In conversation with OmniVis: Rapid cholera testing in Kenya and Bangladesh

It is estimated that each year there are 1.3 to 4 million cases of cholera worldwide and close to 143,000 deaths. In 2017, this number catapulted when over 1 million individuals were infected in Yemen as the country underwent political and military crisis. A lower priority in fragile and conflict impacted areas, cholera is a disease best prevented rather than treated. It is this understanding that is a driving force behind OmniVis’ innovative handheld testing device.

Since 2019, OmniVis has been a part of the GSMA Mobile for Humanitarian (M4H) Innovation Fund portfolio, using grant funding to roll out beta testing of their handheld cholera detection device in Kenya and Bangladesh. The OmniVis cholera detection platform consists of a mobile phone-based application, a hardware platform and a disposable test chip. All three pieces work seamlessly together to detect cholera bacteria in a water sample in under 30 minutes, with 99 per cent accuracy.

By reducing the amount of time it takes to test a water sample for cholera, and allowing that information to be uploaded to a database, OmniVis believes they can fix the three major problems surrounding cholera detection: cost, time and data visibility. Currently, the database is hosted and available to OmniVis beta-testing partners, but the intention is to expand this to be in line with ministry of health codes in countries of implementation and be available for users to check water sources near them before consumption or use. The OmniVis mobile-enabled detection device aims to democratise cholera testing in the future, by taking testing out of a lab and placing it into the hands of end-users.

While cholera can infect anyone, it does not impact everyone equally. Much like the COVID-19 pandemic that has further highlighted deep inequalities in our societies, the underserved, marginalised and vulnerable populations of the world are the least likely to have access to potable water and therefore the most likely to be deeply impacted by cholera. Regular water testing can significantly lower or prevent human contraction of cholera, which means time, energy, and resources spent quelling an outbreak can be spent elsewhere.

Tracking and understanding cholera is the first step to getting rid of it globally, yet it remains a secondary issue in most humanitarian settings. I was able to sit down with Katherine Clayton, Co-Founder & CEO of OmniVis, to discuss the GSMA project in more detail and understand their motivations, their hopes for the project and how they see their impact in the humanitarian space.

How has the COVID-19 pandemic impacted work around cholera?

During the COVID-19 pandemic, I believe the general population has realised the importance of diagnostics, and self-administered tests. Unfortunately, R&D on diagnostics and distribution of medical care has disproportionately addressed COVID-19 in high-income countries, whilst low- and middle-income countries (LMICs) and other diseases like cholera, have been left behind. The redistribution of resources and healthcare focus leaves nations at risk for further cholera outbreaks. Since cholera and COVID-19 are both spread through a lack of access to clean water and sanitation, in the long run eliminating cholera would also lead to lower spread of COVID-19 through increased hand washing and water handling. In fact, according to the International Rescue Committee, there has been a spike in cholera cases during the COVID-19 pandemic. Firstly because those in confined areas oftentimes are in close proximity without access to clean water and sanitation, conditions that are perfect breeding grounds for cholera and COVID-19. Secondly because COVID-19 has caused disruption for those who do disease diagnosis in these affected communities.

I hope there is a shift soon to work on these other diseases due to a newfound understanding on the importance of detection and monitoring by the general population.

What do you see, or hope to see, as the result of putting testing into the hands of the individual?

Building on the understanding brought about by COVID-19 that individual, accessible and accurate testing is vital to the general public, our handheld cholera device is even more relevant than before. The ability to know more about our health and our bodies provides a sense of empowerment. I hope that by making more accessible diagnostics, particularly focused on detecting difficult but highly prevalent diseases, we can enable communities, laboratories, and/or governmental agencies to act more immediately. I also believe that early and more accessible diagnostics or pathogen detection platforms allows people to seek earlier treatment and better prepare for environmental factors that may cause illness. Additionally, more detection means the ability to better develop more accurate epidemiological models – which could lead to more efficient medical supplies management to areas in most need before disease spread is uncontrollable.

How do you navigate differences in language and cultural understandings when creating the user interface for your device?

Co-creation is the best way to navigate language or cultural understandings. By developing devices and working with end users to understand any hang ups in the device or device design, and listening to preferences in ergonomics, user interface, colours, or symbolism, we can better navigate designing a device with better user uptake. We oftentimes work with people who are non-English speakers to determine how usable our device truly is. Where we see issues occur, we investigate alternatives by asking questions, iterating, and testing our interface again.

What do you see as the role of a mobile-network operator (MNO) in engaging with OmniVis and your devices?

Since 2010, with the Haiti earthquake, MNOs have been heroes in disasters, humanitarian crises, and epidemics (and pandemics, now!). We believe that by working with MNOs, we can reach community members with near real-time information of cholera presence in community water sources and provide messaging on what water to avoid as well as actions and next steps to access safe water. Therefore, MNOs can continue to play a huge role with their customers and OmniVis can create an ecosystem around cholera detection, safe water, and community well-being.

What do you see in terms of opportunities for scaling and the long-term future of this project?

Cholera is in ~52 countries worldwide, and not going away any time soon, unfortunately.  We’ve designed this as a solution to scale, both in availability and regional application. Because the hardware device itself is a one-time cost, and the test kits are a cheap and mass-manufacturable component, we want to pursue providing this to national health services, major INGO’s and even community-based organisations who serve populations impacted by cholera. Providing cutting edge technology at an affordable price that allows testing to occur outside a lab really speaks to our desire to scale, have global impact, and to democratise cholera prevention. Additionally, our product is a platform technology. What this means is that we can develop other disposables that target different infectious diseases, a need that has been highlighted as a reality in the past few years. Therefore, with product-market fit and capital to develop new product lines, we can scale OmniVis to test for new diseases of interest.

Next steps

Currently, with M4H grant funding, OmniVis is providing this solution to two on-the-ground partners in Kenya and Bangladesh who are rolling out testing with trained field workers as proof of concept, usability, and efficacy. As OmniVis continue this work, their aim is to get the innovative solution into use by more organisations, increasing the amount of information hosted on their database and increasingly provide access to the database to individuals. Because the solution requires a smartphone to use, OmniVis are focusing on digital accessibility through access to the database, as alerts could be provided through geographically targeted SMS. 

OmniVis is in the final stages of their M4H grant project, and we look forward to hearing more from the team, and sharing lessons from the project so far in the near future.

To learn more about the M4H Innovation Fund, please visit our interactive map, or view the M4H Innovation Fund Portfolio (2017-2022). For more information about OmniVis or to discuss the project in more detail, please reach out to Lauren Pires.

This initiative is currently funded by the UK Foreign, Commonwealth & Development Office (FCDO), and supported by the GSMA and its members.
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