Longitude Prize – technologies that rise to the challenge of resistance, by Roger Highfield

Written by Longitude Prize Team

Three centuries ago, the original Longitude prize helped us to conquer the world. Today the £10 million descendant of that historic award aims to prevent antibiotic resistant microorganisms from conquering humankind.

That is why it is a relief as much as a thrill to receive the first crop of entries for the world’s most inspirational award for innovation.

The evolution of superbugs is now threatening to make antibiotics ineffective and senior public health officials now talk of a “catastrophic threat”, one comparable to that of climate change. Drug-resistant infections could kill an extra 10 million people across the world every year by 2050 if they are not tackled, according to the Review on Antimicrobial Resistance, published in December 2014.

Originally announced by the Prime Minister in 2013, the 21st century Longitude Prize was developed by Nesta, the UK’s innovation foundation, with funding partner Innovate UK, and then subjected to a vote to find the most pressing problem, with the help of the BBC.

The winning challenge is focused on one striking part of the problem of microbial resistance: we are still unable to distinguish bacterial from viral infections, or the type of bacteria, which has caused the overuse of antibiotics and the evolution of multidrug-resistant superbugs.

The aim of the new Longitude Prize is to create a cheap, accurate, rapid, and easy-to-use test for bacterial infections that will allow doctors and nurses to better target their treatments, administering the right antibiotics at the right time.

The entries will be sifted by the Prize Advisory Panel, which contains a remarkable array of distinguished individuals, from Professor Dame Sally Davies, Chief Medical Officer, to the Director of the London School of Hygiene and Tropical Medicine, Professor Peter Piot, who co-discovered Ebola in 1976, and Prof David Heymann, Chair of the Public Health England Board.

More details of these entries will emerge in time but, until then, the Longitude Committee has come up with a list of the kinds of approaches that they expect to see.

To coincide with the Longitude Prize, the Science Museum organised a display on the rise of antibiotic resistance and hosted the Longitude Lounge

Vital functions can already be monitored with wearable and implantable devices. Perhaps they can be adapted to detect infection and relay the results to doctors in real time. Most speculative of all, perhaps they could be miniaturised to the point where they can patrol the body too – not exactly nanobots but certainly a little nod in that direction.

Then there is a ‘Tricorder’ style approach first seen in Star Trek. Hand-held scanners are already being developed to image blood vessels, study blood chemistry and so on, relying on laser beams to peer painlessly below the skin and through muscle and bone to see body structures. These approaches could be customised to analyse a range of vital signs, or reveal a tell-tale immune signature, to establish if a superbug infection is present.

A desktop diagnostic lab that could sit on the desk of a general practitioner is another approach. However, given the processing power in a modern smart phone, a plug in attachment could be developed to utilise an immunoassay, based on a patient’s urine or saliva, to identify up to 10 common infections.

My favourite is an apparently low tech approach, consisting of a lollipop test for “strep” throat. Although many of us complain about this, most sore throats actually are caused by a virus, not streptococcus bacteria, and shouldn’t be treated with antibiotics.

In the United States, for example, some 15 million people see the doctor for a sore throat every year and up to 70 percent of them receive antibiotics, although only a relatively small percentage actually have strep throat: approximately 20 to 30 percent of children and some  5 to 15 percent of adults.

What is needed is a simple, cheap, rapid and accurate test for strep bacteria: clever, robust diagnostic chemistry that does not need refrigeration, that could be put into a lollipop to change colour within a few seconds, say from green to red, but only when exposed to streptococcus. Good for kids but nice for adults too.

Even though we have already received some entries, I know we will get more. Every four months for the next five years we will continue to review submissions until the grand prize is won.  The winner, which will probably be announced by 2020, could be a lone inventor but I suspect is most likely to be the product of many different minds, in many countries, using many technologies.

Whoever wins, the spur remains the same as when the original prize was launched. It is not the money, though £10 million is a considerable sum. Nor is it the glory of being the first or even the most creative. It will be the satisfaction of helping this generation and the next deal with a threat that, as the Prime Minister put it, threatens to send us back ‘into the dark ages of medicine”.

Roger Highfield, Director of External Affairs of the Science Museum, is a member of the Longitude Committee.