Source: Cost-Disruptive Tools for Diagnosis and Screening. AI-generated summary by biochip.com, published . Not independently reviewed.
The Gates Foundation is inviting proposals for cost-disruptive diagnostic and screening tools aimed at some of the biggest testing gaps in global health, especially in low- and middle-income countries. This is a funding call, not a report of a new device or study, and its focus is practical: cheaper, faster tests that can work close to where patients are seen. The opportunity spans sexually transmitted infections, maternal and newborn health, enteric diseases, and manufacturing innovations, with a strong emphasis on point-of-care use, meaning testing done near the patient rather than in a centralized lab. In several cases, the foundation spells out performance targets, such as sensitivity and specificity thresholds, to define what success should look like. Sensitivity is a test's ability to catch true cases, while specificity is its ability to avoid false alarms, and both matter when treatment decisions must happen quickly. The call also makes clear that the value of diagnostics goes beyond individual care: these tools can support outbreak response, surveillance, vaccine policy, and antimicrobial stewardship, which is the careful use of antibiotics to slow resistance. Taken together, the request offers a window into where major funders see the next bottlenecks in diagnostics—and where they want innovators to aim next.
What the funding call is asking for
At its core, the solicitation asks for tests that sharply reduce cost while still delivering strong clinical performance. Think of it like asking engineers to build a smartphone-quality camera for a fraction of the price: the challenge is not just making something work, but making it work well enough, cheaply enough, and simply enough to be widely used.
That requirement shapes nearly every example in the call. The foundation is looking for tools that can operate in real-world health programs, not just in carefully controlled research settings, and it highlights same-visit decisions, rapid public-health action, and scalable platforms as recurring priorities.
Sexually transmitted infection testing at the point of care
One major focus is point-of-care diagnostics for gonorrhea, chlamydia, and trichomonas in symptomatic adults. These infections are common, but in many settings patients may not return for lab-based results, so a same-visit test can make the difference between immediate treatment and a missed case.
The call also seeks point-of-care tools for active adult and congenital syphilis, with target performance of at least 90% sensitivity and at least 95% specificity, including in neonates. Congenital syphilis is syphilis passed from a pregnant person to a baby, and rapid diagnosis matters because treatment decisions often need to be made quickly, sometimes in settings with limited laboratory infrastructure.
Another priority is high-risk human papillomavirus, or HPV, primary screening that could support same-visit screen-and-treat care for cervical precancer. The foundation specifies a target of at least 95% sensitivity for CIN2+ and at least 99% specificity for ≤CIN1; these shorthand terms describe grades of abnormal cervical cell changes, with CIN2+ indicating lesions more likely to need treatment and CIN1 or less indicating low-grade or normal findings.
The STI section also points to a broader platform strategy. Rather than single-use devices with no room to grow, the foundation is interested in systems that can expand modularly to additional analytes, such as bacterial vaginosis, and handle programmatic throughput, meaning enough volume to fit public-health screening programs rather than one-off use.
Enteric disease diagnostics for treatment and surveillance
The solicitation identifies enteric infections as a major driver of illness and death in low- and middle-income countries, naming typhoid, cholera, and pediatric diarrhea pathogens as examples. Enteric diseases are infections of the intestinal system, and they spread through contaminated food, water, or poor sanitation, making them both a clinical problem and a public-health threat.
For typhoid, the foundation wants a point-of-care test to detect acute Salmonella enterica serovar Typhi infection with at least 90% sensitivity and 90% specificity. Acute here means a current infection rather than evidence of past exposure, a distinction that is crucial because many existing tests struggle to tell active disease from old immune responses.
It also calls for an acute Shigella diagnostic that can detect Shigella species with high accuracy during the same patient encounter. That same-encounter requirement matters because diarrhea treatment is often started immediately, and a near-patient result could help clinicians choose antibiotics more carefully instead of treating blindly.
Beyond individual diagnosis, the call asks for high-order multiplex serological platforms for nationally representative, population-level surveillance across endemic and epidemic pathogens. A multiplex test is like a panel switchboard: one sample can be checked for many disease signals at once, which can make surveillance far more efficient when health agencies need a broad picture rather than a single answer.
Outbreak detection and environmental monitoring
The opportunity extends into outbreak response tools, including a point-of-care stool-based or non-stool diagnostic for live poliovirus. The stated goal is to reduce outbreak confirmation time, which could help health systems move faster when every day matters for containment.
The foundation is also looking for low-cost multiplex platforms that can detect priority pathogens in wastewater or other environmental samples for early warning. Wastewater testing works a bit like checking smoke before seeing flames: rather than waiting for large numbers of people to reach clinics, public-health teams can look for pathogen signals in shared infrastructure and spot trouble earlier.
Why manufacturing is part of the story
The raw list of topic areas includes manufacturing innovations, which signals that the challenge is not only scientific but industrial. A clever assay is not enough if it cannot be produced reliably, cheaply, and at scale, especially for health systems that operate with tight budgets and fragile supply chains.
That focus reflects a hard truth in diagnostics: the price of a test is shaped as much by materials, design simplicity, and production methods as by biology. In other words, the funding call is really about the whole pathway from idea to usable product, not just the chemistry inside a cartridge or strip.
Why This Matters
This solicitation highlights where global health diagnostics still fall short. For sexually transmitted infections, the gap is often the ability to test and treat in one visit; for enteric diseases, it is the need to balance patient care, outbreak detection, and national surveillance; and for environmental monitoring, it is the ability to see signals early enough to act.
It also shows how funders are defining success more precisely. By naming target sensitivity, specificity, and use cases, the foundation is telling developers that affordability alone will not be enough; tests must be accurate, fast, and suitable for the settings where disease burden is highest.
The next step is up to researchers, startups, manufacturers, and public-health innovators who can translate these priorities into proposals and, eventually, products. If strong applications emerge, the result could be a new generation of diagnostics built not just to perform well in principle, but to reach clinics, maternity wards, and surveillance programs that need them most.