Published 7 July 2009, doi:10.1136/bmj.b2606
Cite this as: BMJ 2009;339:b2606

Analysis

Access to antimalarial therapy: accurate diagnosis is essential to achieving long term goals

¹ Foundation for Innovative New Diagnostics (FIND), Kampala, Uganda, ² World Health Organization—Regional Office for the Western Pacific

Increased attention to and funding for malaria promises to improve access to effective treatment, but Heidi Hopkins, Caroline Asiimwe, and David Bell argue that without diagnostic testing much of this effort will be wasted

The first 150 words of the full text of this article appear below.

Health care in malaria endemic areas of Africa is at a crucial tipping point. On the positive side, increased commitment to and funding for malaria control is leading to improved access to effective antimalarial drugs, with over the counter availability and extensive subsidies. However, current efforts do not yet adequately address the need for tools to diagnose malaria accurately and track its incidence. Since presumptive case management leads to dramatic overuse of antimalarial drugs, programmes to improve access will also inevitably lead to further inappropriate treatment for individual patients, increased risk of parasite resistance to antimalarial compounds, and the potential diversion of hundreds of millions of dollars worth of antimalarial drugs to patients who do not actually have malaria. It is vital to make effective antimalarial treatment widely available,^{1 2} but doing so without equally intensive efforts to improve access to parasite based diagnosis is likely to be counterproductive. Thoughtful implementation . . . [Full text of this article]

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