Point-of-care diagnostic devices are increasingly recognised as critical to meeting global health priorities. A new generation of rapid devices that detect the presence of pathogens and biomarkers in a drop of fluid, open up the possibility of laboratory quality testing reaching under-resourced settings. These devices raise anthropological questions about the contribution of ‘standalone’ technologies to health systems strengthening, the values that are embedded in technological devices, the kinds of knowledge generated by diagnostic technologies, and the social and political relationships entailed in global health innovation.
The DIADEV project, Investigating the Design and Use of Diagnostic Devices in Global Health, addressed these questions through multiple case studies and device ‘biographies’ developed across contexts of disease ‘elimination’, ‘emergency’ epidemic response and routine care ‘integration’. The project developed a common methodological and theoretical framework for exploring the social, cultural and technical processes involved in developing, deploying and using diagnostic devices in resource-limited settings.
DIADEV had two main objectives.
1. To examine how changing relationships of power between governments, donors, and
businesses in global health shape the design and use of diagnostic devices
2. To investigate how diagnostic devices are transforming health systems in resource-poor
Settings
DIADEV helped establish the social study of medical testing as a sub-field that cuts across the disciplines of medical anthropology, science and technology studies and human geography. Through the development of a comparative biographical approach, the project extended studies of medical testing beyond the context of use, to understand the full life-cycle of diagnostic innovation, use and discard as a process of value contestation and generation. Through the establishment of a substantial body of results and publications, the project was able to identify several important lessons for global health policy, including the finding that the current global health innovation ecosystem perpetuates inequalities and often fails to strengthen health systems, and that the prioritisation of access as a value driving the design of technological solutions contributes to global plastic pollution.
