King's College London

Research portal

Global health, accelerated: Rapid diagnostics and the fragile solidarities of ‘emergency R&D’

Research output: Contribution to journalArticlepeer-review

Ann H. Kelly, Javier Lezaun, Alice Street

Original languageEnglish
Pages (from-to)187-210
Number of pages24
Issue number2
Accepted/In press2022
Published28 Feb 2022

Bibliographical note

Funding Information: Research for this paper was supported by the European Research Council under the European Union’s Horizon 2020 research and innovation programme [grant agreement number: 715450], the Wellcome Trust [Award grant number 204939/Z/16/Z], and a Newton Fund Institutional Links award [grant number 280969145] funded by the Department for Business Energy & Industrial Strategy and the Fundação Oswaldo Cruz, and delivered by the British Council. We would like to thank our many collaborators for their contributions to the wider research projects on which this paper has drawn, including Rashid Ansumana, Imogen Bevan, Momoh Gbetuwa, Mohamed Boie Jalloh, Koichi Kameda, Ilana Löwy, Gustavo Matta, Mohammed Hashim Rogers and Eva Vernooij. Any errors or omissions are the sole responsibility of the authors. We are also grateful to our reviewers, whose close reading and astute comments helped sharpen our argument. Publisher Copyright: © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

King's Authors


A new paradigm of emergency R&D has transformed global health. Beginning with the 2014–2016 Ebola virus disease epidemic in West Africa, experimental product development has been propelled to the frontlines of outbreak response, radically compressing timelines and unsettling regulatory standards, biosecurity strategies and humanitarian protocols. This paper examines these emerging epistemic practices and ethical norms as they played out in the creation of rapid diagnostic tests for Ebola, Zika and COVID-19. In each of these viral public health crises, new platforms for quick detection have been the principal load-bearing pillar of outbreak response, and the effort to speed up their development illuminates the fragile set of accommodations between public health needs and commercial interests that obtain under conditions of emergency. The World Health Organization’s role in stimulating and coordinating the development of these tools provides our analytical through-line, and reveals, we argue, the limitations of an accelerationist model of global health innovation organized around the concept of ‘market failure’. The evolution of this paradigm of ‘emergency R&D’ into a permanent feature of pandemic preparedness will further narrow our imagination of how global health goods should be construed and provided.

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454