By Alison Bird. A nurse in a local clinic in Huambo Province, Angola, checks a patient and her baby before prescribing anti-malarial drugs. The President’s Malaria Initiative (PMI), led by USAID, supports countries in their efforts to scale up access to malaria diagnostics to ensure proper diagnosis of illness.

Maria José Inés, chief nurse at the Benfica Baixa Health Center in the city of Huambo in Angola, has seen many patients with fever over the years and treated countless malaria patients. In many parts of Africa, a majority of fevers have been more likely due to other pathogens than with malaria parasites, underscoring the need for proper malaria diagnosis.  Now even in highly malarious areas where effective prevention is decreasing the malaria burden this is also becoming the case. 

The President’s Malaria Initiative (PMI), led by USAID and implemented jointly with the Centers for Disease Control and Prevention (CDC), supports countries in their efforts to scale up access to malaria diagnosis, in line with the recently revised World Health Organization (WHO) recommendation, including focusing on quality assurance for malaria diagnostics, training in proper use of the diagnostics tests at all levels of the health care system, including community health workers, and information, education and communication materials IEC/BCC to assure that health care workers and patients use the test results as part of more effective management of fever cases. 

In 2007, an estimated 656 million fevers occurred in African children aged 0-4 years, with 78 million children of the 183 million attending a public health care facility likely to have been infected with P. falciparum, the parasite that causes the most dangerous form of malaria. These recent findings come from a modelling system devised by the Malaria Atlas Project, a multinational team of researchers funded mainly by the Wellcome Trust.   

The PMI whole-of-government global target is to halve malaria illnesses and deaths in 70 percent of at-risk populations, or 450 million people by 2014, by accelerating and intensifying malaria control efforts in the high burden countries of sub-Saharan Africa.   The USG strategy also outlines efforts to stop the spread of multi-drug resistance in Southeast Asia and the Americas; increase emphasis on strategic integration of malaria prevention and treatment activities with maternal and child health, HIV/AIDS, neglected tropical diseases, and tuberculosis programs, and on multilateral collaboration to achieve internationally-accepted goals; and intensify efforts to strengthen health systems.