Once a product has been validated, registered and put on the market, and once policy endorsements are obtained, what are the challenges for uptake and scale-up in high burden countries?
- Which validated tests have been successfully scaled-up, what were reasons for the success, and how long did it take to reach scale?
- How do country level policy makers make decisions on technologies to scale-up?
- If some tests have not been scaled-up even after policy endorsements, why? What are the biggest barriers and how can they be overcome? Are the barriers in BRICS countries very different from other high burden countries?
- When and how do donors fund/subsidize and support roll-out of TB diagnostics?
- Who are the major players in funding scale-up (e.g. UNITAID/ GFATM/BMGF/ PEPFAR/USAID), and their historical role and funding mandate/priorities?
- Since donors are already supporting the roll-out of GeneXpert, will they consider other technologies for buy-down and/or scale-up?
- Is WHO endorsement mandatory for donor support for scale-up?
- What are the long-term prospects after donor funding ends?
- Are there markets that are not dependent on donor funding? What is the willingness/ability to pay for new diagnostics in donor-dependent versus non donor-dependent countries?