DIAGNOSTIC INNOVATION FOR INFECTIOUS DISEASES: A COMPARATIVE STUDY OF INDIA AND BRAZIL
Résumé (anglais)
Achieving SDG 3 (Good Health and Well-Being) requires ensuring healthy lives and promoting well-being for all at all ages, with Target 3.3 calling for ending the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases. Diagnostic innovation, the development and deployment of rapid, accurate, affordable, and accessible diagnostic tests, is a critical determinant of infectious disease control, enabling early detection, appropriate treatment, transmission reduction, and antimicrobial resistance surveillance. However, diagnostic capacity varies dramatically across countries, shaped by health system infrastructure, research and development investment, regulatory pathways, intellectual property regimes, manufacturing capability, and public-private partnerships. This study conducts a comparative analysis of diagnostic innovation for infectious diseases in India and Brazil, two large middle-income countries with contrasting health systems, strong pharmaceutical and diagnostic industries, and leadership in global health diplomacy. India has emerged as the "pharmacy of the developing world" for generic medicines and is rapidly expanding diagnostic capacity through major manufacturers, public sector diagnostic networks, and a strong cost-innovation model. Brazil has a universal public health system (SUS) serving 150 million people, with strong diagnostic infrastructure including Fiocruz (Oswaldo Cruz Foundation), Instituto Butantan, and a decentralized network of public health laboratories (LACEN). Brazil has pioneered molecular testing integration for multiple pathogens and led a brain infections intervention study (Lancet 2025) that increased syndromic diagnosis from 77 percent to 86 percent and microbiological diagnosis from 22 percent to 30 percent across 13 hospitals in Brazil, India, and Malawi. Using a qualitative comparative case study methodology, the study analyzes secondary data from government reports, international databases, peer-reviewed literature, and program evaluations over the period 2000 to 2025. The study finds that both countries have built robust diagnostic innovation systems but face common challenges including regional disparities, point-of-care testing gaps, antimicrobial resistance diagnostics lagging, supply chain fragility, and regulatory harmonization needs. The study concludes that diagnostic innovation requires sustained public investment, regulatory agility, local manufacturing, quality assurance, and integration with surveillance. Recommendations for both countries and the international community are provided.
Mots-clés: Diagnostic innovation; infectious diseases; India; Brazil; SDG 3; tuberculosis; molecular diagnostics; point-of-care testing; Fiocruz; ICMR
Résumé (français)
Atteindre l'ODD 3 nécessite de mettre fin aux épidémies de sida, tuberculose, paludisme et maladies tropicales négligées (cible 3.3). L'innovation diagnostique est un déterminant essentiel de la lutte contre les maladies infectieuses. Cette étude analyse l'innovation diagnostique pour les maladies infectieuses en Inde et au Brésil. L'Inde a développé une capacité de diagnostic importante avec des fabricants majeurs (Tulip, Meril, Transasia), un réseau de diagnostic moléculaire pour la tuberculose (NTEP), et une capacité de test COVID-19 d'un million par jour. Le Brésil dispose d'un système de santé universel (SUS) avec une infrastructure diagnostique solide incluant Fiocruz (production de vaccins et diagnostics) et un réseau de laboratoires de santé publique (LACEN). Une étude brésilienne sur les infections cérébrales (Lancet 2025) a démontré qu'une intervention simple a augmenté le diagnostic syndromique de 77 pour cent à 86 pour cent et le diagnostic microbiologique de 22 pour cent à 30 pour cent. L'étude conclut que l'innovation diagnostique nécessite un investissement public soutenu, une fabrication locale, une assurance qualité et une intégration à la surveillance. Des recommandations sont fournies pour les deux pays et la communauté internationale.
Mots-clés: innovation diagnostique, maladies infectieuses, Inde, Brésil, ODD 3, tuberculose, diagnostics moléculaires, tests de diagnostic rapide, Fiocruz, ICMR