Antimicrobial Resistance: Diagnostics
Led by Akhil Bansal, MD at AMR Funding Circle, advised by David McAdams (Duke)
Antimicrobial resistance (AMR) is responsible for over a million annual global deaths and is a growing biosecurity threat. With the expected burden from AMR reaching 10 million deaths by 2050, innovations that are able to slow the growth of resistance could save millions of lives and billions of dollars in healthcare costs. New diagnostic tests are needed to reduce the overuse and misuse of antimicrobials by equipping providers with better decision-making tools and enhancing surveillance capabilities. Diagnostic innovations would lead to global public benefits of improved antibiotic conservation, slower development of resistance, and longer antibiotic lifespans, but this wedge between the private and social benefits results in inadequate investment. Pull funding would help close this gap to incentivize researchers and biotech companies to prioritize investments in novel diagnostics, encourage competition between potential developers, and ensure accessible pricing to promote broad access and adoption.
Read the policy memo and watch the pitch.
Broad-spectrum Antivirals
Led by Jano Costard at SPRIND, advised by Christopher Avery (HKS)
Developing an advanced portfolio of viral therapeutics is a key pandemic preparedness measure to reduce the severity and mortality of a future pandemic. However, commercial markets do not adequately value the social benefit of an antiviral being “broad-spectrum” such that it could be deployed rapidly in response to a future novel pathogen. Pull mechanisms would be able to specify a target product profile that prioritizes drug attributes that have a high public health value such as broad-spectrum efficacy and the ability to reduce transmission. Having these antivirals ready for use against a novel pathogen with little to no modification would allow for faster deployment during a future pandemic, saving lives and reducing economic losses.
Read the policy memo and watch the pitch
Clean Cooling
Led by Daniel Kuehner at Clinton Health Access Initiative (CHAI), advised by Paul Novosad (Dartmouth)
Air conditioning (A/C) is responsible for roughly 4% of all global emissions, a share that will likely rise as millions of people in warm, humid climates enter the global middle class and purchase A/C units. More energy-efficient, climate-friendly A/Cs often have a higher upfront cost, deterring consumers from choosing them over cheaper, but more pollution-intensive alternatives. Moreover, because consumers do not internalize the cost their cooling units impose on the environment, there is an insufficient commercial incentive to invest in climate-friendly cooling. A pull mechanism for more climate-friendly A/C units in low- and middle-income countries could be helpful in incentivizing firms to invest R&D in cooling innovation, contributing to climate adaptation and mitigation.
Green Cement
Led by Benjamin Stephens at Instiglio
Concrete is the second-most consumed resource in the world (after water), but the production of its primary input, cement, is highly pollution-intensive, and is responsible for roughly 7% of all global emissions.Unlike other major pollution sources such as cars and electricity, there has been relatively less effort invested in reducing the carbon intensity of cement. There is also little commercial incentive for firms to invest in research to reduce their carbon footprint, as the benefits of a cleaner environment are diffused across the entire public. As a result, there is an opportunity for pull mechanisms and procurement reforms that provide firms with a financial incentive to green their production processes.
Indoor Air Quality
Led by Gavriel Kleinwaks at 1 Day Sooner, advised by Richard Bruns (Johns Hopkins)
Innovations in indoor air quality can reduce pathogen spread indoors. For example, far-UVC technology is similar to the commonly used UV water treatment, but, instead, can be used to kill pathogens spread indoors through air and respiratory droplets. Since indoor spaces have an especially high risk of pathogen transmission, this technology could play a major role in preventing future pandemics and, in the event of a pandemic, help keep important institutions open (e.g., schools and hospitals). To enable wider spread adoption of innovative products, targeted research is needed to develop cheaper products that appeal to customers. However, the private incentive to invest in indoor air quality is incommensurate with the social value (i.e., reducing transmission of pathogens benefits society at large – not just individual building owner customers). Pull funding, such as advanced market commitments, could help close this gap between private and social value and, thus, stimulate more R&D and scale-up in this space.
Personal Protective Equipment
Led by Aman Patel at Technologies for Pandemic Defense, advised by Christopher Avery (HKS)
Highly effective personal protective equipment (PPE) is a critical defense tool against future pandemics. PPE that can be deployed rapidly and is pathogen agnostic could reduce transmission and protect critical workers before vaccines or therapeutics are available. However, there is little commercial incentive to invest in these products before a pandemic, when few are buying high-quality PPE products. A pull mechanism could create an incentive to invest in creating such a product now and ensure rapid accessibility during the next pandemic through stockpiling, reusable designs, or capacity commitments.
Repurposing Generic Drugs
Led by Beth Boyer at Duke Margolis
Drugs and other medical innovations often have uses beyond their original intended purposes. However, firms have little financial incentive to research these novel, but socially valuable uses because firms cannot enforce patents on new uses for off-patent drugs. This may have played out during COVID: research suggests that, for COVID, pharmaceutical corporations were much less likely to sponsor research on repurposing drugs with generic competitors. Pull mechanisms are capable of addressing this problem because they can incentivize investment to achieve well-defined health outcomes. Funders can target these funding mechanisms to fight future pandemics (e.g., to produce antivirals) and, also, to address other health conditions, more broadly.
Read the policy memos: US Common Diseases and Neglected Tropical Diseases and watch the pitch