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A controversy has broken out over a diagnostic for tuberculosis that, until recently, had been subsidized by the World Health Organization — the latest flare-up over access to a medical product in mostly poor countries.

At issue is a TB test developed by Cepheid, which reached a 10-year deal with the WHO in August 2012 to supply its GeneXpert diagnostic to dozens of low- and middle-income countries. In exchange for $11.1 million, which was provided by the WHO and others, the company agreed to supply its test for $9.98 per cartridge, a reduction from the previous price tag of $16.86.

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For the most part, the deal appeared to work well. The 130 countries covered by the agreement accounted for more than 99% of locations worldwide where TB is a public health issue. And by 2020, nearly 46 million cartridges — which can deliver results in hours instead of days or weeks, like older tests — had been delivered at the lower price.

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