Retooling Task Force

1. Retooling Task Force

2. Checklist of Key Actions for Diagnostics Liquid Media for Culture and Drug Susceptibility Testing • Generic checklist for TB Diagnostics developed by Retooling Task Force adapted specifically for LMC-DST • Based on expert opinion, further refinement was made • Checklist was sent to 27 NTP managers with copies to WHO regional representatives soliciting their feedback and comments • Refined checklist finalized, to be widely disseminated Similar checklists for each upcoming new technology will be developed as they become available

3. Checklist of Key Actions for LMC-DST Dissemination - Global • Stop TB Partnership groups • Relevant WHO Depts, bodies, region/country offices • Global Laboratory Initiative • International organizations eg UNION, IOM • Regulatory authorities • Sponsoring agencies • Technical agencies • Professional associations • National TB Control Programmes and MoHs • NGOs • Patient community and civil society organizations • Test manufacturers • Test developers and evaluators • Untargetted (available on RTF website)

4. Checklist of Key Actions for LMC-DST Dissemination - National • National TB Reference Laboratory • NGOs • Patient community and civil society organizations • Test manufacturers/distributors/agents • Test developers eg FIND country offices • National regulatory authorities • Laboratory equipment suppliers/service • Professional associations • Lab training institutions • Procurement/equipment management services • Authorities at main port of entry for country (delays) • Health systems initiatives at MoH (eg SWAp) • Untargetted (available on national website - NTP?)

6. Retooling Task Force

7. What should be in the diagnostics pipeline?What are the stages in the pipeline?How are candidate tests positioned along the pipeline?How is the appropriate health service delivery level or other setting specifications determined for particular candidate tests?What evidence is required at each stage to move forward?

8. Wide stakeholder agreement that there is a need for: • Inclusive pipeline • More, and more diverse, partners engaged in development and evaluation of new diagnostics (commercial and non-commercial) • A clearly-defined common pathway for TB diagnostics development and evaluation • Clear criteria for defining setting/HS delivery specs • Clear criteria for positioning tests in pipeline • Standards of evidence required for progression

9. WG Challenges • Expanding development pipeline • Wide range of technological platforms • Increasing need for collaboration between test developers • Increasing need to consult with end-users Reorganization of Workgroup To promote efficiency in its work and create synergies with partners

10. Working Group Reorganization New constituency-based Core Group 8 Sub-Groups around technologies and relevant issues Revised Strategic Plan Work-plan for the biennium

11. Working Group Structure Core Group Chair: Giorgio Roscigno (FIND) Secretary: Andy Ramsay (WHO/TDR) JF de Lavison: Diagnostics Manufacturers Assoc Arend Kolk: Academia Vaira Leimane: NTP - High MDR-TB prevalence Suvita Luka: Patient Community Representative Carol Nyirenda: Patient Community Representative Mark Perkins: Product Development John Ridderhof: Laboratory Capacity Strengthening Felix Salaniponi: NTP – High HIV prevalence Francis Varaine: Non-Governmental Organization

12. Working Group Structure 9 Subgroups Optimizing smear microscopy L.Cuevas/P. Klatser Culture-based diags and DST D.Moore/J-C Palomino NAATs L.Rigouts/T Shinnick Diagnostics for LTBI R.Menzies/K Weldingh POC tests C.Boehme/R McNerney Evidence synthesis for TB diags R.O`Brien/M.Pai TB Diags and Poverty D.Bocca/B.Squire TB Diags and HIV H.Getahun/B Laughon TB Diags and children To be confirmed

13. Priorities in Work-plan • Intensify collaboration within and between WGs • To describe an inclusive pipeline • To develop criteria for describing the intended setting and use of TB diagnostics

14. Priorities in Work-plan • To develop a Scientific Blueprint for TB diagnostics development and evaluation that will clearly lay out the stages in the pipeline leading to global implementation and the nature of the evidence required to move through these stages • To develop criteria to place developing technologies in the "value chain" and determine likely time-lines for availability. • To work closely with the Retooling Task Force and other partners to facilitate adoption, introduction and implementation of new and improved diagnostics

16. Retooling Task Force

17. Diagnostics development and evaluation process Downstream Upstream Evaluation Discovery and research Development Phase I Evaluation - Proof of Principle Phase II Laboratory Evaluations Phase III Evaluations Field trials Phase IV Cost-effectiveness studies Policy, Prequalification, bulk procurement, negotiated pricing, Access FIND’s focus

18. Moving from development and evaluation to retooling Downstream Upstream Evaluation Discovery and research Development Phase I Evaluation - Proof of Principle Phase II Laboratory Evaluations Phase III Evaluations Field trials Phase IV Cost-effectiveness and impact Policy, Prequalification, bulk procurement, negotiated pricing, Access FIND’s focus Implementation Research NDWG Recommendation WHO Endorsement NDWG Subgroups NDWG Core Committee Retooling Task Force

19. Partnership essentialRoles for partners along continuum WHO-coordinated Diverse Partners WHO STB, TDR, Expert consultation DIVERSE PARTNERS Coordinated global activity Academia, TDR, STB FIND, Industry, NGOs, NTPs, Community DIVERSE PARTNERS Country-led Academia, TDR, STB FIND, Industry, NGOs, NTPs, Community WHO Endorsement Implementation Research NDWG Recommendation NDWG Subgroups NDWG Core Committee Retooling Task Force