Malaria Medicines and Diagnostics WHO/UNICEF Technical Briefing Seminar on Essential Medicines Policies 30 October 2012, WHO Headquarters, Geneva - Salle A A. Bosman, MD PhD Coordinator, Diagnosis Treatment and Vaccines

Malaria positivity rate in African health facilities 39 studies conducted between 1986 and 2007 in 16 African countries <year 2000 >year 2000 100 90 7686 5372 7785 2118 700 2376 80 70 60 56% PR (%) 50 50% 40 31% 30 27% 20 20% 13% 10 <5y 5-15y >15y <5y 5-15y >15y Age groups Age groups D’Acremont et al, Malaria J 2010

- - - - + - + LLIN/IRS RDT ACT Medicines non-ACTs for NMFI Interactions in malaria between medicines, diagnostics and vector control LLIN/IRS - - - - RDT ACT Severe malaria treatment + - Medicines for NMFI non-ACTs + Product interactions more complex in private sector (order of entry, perseverance etc.)

World Health Organization 19 June, 2018 Deployment of RDTs in Livingstone (Zambia): impact on malaria cases and ACT consumption ACT ACTs RDTs From over 25'000 ACTs in 2007 to less than 5'000 in 2008 Source: NMCC, Zambia MoH

World Health Organization The example of Senegal: ~ 0.5 million less ACT consumed in 2008-2009 19 June, 2018 Suspected cases Tested cases Positive cases Treated cases In Senegal, after scaling up of RDT implementation at country level, we can see that the curve for suspected cases and that for tested cases become superposed, which indicates that probably most suspected cases are now tested for malaria. Similarly, the curve for positive cases and that for treated cases are very close in 2009, which is an indication that only positive cases are now treated for malaria. These extrapolations can be only made in the absence of major stock-outs of RDTs and ACTs. World malaria report 2010

ACT procurement with international funds World Health Organization ACT procurement with international funds 19 June, 2018 data provided by 8 companies eligible for procurement by WHO/UNICEF

World Health Organization RDT performance in Phase 2 of Rounds 1 – 3 against wild type (clinical) samples containing P. falciparum at low (200 parasites/μl) and high (2000 or 5000 parasites/μl) parasite densities and clean-negative samples 19 June, 2018 PDS at 2000 parasites/μl PDS at 200 parasites/μl False Positive Rate Invalid Rate

Malaria RDT sales Sales to public and private sectors Sales by panel detection score (PDS)

RDT Product Testing: Rounds 1 - 4

T3 – Test. Treat. Track. Scaling up diagnostic testing, treatment and surveillance Infographic disponible: http://www.youtube.com/watch?v=vnsoTPE_PUc&feature=youtu.be