After a week-long pressure campaign by grassroots activists — led by author and philanthropist John Green — Danaher, the corporation that owns molecular diagnostics company Cepheid, has announced its plans to reduce the cost of tuberculosis testing materials.
Cepheid is the creator of the most helpful diagnostic resource for TB: The GeneXpert machine. While the machine itself is considerably cost-effective, global health advocates have long criticized the high price of its testing cartridges.
This morning, however, The Global Fund to Fight AIDS, Tuberculosis and Malaria; the Stop TB Partnership; and USAID jointly announced a new collaboration with Danaher to provide Cepheid’s Xpert testing cartridges at the price of $7.97, a 20% reduction from the current price of $9.98.
Inspired by the years-long Time For $5 campaign, Green and his online community, Nerdfighteria, elevated the conversation about Danaher’s high-cost cartridges beginning on September 12, after Green shared an impassioned video on his popular YouTube channel. Green’s video received more than 450,000 views.
After a week of organized efforts — including clever memes urging Danaher to reduce the cost of cartridges to $5 — Green, Nerdfighteria, and swaths of long-time global health advocates and nonprofits, are celebrating progress.
“This isn’t the 50% reduction we hoped for, but Danaher is also committing to zero profit in their distribution of standard TB tests to impoverished communities,” Green tweeted. “They will sell the cartridges at cost and bring in an ‘internationally accredited third-party’ to assess prices and adjust them accordingly so that Danaher earns no profit from selling these cartridges. That is a huge deal.”
While the company has not committed to a price change for its extensive multidrug-resistant testing cartridges (which currently cost about $15), this news is being lauded as a step in the right direction by activists.
“I very much welcome Danaher’s commitment which should enable significantly expanded access to the communities most in need,” Peter Sands, Executive Director of the Global Fund, said in a press release. “Reducing the price of these sophisticated TB tests by 20% will give a significant boost to our collective efforts to scale up testing and save lives.”
According to the Global Fund’s press release, the Xpert cartridges are particularly important for the diagnosis of drug-resistant TB. Green clarified on Twitter: “The standard test can test for MDR [multi-drug resistant TB] but not for XDR [extensively drug-resistant TB] or pre-XDR. No movement on that cartridge (yet), which is disappointing. So the work goes on.”
Danaher also shared a press release, announcing the reduction in cartridge prices, and did not include further information on the XDR tests.
Rainer M. Blair, the president and CEO of Danaher said: “Danaher is committed to solving critical healthcare challenges impacting patients around the world. Today’s agreement to provide the Global Fund with ‘at-cost’ TB tests for low- and middle-income countries will help improve the lives of millions of people. TB is the leading cause of infectious disease-related deaths worldwide and accurate, fast diagnosis is the critical first step to effective treatment.”
The release also shared that “recent speculation, based on the analysis of partial information, has significantly understated the cost of [Cepheid’s] TB test cartridges, resulting in considerable overstatement of their profitability.”
This, according to Danaher’s press release, has led to the company’s commitment to receiving an annual third-party assessment in regard to the production and distribution costs of the testing cartridges, as Green outlined in his tweet.
A 2018 analysis estimates it costs between $7.06 and $8.82 to manufacture Cepheid’s cartridges, and a statement from Doctors Without Borders estimates it costs the company less than $5 today in 2023. It is unclear if these numbers are the most accurate current estimate, but activists are hopeful that a third-party assessment will provide more answers — and transparency from Danaher and Cepheid.
Much of the conversation surrounding the profitability of the test cartridges comes from Nerdfighteria. Activated by Green’s leadership and informed by decades of organized advocacy by TB survivors and health organizations, the online community mobilized rapidly earlier this month to spread awareness about Danaher and Cepheid’s overpriced TB tests.
“I think Nerdfighteria is playing a very important part in this push for change, but I want to be clear that we are led every step of the way by far more experienced and knowledgeable activists, including Doctors Without Borders, Partners in Health, and the Treatment Action Group,” Green said in a message to Good Good Good.
“We’ve learned a lot about how to coordinate and use Nerdfighteria’s creativity to push for a more just and equitable world. And we will continue to try to fight injustice where we see it, and where we feel that we can make a difference.”
While this victory isn’t the sweep activists have been angling for, it still makes a big difference.
The Global Fund estimates that around 20 million Xpert cartridges were produced in 2022 alone, and that this new agreement would enable more than five million more tests to be provided to the communities who need them most.
“Almost half of people diagnosed with TB are still diagnosed using the microscope and clinical examination, like hundreds of years ago, while the recommended diagnosis for everyone is the rapid molecular test,” Lucica Ditiu, the Executive Director of the Stop TB Partnership, said in the press release.
“This drop in the Xpert cartridge price is a step forward as we now have two rapid molecular tests below $8, which makes it a bit easier on the already small national budgets for TB. This is not just due to the collective efforts of our three organizations, but also thanks to the efforts of multiple partners, TB survivors, civil society and advocates from the TB and health space as well as simple citizens who care for people with TB.”
As advocates celebrate this news — especially leading up to this week’s United Nations High-level Meeting on the fight against TB — they are also prepared to continue their work.
“This is a very important step toward equitable access for TB tests, but we still have a very long way to go,” Green told Good Good Good. “I remain concerned about the price of Danaher's XDR-TB cartridge, which has not reduced in price and which can identify the most deadly and dangerous strains of tuberculosis.”
Still, activists are energized by hope.
“This has just proven to me how effective grassroots community activism can be,” one Nerdfighter said on Twitter. “I can get cynical sometimes but this gives me faith that things can change.”
Danaher’s announcement is also not the only good TB news to reach advocates in recent weeks. Green shared with Good Good Good that a paper was published recently showing that “adequate nutrition can prevent over a third of TB cases in families where one member has gotten sick.”
“This is an extraordinary finding, and a reminder that TB does not live separate from the world and its social forces,” Green said. “TB is an expression of injustice, and we have to fight that injustice everywhere we see it — from diagnostics to nutrition.”
Header montage photo credits — from left to right: Centers for Disease Control and Prevention (Public Domain); vlogbrothers/YouTube (courtesy); USAID Asia/Flickr (CC BY-NC 2.0); The Global Fund/Vincent Becker (courtesy)
