To address the public health emergency arising out of COVID-19, India Health Fund (IHF), an initiative of Tata Trusts, has designed and conceptualized multi-disease platform solutions which were earlier used for addressing TB screening and diagnosis.Further, IHF has also repurposed and adapted technologies from its current portfolio of TB and malaria to address COVID-19. IHF has also conducted a nationwide call Quest 2020 searching for innovations and novel approaches on airborne infections and is currently evaluating the path-breaking applications.The two important tools that are currently being supported for COVID-19 are TruNat Beta COV developed by Molbio Diagnostics and qXR and qScout by Qure.ai respectively. The first tool is the TrueNat Beta COV, an ICMR approved confirmatory RT-PCR test. The device is a portable, battery-operated, easy to use technology which requires minimal training and can be easily deployed in high-burden areas for point-of-care screening. Test results are available within an hour and the cost of each test is Rs 1,350. This was the second Indian made test for COVID-19 to be approved by ICMR.

“The second technology is qScout, an AI-based X-ray algorithm developed by Qure.ai, the tool allows for progression monitoring of COVID-19 positive patients who have visible lung damage due to COVID-19. The same AI enabled solution had been successful screening of TB patients and bridging gap in delayed diagnosis. Many others continue to be developed and screened, including rapid diagnostics, novel PPE equipment, infection control technologies and apps for contact tracing,” informed Jayeeta Chowdhury, programme director at IHF, Tata Trusts.

“The Government of India has been proactive in fast-tracking the regulatory approvals for novel technologies and supporting their on-ground deployment. During this crisis, multiple state governments and agencies, such as the Government of Maharashtra and the Municipal Corporation of Greater Mumbai (MCGM), among others have rapidly deployed novel, cutting-edge technologies for tackling COVID-19. This has demonstrated the need for such innovations in the health sector and should pave the way for a more structured rollout of innovative technologies in healthcare in places where they are most needed,” Chowdhury added.

The state governments of Goa and Andhra Pradesh have been first to place order of the TrueNat diagnostic platforms and other state governments are in the process of purchasing the same. The Government of Andhra Pradesh had already procured the same platform for TB tests earlier.

Talking about the recent innovations in terms of diagnostics and therapy, Chowdhury informed that there are many ongoing global efforts but given the time drug development takes, accelerating development of screening and diagnostic tool and ensuring access to screening and tests is most crucial now.

Technologies in diagnostics are Quantitative Reverse Transcription-Polymerase Chain Reaction (RT-PCR), Isothermal amplification- eg LAMP assays, Hybrid system combining PCR & advanced detection methods, CRISPER-CAS based technology, DNA sequencing based technology and Rapid tests- Antigenic tests and Serological tests (IgM/IgG antibody based)

Innovations in therapy are convalescent plasma therapy, antiviral drug remdesivir, antiviral drug favilavir, hydroxychloroquine (Plaquenil) and chloroquine (Aralen), lopinavir-ritonavir (Kaletra), oral broad-spectrum antivirals , therapeutics approved for other indications like ivermectin, tocilizumab and open source drug discovery.

Speaking about the environment in India to help adopt technologies in the interest of patient safety, she said that Government of India has created an accelerated pathway for approving healthcare innovations, and this has been improving the testing facilities for COVID-19 patients, while the need is expanding daily. The rapid approval of technologies for COVID-19 has to continue for tackling equally deadly diseases like tuberculosis.

Regulatory challenges include the turnaround time in obtaining manufacturing license, local approval for antibody test kits, obtaining marketing license to sell the kits commercially in India. Similarly procuring raw materials from outside India takes around 15 to 20 days depending on the global demand.

The Government of India has taken steps to make the environment conducive to adopt technologies for COVID-19. Its initiatives include telemedicine guidelines imports of medical equipment- exemption from customs duty and health cess, (with effect from April 9, 2020 to September 30, 2020) on import of consumables like artificial respiration or other therapeutic respiration apparatus (ventilators), face masks and surgical masks, personal protection equipment (PPE), COVID-19 testing kits and launch of Arogya Setu app.