Advocacy For Affordable Malaria Diagnosis In Uganda
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Malaria is the biggest single cause of illness and death in Uganda. The country has the third highest number of malaria deaths and one of the highest reported malaria transmission rates in the world. Malaria accounts for 30%-50% of outpatient visits, 15%-20% of hospital admissions, and up to 20% of all hospital deaths. Overall about 16 million cases and about 10,500 deaths are reported per year. Early diagnosis and treatment of malaria reduces disease and prevents deaths. Accurate diagnosis is vital to good malaria case management. Testing makes treatment more effective; allows a health work to carry out further investigations on a patientwho tests negative; and plays a central role in combatting rising levels of resistance to anti-malarial medicines. It also contributes to reducing malaria transmission. The National Malaria Control Policy recommends that parasite-based diagnosis with microscopy or malaria rapid diagnostic test (mRDT) before treatment is performed for any suspected malaria cases. However, access to testing is still far from universal. An end-use verification (EUV) survey conducted in April 2016 by the US President’s Malaria Initiative (PMI) found that only 69% of the treated malaria cases received a diagnostic test – still lower than the 90% national target, but an improvement from the 2015 survey (61%). Malaria diagnosis in the public sector is in principle accessed free of charge, but in the private sector it accessed at a cost. A poll conducted by HEPS Uganda and Trac Fm among 3,200 listeners of eight FM radio stations spread in different parts of Uganda – conducted in January and February 2017 – showed that up to 24% of them do not test for malaria before treatment because of high prices of the test. In addition, the number of mRDT manufacturers and mRDT brands have increased rapidly over the past few years. These have led to different prices, which has created confusion among policy makers, service providers and service consumers alike and undermined access and confidence in making choices. High prices also result from the fact that some importers are – against policy – taxed. Others are not taxed, but make provision for taxes – which they the pass on to consumers in form of high prices for fear that future tax audits may require them to pay tax arrears.