Companies support diagnostic capacity to safeguard medicines against drug resistance

To treat an infection effectively, the cause must first be identified. Diagnostics are the tools, tests and technologies used for this purpose – to determine the type of infection, identify the pathogens responsible and assess whether antibiotics are needed and which ones are most likely to work.  

Nearly half of the global population (47%) have little to no access to essential diagnostics, a challenge that is particularly acute in low- and middle-income countries (LMICs).* Without these tools, patients in these countries may never receive the right treatments and/or could end up using antibiotics inappropriately, driving the spread of antimicrobial resistance (AMR). 

For powerful, last-resort antibiotics and newer, innovative treatments that are vital in the fight against AMR, proper diagnostic capacity is crucial. Access to these drugs can be lifesaving, yet they often come with strict usage guidelines and should not be prescribed without appropriate testing, as improper use risks diminishing their effectiveness. 

Because some LMICs lack diagnostic capacity, pharmaceutical companies can be hesitant to supply certain antibiotics in these markets, knowing that the necessary diagnostic tests to guide proper use are unavailable. While this cautious approach is intended to preserve the effectiveness of medicines, it can inadvertently deny patients access to lifesaving treatments, putting vulnerable populations at risk. 

_{^{* Fleming KA, Horton S, Wilson ML, et al. The Lancet Commission on diagnostics: transforming access to diagnostics. The Lancet. 2021;398(10315):1997-2050.}} 

By supporting diagnostic capacity in LMICs, Cipla, Johnson & Johnson, Otsuka and Pfizer aim to ensure patients are prescribed the right antibiotics in a timely manner, promoting the responsible use of these medicines.

From training to supplies: How companies are supporting better diagnostics 

Four companies – Cipla, Johnson & Johnson, Otsuka and Pfizer – demonstrate Best Practice in supporting diagnostic capacity in LMICs. Their actions aim to ensure patients are prescribed the right antibiotics in a timely manner, promoting the responsible use of these medicines. 

In India, Cipla provides sensitivity discs and E-strips directly to hospitals to help doctors appropriately prescribe and use ceftazidime-avibactam. This is a powerful, last-resort antibiotic recommended as first-line treatment for severe infections caused by multidrug-resistant (MDR) gram-negative bacteria. Having access to these susceptibility tests allows healthcare professionals (HCPs) to determine whether the bacteria is susceptible or resistant to the antibiotic. Cipla also extends this initiative to two on-patent antibacterial medicines in its portfolio – cefepime-enmetazobactam (Cipenmet®; Esblocip®) and plazomicin (Zemdri®) – by providing hospitals with the corresponding sensitivity discs and E-strips for these products as well. 

Johnson & Johnson is working to train more than 100,000 community healthcare workers in underserved regions of India where there are high rates of underdiagnosed tuberculosis (TB) – including Delhi, Hyderabad and Pune – to accelerate early diagnosis and address the persistent underdiagnosis of TB in the country. This initiative builds on a pilot that took place in 2024 in partnership with the Johnson & Johnson Foundation, the National TB Elimination Programme, PATH, and TB Alert India. 

In more than 50 countries, Otsuka gives laboratories the pure delamanid compound for free so they can test how Mycobacterium tuberculosis bacteria respond to it. Delamanid is the active ingredient used in medicines that treat MDR-TB. These tests help determine whether the bacteria are susceptible or resistant to delamanid and therefore whether the drug is likely to be effective for treatment. In addition, Otsuka is collaborating with diagnostic companies to accelerate the development of delamanid drug susceptibility testing kits, which have reached the late stages of development ahead of production. 

Between 2022 and 2025, Pfizer worked with around 30 hospitals in Colombia through the “Genomic Programme” – an epidemiological monitoring initiative that supported the in vitro screening of ceftazidime-avibactam (Zavicefta®). The programme, which ended in March 2025, helped hospital laboratories test bacteria against ceftazidime-avibactam – an antibiotic used to treat serious gram-negative bacterial infections – to see whether the bacteria were susceptible or resistant. By improving the speed and accuracy of lab results, the programme enabled HCPs to diagnose serious gram-negative infections more quickly and ensure that patients received the most effective antibiotic as early as possible.  

Examples highlight how companies can step up to protect antibiotic efficacy 

These examples demonstrate how Cipla, Johnson & Johnson, Otsuka and Pfizer are engaging in efforts to ensure their products are being used responsibly. By equipping local hospitals and laboratories with diagnostic tools and supporting HCP training, these companies are helping support more timely and appropriate treatment decisions for patients. Such steps not only protect patient health but also help curb AMR by preserving the effectiveness of vital antibiotics. 

Although building or strengthening diagnostic capacity is not a core responsibility of pharmaceutical companies – and health systems cannot rely on them to provide such support in the long term – initiatives like these could help countries with limited resources in the years following a product’s approval, when diagnostic access is still limited. Companies with powerful, last-resort antibiotics and innovative treatments with stringent usage guidelines could adopt similar approaches when expanding access to their products in LMICs. Doing so would allow patients currently facing drug-resistant infections to benefit from these much-needed treatments, while promoting their responsible use, preserving their long-term effectiveness and contributing to broader stewardship efforts.