How a Nigerian doctor is transforming TB testing

When I heard about the Innovation Prize for Africa (IPA), I was curious. I hadn’t considered myself to be an ‘innovator’ in the traditional sense and certainly not an entrepreneur or businessman. I am a physician and a Reader in Medicine at Obafemi Awolowo University, Nigeria. I have an MBBS degree from the University of Ibadan, Nigeria and a Postgraduate degree in Internal Medicine and Pulmonology from the Postgraduate Medical College Nigeria. I have been recognized with several awards and for my researches in different aspects of medicine and pulmonology. I spend most of my days working as a physician/ pulmonologist and as a Faculty in a medical school, training the next generations of scientists, doctors and specialist doctors.

Yet in 2017 I decided to apply to the Innovation Prize for Africa – for several reasons. The extent of the TB problem in parts of Africa which death rate has now exceeded HIV – so the magnitude of the issue drove me to a large extent. More than 90% of new TB cases and deaths occur in developing countries – and Nigeria (my country) ranks 4thworldwide. I deal with TB daily in my job – with patients and caregivers. I have known for some time that (as is usually the case in medicine), early diagnosis is directly related to chances of survival. The problem of stigma though reducing is still an issue.

Before my innovation, available TB tests were high tech; cannot be deployed in rural centres and are dependent on the patient being able to provide sputum (a mix of saliva and mucus coughed up from the lower respiratory tract, typically because of infection) – which many patients struggle to produce. The highly invasive and uncomfortable nature of the tests is an obvious disincentive to get tested. It is a time-consuming testing process that often requires patients to make repeated visits to the clinic before a diagnosis is made. Understandably, this very often causes a delay in diagnosis. More desperately, it leads to huge numbers of missed diagnosis – up to of three million cases. Undiagnosed cases easily allow for TB to spread further.

My solution

Through my extensive work on TB and HIV, I understood that TB can be detected in sweat – the challenge was to develop a simple, affordable way of testing sweat that could also be rolled out regionally, including in the most remote populations. It was important for me to create something that was non-invasive, quick, and a one-time event: a point-of-care test to detect TB within minutes. That was my goal. The product, which is called Sweat TB Test, leverages on TB-specific markers in the sweat of patients. Sweat TB Test is a sensitive and accurate device that will enable faster diagnosis and is a low-cost intervention that can be deployed at all levels of health especially in rural centres to support TB control programs. I also hope that my development and success in winning the African Innovation Foundation’s Innovation Prize for Africa will serve as encouragement to local scientists to develop their own home grown and patient-centered solutions.

Why I believe in Innovation

Innovation must be about creating a significant and positive change. So, aspiring innovators must reflect the change they want to see – like myself, they must embody the need for change and instinctively want to act as a change agent. However, it is important for potential innovators to understand that for their idea to succeed and achieve its potential, they will need to build and develop their business and financial management competencies and skills. I had to work hard to learn how to take the product to market – and that meant learning how to find a company that could manufacture the test, how to price it, how to distribute and most importantly how to do all of that in a profitable way. The profit is important – not necessarily to provide myself with an income but to sustain the business itself and evolve to develop new products.

A Brighter Future

Since Being among the top ten nominees for the IPA 2017 and the support (though I didnot win the prize then) I received afterwards enabled me to develop the prototype, conducted a randomised testing to evaluate the clinical performance of the strip,see further areas of refinement. and developing a commercially sustainable business model. We have reinvested to develop a new multimodality device that putspatients’ preference choice into account. making it easier and possible to use other body fluid, collected also non-invasively. So, we have revised it based on research findings to upgrade and reinvent it for that purpose.

There have been requests for the device from different people.

Even though, supports and funding are still required, I have made significant progress moving forward.

The interest and enthusiasm that both the first device and the new one has generated all over the globe have been tremendous. For instance,I was at the Global Health and Innovation Conference in the USA, it was a great experience connecting with potential implementing networks and partners.

The product I have developed may of course turn out to be the most important achievement in my entire life: it really is a game-changer and a life-saver. This will always give me enormous comfort. However, I also hope that my success, combining bedside medicine with the bench and social innovation involved in healthcare innovation and product development, will act as a beacon of hope for others who have ideas or products that can further improve life chances and health outcomes for our fellow Africans. If I can leave a small legacy in that respect, I will be a very happy man.

Dr. Olanisun Olufemi Adewole

Reader in Medicine at Obafemi Awolowo University, Nigeria.