centre, McGill University, Montreal, Canada
  4. 4Bill and Melinda Gates Foundation, Seattle, Washington, USA
  5. 5Foundation for Innovative New Diagnostics, Geneva, Switzerland
  6. 6Brigham and Women's Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Nora Engel; n.engel{at}


Several barriers challenge development, adoption and scale-up of diagnostics in low and middle income countries. An innovative global health discussion platform allows capturing insights from the global health community on factors driving demand and supply for diagnostics. We conducted a qualitative content analysis of the online discussion ‘Advancing Care Delivery: Driving Demand and Supply of Diagnostics’ organised by the Global Health Delivery Project (GHD) ( at Harvard University. The discussion, driven by 12 expert panellists, explored what must be done to develop delivery systems, business models, new technologies, interoperability standards, and governance mechanisms to ensure that patients receive the right diagnostic at the right time. The GHD Online (GHDonline) platform reaches over 19 000 members from 185 countries. Participants (N=99) in the diagnostics discussion included academics, non-governmental organisations, manufacturers, policymakers, and physicians. Data was coded and overarching categories analysed using qualitative data analysis software. Participants considered technical characteristics of diagnostics as smaller barriers to effective use of diagnostics compared with operational and health system challenges, such as logistics, poor fit with user needs, cost, workforce, infrastructure, access, weak regulation and political commitment. Suggested solutions included: health system strengthening with patient-centred delivery; strengthened innovation processes; improved knowledge base; harmonised guidelines and evaluation; supply chain innovations; and mechanisms for ensuring quality and capacity. Engaging and connecting different actors involved with diagnostic development and use is paramount for improving diagnostics. While the discussion participants were not representative of all actors involved, the platform enabled a discussion between globally acknowledged experts and physicians working in different countries.

  • Diagnostics and tools

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  • Handling editor Soumitra Bhuyan.

  • Contributors NE, KW, RW and MP analysed the data. NE, KW, MP, JG, IC, RW and CB wrote the paper.

  • Competing interests MP reports that he serves as a consultant for the Bill and Melinda Gates Foundation. NE reports that she serves as a consultant for FIND. CB reports that she is employed by FIND. JG reports that he is employed by the Bill and Melinda Gates Foundation.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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