“Unlike some countries, we didn’t go into this crisis with a huge diagnostics industry. We have the best scientific labs in the world, but we did not have the scale,” Matt Hancock said this week, facing a barrage of questions on why the UK is lagging behind others on coronavirus testing.
The UK’s health secretary said his German counterpart could call on 100 test labs and rely on the heavy presence of Roche, one of the world’s largest diagnostics companies, to achieve its current level of more than 50,000 tests a day. The UK had had to build from a lower base, he said.
Industry players say this is a fair characterisation. “We have a lot of diagnostics capability in this country but what we don’t have is the global diagnostics giants,” said Tony Cooke of Cambridge Clinical Laboratories. “Even when we have our own companies, a lot of the supplies are coming from the US or Germany.”
The UK is not alone in struggling to meet demand. France has carried out even fewer tests than the UK, and Spain tried to bridge supply chain issues by buying millions of test kits from China that later had to be withdrawn after giving flawed results.
As well as Roche, which has developed a single machine that can churn out 1,000 test results a day, Germany also has Qiagen, a major supplier of genetic testing kits, which are being used to diagnose Covid-19. Both companies also produce reagents and components used in kits put together by other manufacturers. The US has called on Abbott, Thermofisher, Quest Diagnostics and Hologic.
The more distributed hospital lab system in countries such as Germany and Italy has also served them well in being able to increase testing for Covid-19. The NHS has spent years centralising its testing labs, which under normal circumstances was both economical and clinically robust. It has allowed labs to be aligned to standard diagnostic criteria and to use the same test kits, reagents and equipment from the same suppliers, allowing bulk purchases from single suppliers at a competitive price.
During a pandemic, however, this dependency on a handful of non-domestic suppliers, such as Roche, for kits and reagents becomes a fundamental flaw.
Allan Wilson, the president of the Institute of Biomedical Science, says the UK could have done a better job of surveying its diagnostic landscape and built a strategy around existing strengths, which include having a large number of research labs and smaller, but highly innovative diagnostics companies.
The re-engineering of HIV testing machines into 90-minute Covid-19 tests by Diagnostics for the Real World in Cambridge, which within a week will meet the entire testing requirements of Addenbrookes hospital in the city, is an example of the type of approach that could have been encouraged nationally.
“We were slow to make that decision in testing and we approached it in too narrow a perspective,” said Wilson. “We’re doing it regional locally, people forming and forging partnership arrangements, looking for support from universities and commercial companies.”
Industry figures say that more could be done in future to nurture some of these startups and medium-sized companies into home-grown giants.
There is a record to show that innovative businesses started in the UK have this potential, but that beyond a certain level of success the companies tend to migrate to the US where venture capital and buyers are in more ready supply.
Medisense, which was spun out of Oxford University in the 1990s, revolutionised the blood glucose sensing industry in the 1990s, then was acquired by the US company Abbott. Solexa, a genetic sequencing company spun out of Cambridge, was acquired by Illumina in the US for about $650m in 2007 and is now worth about $40bn.
Gordon Sanghera, the chief executive of the sequencing and diagnostics company Oxford Nanopore, whose technology was used to characterise the very first example of the coronavirus in Wuhan, said Hancock’s acknowledgement of the need to nurture a domestic industry was welcome and should not be forgotten after the crisis has passed.
“Hancock’s declaration that the UK needs a new diagnostic industry is right, and we have plenty of seeds,” he said. “It’s the collaboration with the broader scientific community, and looking at access to capital for UK companies, that will make those seeds grow and bear fruit that helps people not only in the UK, but all around the world.”