Longitude Prize on AMR

A case study

At a glance

Antimicrobial resistance (AMR) is a growing global health crisis. The Longitude Prize on AMR, designed and delivered by Nesta’s Challenge Works, was launched to incentivise the creation of a new diagnostic test that could, in a matter of minutes, identify whether an infection is bacterial, and if so, the right antibiotic to prescribe to slow the spread of antibiotic-resistant infections, which kill more than a million people every year.

After 10 years of development, the £8 million Longitude Prize on AMR was awarded to international team Sysmex Astrego for the PA-100 AST System in summer 2024.

The challenge

Antibiotic resistance is accelerated by the overuse and misuse of antibiotics. Already, antibiotic-resistant infections kill over a million people a year, and it’s predicted that by 2050 this figure will rise to 10 million annually, matching the death toll from cancer.

Urinary tract infections (UTIs) are the most common bacterial infections treated by the NHS in England. Existing diagnostic methods for it are slow, leading to the over-prescription of antibiotics as doctors were forced to treat patients ‘just in case’.

When the Longitude Prize on AMR was launched, there was a significant lack of momentum and investment in tackling this critical issue.

What we did

In 2014, Challenge Works designed and delivered the £8 million Longitude Prize on AMR. The prize was designed to act as a catalyst, creating a powerful 'pull' to incentivise innovators to develop a rapid, accurate diagnostic test.

The ambition was to attract the world’s brightest minds to create a solution that could quickly identify bacterial infections and prescribe the correct antibiotic, thereby slowing the spread of resistance and revolutionising healthcare.

The impact

Over the course of the decade-long competition, the prize successfully mobilised hundreds of teams in more than 40 countries, leading to a wide range of innovations, many of which are now close to market. The process highlighted the power of challenge prizes in focusing innovation on complex problems. The winning innovation, Sysmex Astrego’s PA-100 AST System, could identify a bacterial infection from a small urine sample in just 15 minutes and, critically, identify the correct antibiotic within 45 minutes. Enabling doctors to accurately diagnose infections and prescribe the right treatment in under an hour is a dramatic improvement over the three days it currently takes to get a diagnosis for a UTI and has the potential to end the ‘just in case’ prescribing of antibiotics that currently promotes drug resistance.

The success of the Longitude Prize on AMR is a significant step forward for the fight against antimicrobial resistance. The prize has not only fostered innovation but has also created a legacy of successful businesses and a new generation of point-of-care diagnostics. This progress is expected to lead to a global healthcare revolution, where patients receive fast and accurate treatment, safeguarding the future effectiveness of our medicines.

What we learnt

Challenge prizes as a catalyst

The Longitude Prize on AMR inspired new partnerships and collaborations across disciplines, leading to the formation of new businesses equipped to tackle the challenge of AMR, as a complex, under-invested problem. This has in turn led to the development of several diagnostics for a range of infections, many of which are nearing the market. One such example is a team at the University of South Wales who won a grant from the prize to kick-start their UTI diagnostic project, later raising private investment and spinning out as Llusern Scientific, a social enterprise that has since developed a number of diagnostics that are either on or close to market.

One of the key learnings from the Longitude Prize on AMR was that its fully open, ‘first past the post’ design - without stage gates - encouraged a large and diverse field of innovators to participate throughout the prize. While this approach generated broad engagement and creative ideas, it also revealed the challenges of sustaining momentum and supporting teams to progress from early-stage innovation to viable, market-ready solutions throughout the duration of the prize. These insights have informed the evolution of Challenge Works’ prize method, which now uses a stage-gated structure to provide a clear pathway for progression with targeted support for teams as they advance through the competition.

Set a clear, ambitious target

By defining a clear goal - a rapid diagnostic test to detect bacterial infections and support more targeted use of antibiotics - the prize focused innovators' efforts and provided a benchmark for success. This was crucial for attracting the right talent and driving breakthrough results.

Focus on the end user

The prize's criteria were not just about driving technological breakthroughs. Critically, they also focused on the applicability of solutions to real-world contexts - how durable they were and easy-to-use by healthcare professionals with minimal training. By focusing on rapid and accurate diagnosis, the winning innovation can prevent the unnecessary and untargeted use of antibiotics, helping to preserve life-saving antibiotics for generations to come.

Challenge prizes as a catalyst

The Longitude Prize on AMR inspired new partnerships and collaborations across disciplines, leading to the formation of new businesses equipped to tackle the challenge of AMR, as a complex, under-invested problem. This has in turn led to the development of several diagnostics for a range of infections, many of which are nearing the market. One such example is a team at the University of South Wales who won a grant from the prize to kick-start their UTI diagnostic project, later raising private investment and spinning out as Llusern Scientific, a social enterprise that has since developed a number of diagnostics that are either on or close to market.

One of the key learnings from the Longitude Prize on AMR was that its fully open, ‘first past the post’ design - without stage gates - encouraged a large and diverse field of innovators to participate throughout the prize. While this approach generated broad engagement and creative ideas, it also revealed the challenges of sustaining momentum and supporting teams to progress from early-stage innovation to viable, market-ready solutions throughout the duration of the prize. These insights have informed the evolution of Challenge Works’ prize method, which now uses a stage-gated structure to provide a clear pathway for progression with targeted support for teams as they advance through the competition.

Set a clear, ambitious target

By defining a clear goal - a rapid diagnostic test to detect bacterial infections and support more targeted use of antibiotics - the prize focused innovators' efforts and provided a benchmark for success. This was crucial for attracting the right talent and driving breakthrough results.

Focus on the end user

The prize's criteria were not just about driving technological breakthroughs. Critically, they also focused on the applicability of solutions to real-world contexts - how durable they were and easy-to-use by healthcare professionals with minimal training. By focusing on rapid and accurate diagnosis, the winning innovation can prevent the unnecessary and untargeted use of antibiotics, helping to preserve life-saving antibiotics for generations to come.