Towards subsidized malaria rapid diagnostic tests. Lessons learned from the global subsidy of artemisinin-based combination therapies: a review

The global subsidy 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 global subsidy of ACTs has been effective in increasing availability of ACTs in the private sector, but it has failed to decrease average prices of ACTs and 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 the global subsidy of ACTs in malaria-endemic countries.