Proteus partnerships bridge the ‘valley of death’ and develop point-of-care diagnostics for corneal infection
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03/07/18

Postdoctoral researcher Beth Mills explains Proteus’ partnership with the University of Liverpool and Aravind Eye Hospital in Madurai, India, to develop rapid, point-of-care diagnostics for corneal infections in resource-limited settings.


It has been well established that the health bioeconomy1 –  the environment which health-business’ are situated within to promote economic activity (including research and development platforms, manufacture, regulatory necessities, healthcare service provision, and end-user and patient experiences), suffers from an inherent incapability to capitalise on academic resources, advances, and endeavours to benefit health outcomes. I.e. either products with translatable potential are not translated, or commonly, research and prototype technologies are developed with a hypothetical end-user in mind, and in reality, are not appropriate for clinical utility or have no market appeal. This disconnect between academic research and route to commercialisation and marketplace is known as the ‘valley of death’ 2.

A diagram of Proteus technology

Proteus technology is now undergoing clinical trials.

By strategically aligning with experts from multiple academic disciplines, with clinicians, regulatory advisors and commercialisation specialists, Proteus has set itself up to successfully innovate and translate technologies in a way that is impossible for most academic groups. As if to highlight the success and uniqueness of Proteus, they are the only academic group to secure funding from CARB-X3, a prestigious world-renowned US initiative to provide business support for groups combating the antimicrobial resistance crisis.

The outpatient block of the Aravind Eye Hospital

Outside the outpatient block of AEH, Madurai, India

As Proteus goes from strength to strength, a new collaboration with Professor Rachel Williams4 at the University of Liverpool (UoL) and Aravind Eye Hospital (AEH)5 in Madurai, India, has been established to embark on a highly exciting research project to develop rapid point-of-care diagnostics for corneal infections in resource limited settings.

Current corneal infection diagnostics are invasive and require specialists.

The requirement for such technology, particularly in India, is huge. 12m of the 45m global blind live in India. The impact of blindness is devastating, leading to loss of livelihood, income and self-worth, and life-expectancy after blindness only 2.5-3 years. In particular, an estimated 8.8 million people in India suffer corneal blindness in at least one eye, with 40 % of those contracting blindness under the age of 15. Moreover 95% of blindness is estimated to be avoidable with correct diagnosis/treatment strategies6. However quick, cheap and easy-to-use diagnostics are lacking where they are most needed, therefore the potential impact of succeeding with this frugal innovation is enormous.

The ambition of this project would be impossible to realise without the partnerships we have in place, each bringing their own expertise, experiences and local knowledge. They are essential to develop technology that will be applicable to the needs and requirements of the end user, enabling rapid translation, and transcending the all-too-familiar ‘valley of death’, and positively impact the bioeconomy.

Innovative, high throughout, 4-patient tandem cataract surgery, developed at AEH.

Aravind Eye Hospital is a giant in the eyecare world. It opened in 1976 with 11-beds and it is now the largest and most productive eye care centre in the world. Throughout this rapid expansion, they have never lost sight of their primary objective to eradicate needless blindness and to provide the highest quality of eyecare, with dignity, to anyone who needs it. To achieve this goal, they have innovated strongly, revolutionising surgical procedures and instigated village screening camps. They have developed a world-renowned business model7, and brought production of medical instruments, devices and pharmaceuticals in-house to their manufacturing facility, Aurolabs, to ensure cost-effectiveness. The entirety of their business is not-for-profit, they are fully self-sustaining, and provide free, or heavily subsidised care to over half of their patients.

The many branches of the Aravind Eye Hospital, each positively impacting the bioeconomy.

The scale and efficiency of Aravind and Aurolabs8 is staggering. In 2016, AEH performed 4m outpatient examinations and 500,000 surgeries, of which half were free to the patient. Incredibly, 70-80 village clinics are held per week, enabling 75-80 % of people in need to engage with care, compared to just 7 % without the clinics. This unprecedented access to the rural community, who are most at risk of corneal trauma and infection will be key to ensuring our diagnostic devices are fit-for-purpose and available in the areas where they are most needed.

Entrance to Aurolab and their corporate social responsibility pledge.

Aravind also share their strategies to try to improve healthcare and the bioeconomy world-wide, through the Lions Aravind Institute of Community Ophthalmology (LAICO)9. The AEH model has been adapted and implemented in over 300 hospitals worldwide in over 50 countries, and has even been highlighted in the New York Times10. Aurolabs now export their products to over 140 countries and have 8 % of the global market share for ocular lenses. I highly recommend viewing of this YouTube video to see the impact AEH has had to local and global community:

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How does Aravind practice love, kindness and compassion in its daily work? This documentary while attempting to answer this question uncovers ‘The Aravind Way’ of doing things.  Video credit: Aravind Eye Care System, 2016.

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Ramesh, an Aravind microbiologist

Ramesh, a microbiologist at AEH.

I had the absolute honour and pleasure of spending the last week visiting AEH to begin the collaboration and to experience everything they have to offer. My short time at Aravind was invaluable and taught me that spending time physically co-located is essential for understanding the nuances in expectations, passing on protocols, testing technology together, and establishing what is truly feasible in resource-limited settings. The tacit knowledge transferred both-ways between myself and the microbiologists and clinicians at Aravind are invaluable to determining a work-flow moving forwards.

Beth Mills with 4 members of the Aravind Eye Hospital team

Myself and the microbiology team at Aravind

I was overwhelmed on my visit by the passion to innovate at AEH. The need for new diagnostics is paramount, and this collaboration moves Proteus, UoL and AEH in a new and exciting direction, drawing on the strengths and expertise of one another. If successful we will be poised to transform patient care-pathways, improving patient outcomes, contributing further to the global health bioeconomy.