Simple malaria tests and complex challenges

Malaria, one of the world’s greatest public health challenges, kills 750,000 people annually, 90% of them children in sub-Saharan Africa. The burden of malaria can be dramatically reduced and in many cases eliminated, if all people at risk have access to accurate diagnosis and effective treatment. Although parasite-based malaria diagnosis is now a global policy, it remains inaccessible to most people who would benefit from it. Successful roll-out of universal malaria diagnosis will require a strategic mix of community engagement and improved knowledge on health-seeking behaviour, health-worker recruitment and training, sustainable management algorithms and the infrastructure to support them. These are system-wide issues, providing challenges but also huge opportunities for improvement in healthcare delivery. This work examines some of the implications of this revolution in the provision of health care. Developing such an understanding of the opportunities opened by accurate point of care diagnosis for acute disease, and the limitations, is essential to ensuring the potential for impact of these new technologies on public health is achieved. Inside Preface by Dr David Bell, FIND