Scale-Up

SCALE-UP

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?

1. Which validated tests have been successfully scaled-up, what were reasons for the success, and how long did it take to reach scale?
2. How do country level policy makers make decisions on technologies to scale-up?
3. 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?
4. When and how do donors fund/subsidize and support roll-out of TB diagnostics?
   1. Who are the major players in funding scale-up (e.g. UNITAID/ GFATM/BMGF/ PEPFAR/USAID), and their historical role and funding mandate/priorities?
   2. Since donors are already supporting the roll-out of GeneXpert, will they consider other technologies for buy-down and/or scale-up?
   3. Is WHO endorsement mandatory for donor support for scale-up?
   4. What are the long-term prospects after donor funding ends?
   5. 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?