What is the name of your organization?
William J Clinton Foundation
What is the name of your solution?
RAPID-MP
Provide a one-line summary or tagline for your solution.
Rapid Antibiotic PAD-based Inspection & Detection in Madhya Pradesh
In what city, town, or region is your solution team headquartered?
Bhopal, Madhya Pradesh, India
In what country is your solution team headquartered?
India
What type of organization is your solution team?
Nonprofit
Film your elevator pitch.
What specific problem are you solving?
Antimicrobial Resistance (AMR) is a critical public health threat in Madhya Pradesh (MP), India, home to 72 million people. A key factor driving AMR is the widespread use of substandard and falsified antibiotics (https://onehealthtrust.org/wp-content/uploads/2019/04/access-barriers-to-antibiotics.pdf). These poor-quality medicines often deliver doses too low to be effective, leading to treatment failures, longer illnesses, and helping infections become resistant. According to WHO estimates, over 10% of antibiotics in low- and middle-income countries (LMICs) are substandard or falsified. Estimates from a survey in India found up to 39% of antimicrobial agents fail quality standards (https://tinyurl.com/rvfhw9sy;https://doi.org/10.4103/ijmr.ijmr_331_18). Instances of severely substandard and falsified antibiotics have been documented in MP, highlighting the urgency of the issue. The private healthcare sector, often the first point-of-care, is especially vulnerable due to weaker regulatory oversight.
This problem is compounded by India's limited drug-testing infrastructure – a challenge mirrored in MP. Current testing relies heavily on centralized labs, requiring expensive equipment, trained staff, and costly, slow sample transportation, limiting testing capacity and hindering timely detection and regulatory responses (https://doi.org/10.1371/journal.pone.0289865). At present, no affordable or easy-to-use screening tools exist at the point of care(https://doi.org/10.1117/12.2044776).
What is your solution?
We propose to introduce Paper Analytical Devices (PADs) (https://doi.org/10.1117/12.2044776) as a frontline screening tool in 20 districts of MP to rapidly detect falsified and severely substandard antibiotics in the private sector. PADs are small, portable test cards that quickly assess whether a medicine tablet contains the correct active ingredients. They are produced by wax printing on Ahlstrom 319 paper, a fast chromatography paper that creates separate reaction lanes and contains trace quantities of chemical reagents to produce distinctive color changes based on pharmaceutical content. PAD tests require no electricity, chemicals, solvents, or sophisticated laboratory equipment, making them particularly suited for low-resource settings. Results are interpreted using the PADreader, a mobile phone application that employs image analysis and neural network-based algorithms to accurately classify test outcomes as "pass" or "fail."
In this project, we will equip government drug inspectors in 20 MP districts with 1,000 PADs each, to screen 20 priority antibiotics known to yield highly reliable results with PADs. Flagged samples will undergo confirmatory testing through existing government laboratory systems. We will also provide analytical, decision-making, and policy support to MP’s Food and Drug Administration (FDA), demonstrating the operational feasibility and scalability of our approach.
Who does your solution serve, and in what ways will the solution impact their lives?
Our solution addresses the needs of multiple stakeholders impacted by substandard and falsified antibiotics in MP, particularly in rural and underserved communities, who are most at risk of receiving such drugs. By providing a low-cost, point-of-care testing tool - PADs, we will enable real-time screening for quality of antibiotics, ensuring that falsified or severely substandard drugs are identified and removed early from circulation—before they can contribute significantly to treatment failures, prolonged infections, or acceleration of AMR. This directly benefits patients by ensuring they receive effective treatment, and by reducing the risk of complications.
Drug Inspectors will benefit as they will be empowered to detect poor-quality antibiotics, allowing them take immediate action to protect the community they are serving. Meanwhile, pharmacies and manufacturers will benefit from the timely feedback on drug quality, empowering them to correct production or distribution challenges and maintain rigorous vigilance over their supplies.
Finally, public health administrators and state drug regulatory authorities will gain critical, field-based insights on antibiotic quality to support decision-making, and strengthen enforcement efforts – contributing to the control of AMR in the state. Additionally, policymakers will receive evidence to expand this model, improving drug quality surveillance at the last mile.
