Expanding access to malaria diagnosis and treatment

Abstract

All malaria-endemic countries in the Region of the Americas have taken on the challenge of eliminating the disease and have focused their health programs and strategies on that goal. This technical note provides guidance on actions to expand access to malaria diagnosis and treatment. Access to diagnosis is the foundation of the entire response to the disease. Despite repeated calls and efforts emphasizing the importance of early diagnosis and treatment for malaria elimination in the Americas, significant gaps remain. Lack of detection and/or late detection of cases undoubtedly continue to be factors that perpetuate malaria transmission in the Region. In areas with malaria transmission, diagnosis and treatment need to be available as close to people as possible: at the first point of contact with the health system, and in hard-to-reach areas, within the community itself. The Pan American Health Organization (PAHO) proposes a framework for action to improve access to malaria diagnosis and treatment based on expanded access to diagnosis, including expanded use of rapid diagnostic tests (RDTs) and immediate comprehensive treatment. This framework considers diagnostic methods and antimalarial drugs to be public goods. To achieve this change in malaria operations, it will be necessary to involve many more actors from the health system, affected communities, and society in general in malaria diagnosis and treatment. This strategy calls for an expansion of the diagnosis-treatment (DT) component of the Diagnosis, Treatment, Investigation, and Response (DT-IR) strategy that PAHO and partners in the Region have been promoting for malaria elimination in the Americas.