Towards subsidized malaria rapid diagnostic tests. Lessons learned from programmes to subsidise artemisinin-based combination therapies in the private sector: a review

Health Policy Plan. 2016 Sep;31(7):928-39. doi: 10.1093/heapol/czv028. Epub 2015 Apr 9.

Abstract

The idea of a private sector subsidy programme of artemisinin-based combination therapies (ACTs) was first proposed in 2004. Since then, several countries around the world have hosted pilot projects or programmes on subsidized ACTs and/or the Affordable Medicines Facility-malaria programme (AMFm). Overall the private sector subsidy programmes of ACTs have been effective in increasing availability of ACTs in the private sector and driving down average prices but struggled to crowd out antimalarial monotherapies. The results obtained from this ambitious strategy should inform policy makers in the designing of future interventions aimed to control malaria morbidity and mortality. Among the interventions recently proposed, a subsidy of rapid diagnostic tests (RDTs) in the private sector has been recommended by governments and international donors to cope with over-treatment with ACTs and to delay the emergence of resistance to artemisinin. In order to improve the cost-effectiveness of co-paid RDTs, we should build on the lessons we learned from almost 10 years of private sector subsidy programmes of ACTs in malaria-endemic countries.

Keywords: Affordable Medicines Facility-malaria (AMFm); artemisinin-based combination therapies (ACTs); malaria; rapid diagnostic tests (RDTs); subsidy.

Publication types

  • Review

MeSH terms

  • Antimalarials / supply & distribution
  • Antimalarials / therapeutic use*
  • Artemisinins / supply & distribution
  • Artemisinins / therapeutic use*
  • Diagnostic Tests, Routine / economics
  • Diagnostic Tests, Routine / statistics & numerical data*
  • Diagnostic Tests, Routine / trends
  • Humans
  • Inappropriate Prescribing / prevention & control*
  • Malaria / drug therapy*
  • Private Sector*

Substances

  • Antimalarials
  • Artemisinins
  • artemisinin