Text on image: Time for $5. © MSF

‘Time for Five’ coalition launches global petition targeting medical test maker Cepheid and parent corporation Danaher

MSF and partners protest outside Danaher in Washington, DC, demanding price drop to $5 per test

Ahead of World Tuberculosis (TB) Day, Doctors Without Borders/Médecins Sans Frontières (MSF) protested alongside other global health activists outside the headquarters of US corporation Danaher, which owns diagnostics maker Cepheid, demanding they drop the price to US$5 for all their ‘GeneXpert’ medical tests that they sell in low- and middle-income countries, for diseases such as tuberculosis (TB), HIV, hepatitis, sexually transmitted infections (STIs) and Ebola. Testing is the first step to getting someone who is sick on the treatment they need and preventing further spread of infectious diseases. The protest coincided with the launch of a global petition targeting Cepheid and Danaher. The ‘Time for Five’ coalition is comprised of 150 organizations globally, including MSF, Partners in Health and Treatment Action Group.

“We’re here to demand an end to profiteering on life-saving medical tests,” said Hanna Darroll, Global Health Campaign Officer for MSF-USA. “Danaher and Cepheid benefitted from at least $252 million in public funding to develop these tests, but then they’ve turned around and are charging exorbitant prices anyway, meaning that millions of people in low- and middle-income countries can’t get properly diagnosed and offered the treatment they need to survive. Our research shows that Danaher could be charging $5 per test and still make a hefty profit, so we’re here to tell Cepheid and Danaher: it’s time for five!”

MSF published research in 2019 estimating that each GeneXpert test cartridge could be sold at a profit for $5 at the sales volumes that Cepheid and Danaher have long reached. In response to pressure mounted by the Time for Five coalition and TB activists online in September 2023, Danaher announced it would lower the price of the primary test used to diagnose TB from $10 to $8, which was an important first step. It also announced it would validate its actual cost of production annually by an internationally accredited third party and adjust its pricing accordingly, but no details on this are available yet.

According to the Global Fund, the price reduction is expected to result in annual savings of $32 million, enabling the purchase of an additional 3.6 million tests every year. This means that many more people with TB will receive timely diagnosis and treatment, and ultimately more lives will be saved. But Cepheid and Danaher continue to charge between $15 and $20 for the same type of test used to diagnose the deadliest form of TB, extensively drug-resistant TB ($15), HIV ($15), hepatitis ($15), STIs ($16-$19) and Ebola ($20). These prices are 200 per cent to 400 per cent higher than the $5 it’s estimated to cost Cepheid and Danaher to make one test.

“It’s unconscionable that Danaher is making tens of billions in revenue each year, including from GeneXpert sales, while people who need these tests to be diagnosed and started on proper treatment can’t access them because they are too expensive,” said Saloni Fruehauf, Campaign Manager for MSF’s Access Campaign. “Many of us recall what it was like during the COVID pandemic not to be able to access critical medical testing to know if we were infected, or to be able to resume work or activities, and it’s a horrible feeling. We’re calling on all our supporters and anyone who wants to put an end to this deadly profiteering to sign our petition and join our call on the corporations to do the right thing and make all of these tests $5 for low- and middle-income countries.”

GeneXpert is a critical test used for diagnosing diseases at the ‘point of care,’ meaning close to where people live and where there is often no laboratory. It is used to diagnose HIV in newborns exposed to the virus, however today, half of these infants are not tested with a WHO-recommended test such as GeneXpert. The test is also used to diagnose hepatitis C virus, which is vitally important now that there is a cure for people who are diagnosed. GeneXpert is also used to diagnose multiple STIs and Ebola. For TB and its drug-resistant forms (DR-TB), GeneXpert has been particularly groundbreaking, though still too few people have access.

“The GeneXpert tests are nothing short of revolutionary for DR-TB, as they can give you results in hours that used to take up to even three months because we had to send samples to distant regional labs and wait for them to grow the bacteria,” said Dr. Muhammad Shoaib, Medical Coordinator for MSF in Pakistan. “Not enough people have access to GeneXpert testing and the high price is a major factor – here in Pakistan, we have an estimated 15,000 cases of DR-TB annually, but only 3,500 cases were registered, which shows that there’s a big gap between the number of people who need this testing and how many actually get it. With funding for TB declining, we desperately need more affordable tests.”

62 per cent of the people with TB notified to WHO in 2022 could not access a WHO-recommended rapid molecular diagnostic test such as GeneXpert, and were instead diagnosed using either sputum microscopy, a technique more than 100 years old, or based just on assessment of clinical symptoms without any testing.

“Before coming to our clinic, an 11-year-old boy with DR-TB had been misdiagnosed and treated twice in four years, but never got healthy,” said Dr. Shoaib. “Once he came to us, we were able to give him the right test and put him on effective treatment right away, and now he has returned to school. As a doctor, it’s so important to be able to diagnose people, including kids, and offer them the right TB treatment quickly, for the sake of their own health, and also to prevent TB spreading to those people who are close to them.”