Gates Package — page 946

Ideally, in the future, everyone's results will be linked into a digital data system--with the proper safeguards for privacy--so that public health officials can see what's going on in their community. It's especially important to identify the people who are most likely to spread the disease, since studies have shown that some COVID patients infect many others, while many COVID patients don't even infect people they're in constant contact with. So let me tell you about some of the exciting work that's going on in diagnostics, with my usual bias for innovations that will benefit people in poor countries as well as wealthier ones. The one I'm most enthusiastic about comes from the British company LumiraDx. It's developing systems that can be used to test for multiple diseases, all at once, in pharmacies, schools, and workplaces. These are antigen tests, so they provide rapid results and are easy to use, but they're far more accurate than other antigen tests, hitting the mark about as well as PCR machines do. They're designed for high volume; a single production line can produce hundreds of millions of tests in a year, and a new test for an emerging pathogen can be developed with little or no retooling. LumiraDx's biggest contribution, though, is its ability to drive down costs exponentially. After you buy the machine--which, at $1,500, is still expensive--you can run each individual test for something like $1 to $1.50; the previous generation of tests cost roughly 10 times as much. That makes the marginal cost of each LumiraDx test nearly as low as the lateral flow approach, but with an accuracy approaching PCRs. In 2021, a group of partners that included the African Union and the Gates Foundation provided 1,500 LumiraDx machines to countries throughout Africa. That's a tiny fraction of the need, though, and I hope more funders step up. For now, PCR tests remain the gold standard in terms of accuracy, but they also remain slow and expensive. Several companies, though, are out to change this through a process called