Introduction
The tapeworm Taenia solium
The pork tapeworm Taenia solium is challenging health worldwide: 50 to 100 million cases of cysticercosis, the disease caused by T. solium eggs infection, are registered currently, more than 2/3 of the global population live in areas, where it is endemic. Symptoms affect especially the nervous system, including meningitis, convulsions, epileptic seizures, dementia and blindness. This complex is referred to as neurocysticercosis (NCC) and is probably the most preventable cause of epilepsy worldwide. The World Health Organization (WHO) estimates that “T. solium is the cause of 30% of epilepsy cases in many endemic areas where people and roaming pigs live in close proximity.” Furthermore, WHO estimates that t.solium leads to total of 2.8 million disability-adjusted life-years (DALYs). T. solium cysticercosis is found on the WHO list of Neglected Tropical Diseases (NTDs) since 2010.
The therapy of cysticercosis is easy and reliable – drugs without patent protection are available. The diagnosis is considered a problem particularly in countries with low social index, being either too expensive or not available. The development of an affordable, easy-to-use and reliable tool to detect T. solium is needed urgently. Chances are the reduction of diagnosis costs by 80%, a better targeted therapy and the improved treatment in rural areas of endemic countries.
The vision and conviction of diagnost-x
The vision of diagnost-x
It is the vision of diagnost-x to use hot spot identification and targeted treatment to curb the worldwide spread of T. solium and reveal missing epidemiological data. Furthermore, access to curing treatment is given to local people regardless their personal income or social stand. This could be the foundation for a united and social way of dealing with this NTD. By discovering insufficient health care structure and transmission pathways, preventive measurements can be established to support a sustainable, ressource-saving fight against T. solium.
The conviction of diagnost-x
Therefore, diagnost-x is going to be a social business. Social entrepreneurship is crucial in order to focus on the overall goal while working financially independent from donations and charity, especially regarding the fact that Cystericosis and Taenias are Neglected Tropical Diseases. The majority of the profite diagnost-x is going to generate will be reinvested in expansion plans and further research on the diagnostic assay. diagnost-x is commiting itself to democratic values and human dignity. Seed financial support is essential for research and development. As a social business, diagnost-x is looking for social VC fonds who commit themselves to build sustainable businesses with a positive social impact. Collaborations with local people as well as established NGOs is focused to benefit from a united community approach.
The business idea behind diagnost-x
The main idea is to produce a quick test that makes diagnosis accessible in remote regions. Even though the technology behind the test is new and innovative, it will be easy to use, without the need for professional knowledge, getting results on the spot at low costs. This will allow the identification of hotspots and thus allow for more targeted treatment and prevention and more reliable epidemiological data. A test like this easy to use and cheap test for t.solium would close a gap long identified by World Health Organization (WHO) and taeniasis/cysticercosis networks. Throughout the process of the iGEM-project, experience and know-how concerning technology and development were acquired and a worldwide network with other stakeholders in the area was established, which can serve as a good foundation for the planned social enterprise. As described above, taeniasis/cysticercosis is listed as a Neglected Tropical Disease (NTD) by the WHO and is considered as a poverty-associated illnesses. Even if the diagnosis costs were to be reduced by 80%, the affected population would not be able to afford the test or the treatment. The crucial challenge of diagnost-x will thus be reaching the target population regardless their financial and social status. We want to develop a Social Business, that strives for fiscal optimimization, that is able to sustain itself after a start-up funding and that is committed to supporting the efforts to control and eliminate cysticercosis/taeniasis. Our test will be the first step worldwide to reduce diagnosis costs by up to 80% and the first to make diagnosis possible in remote areas without access to laboratory facilities or clinical technology (which were needed for previous ways of diagnosis). The method of diagnosis will be easy to teach and learn without needing a professional training or background, and transport and storage will be made simple. Another crucial element will be awareness raising and education of the affected population concerning the dangers and adverse health effects of T.solium as well as prevention methods. Targeted social media marketing will allow us to address individuals with a higher socioeconomic status and raise awareness for the issue in their area, motivating and incentivizing them to donate money for the reduction of T.solium infections in their area (district?!). A key message should be that T. solium is a threat to every individual in affected areas and that it can be easily transmitted via lack of hygiene, food and contact with infected people.
India was chosen as the first country to target to identify hotspots, as we are already in collaboration with healthcare professionals from India and our test was developed based on T. solium RNA from India. Diagnost-x is aiming to expand their activity to other countries in Asia, as well as to the continents of Africa and South America. A prerequisite for this kind of expansion would be a period of growth enabling the social enterprise to mobilize and manage the resources needed for such a step. The financing of the social enterprise will be based on several pillars. After a short start-up finance supported by a social-venture-capital fund, we will establish financial support through existing funding opportunities by governmental and international agencies such as the European Union (accessible through partner organizations such as Cystinet), the World Health Organization and local and national governments. Additionally we will offer the identification of Hotspots and the following treatment of the infected population and their surroundings in hotspot areas as a service to governments, local authorities and to privileged individuals with an interest in a total reduction of t.solium. In order to assure a close cooperation with affected population and to take issues around culture and trust in institutions into account, we will focus on working with existing clinics and NGOs working in the respective areas.
Competitor analysis and Marketing
Market and competitor analysis
Currently used tools for diagnosis of human cysticercosis are serum-based which makes them less sensitive and specific compared to imaging techniques. Only two tests are commercialized: EITB (enzyme-linked immunoblot) and Ag-ELISA (antigen enzyme-linked immunosorbent assay). They must be transacted in laboratories and are too expensive for a grand implementation. Easy-to-use, reliable tools are still needed. Some lateral flow formats are being tested. For testing on taeniasis, microscopy is the only technique that does not require laboratory. PCR-based (nested, multiplex, RT-) are species specific in contrast to copro-Ag-ELISA. Diagnost-x is aiming to develop a lateral flow test that is cheap, easy to store, transport and use and offers a high reliability. No single tool that covers those necessities is available currently which is crucial since T. solium threatens the health of billions of people worldwide. According to the WHO, it is responsible for 30% of epilepsy cases in dense populations with pig husbandry. As we are closing a gap for many stakeholders in this area with our tests, we have received several offers of support. Cooperation with networks such as Cystinet can help us access the market by providing an existing network. Challenges such as further research and defining the epidemiological impact can be overcome with the help of such a network. Support by supervision of test development, supply of samples and other expertise are in the range of possible areas of cooperation. They can also provide a local network and facilitate the cooperation between community organization such as health centers, NGOs and officials which will support the process.
Marketing and sales
diagnost-x is going to provide a full-service hot spot identification for T. solium with a followed up deworming program, if necessary. The aim of the diagnost-x marketing strategy is based on two main goals. First, raising awareness among the local people and possible big stakeholders (e.g. NGOs, local government, WHO) for a innovative way of facing cysticercosis and taeniasis as a neglected tropical disease. Second, a cross-channel shocking campaign is used to microfinance a hot spot identification and deworming program for the targeted area. The target group for the microfinanced service are young (20-40 years old) middle or upper class people, educated or striving for an highschool or university degree, regardless their social origin, active on social media and ideally with an affinity for social responsibility. Targeted person can decide individual the amount of money they would like to invest in improving the local healthcare. To optimise conversion rate, the targeted person must realize that a T. solium infection in a part of their community can be easily transmitted by food processing and animal or human contact. Cross-channel marketing is used to address a huge amount of people within the targeted area. Regarding the fact, that India is the leading country based on number of facebook users in 2017 with a total amount of ~241 million users, social media advertising is prioritised and a suitable way to gain the targeted groups attention.