Subsidy and Incentive Structure for Malaria RDTs

The Challenge

As a result of the World Health Organization’s introduction of T3: Test. Treat. Track., there is a strong focus on testing for malaria prior to treating symptoms. However, testing is uncommon in many endemic areas where malaria is considered synonymous with fever. Identification of malaria based on the presence of a fever has a high potential for misdiagnosis with other serious illnesses, particularly for children. Yet the traditional diagnostic standard of laboratory microscopy is resource-intensive, requiring both skilled technicians and laboratory equipment, and only available in the public sector.

The Opportunity

Rapid Diagnostic Tests for malaria (mRDTs) offer the potential for a fast, inexpensive, and accurate method to identify malaria. While several countries have effectively rolled out broad access to mRDTs through public health programs, others face the challenge of establishing access through the private sector, where nearly half of patients seek care. Applying a market dynamics approach, such as addressing supply and demand barriers, to unlock private sector scale up has the potential to dramatically expand access to diagnostic testing and improve identification, treatment, and outcomes for malaria and other febrile illnesses.

Our Work

Beginning in June 2013, with support from the Bill and Melinda Gates Foundation, R4D undertook an analysis to understand the incentive structure for mRDT access and use in the private sector, including evaluating the potential impact of a subsidy to achieve those goals.

  • Market assessment: R4D assessed the market for mRDTs with a focus on the private sector through literature review and expert consultations.
  • Our team developed a framework of incentive structures on both supply and demand sides in the mRDT market to inform potential ways to maximize access through the private sector, including catalytic supplier incentives, product presentation, and regulatory action.
  • We evaluated potential subsidy and incentive models to consider resource needs, impact on uptake in both availability and use of mRDTs, and other key considerations.
  • Our team recommended a phased approach to market shaping to prioritize known market failures while collecting more data on potential secondary issues before designing additional interventions.
  • Global strategy: R4D participated in global discussions on increasing access to and use of mRDTs in the context of integrated case management, international funding mechanisms, and the role of the private sector.

Global & Regional Initiatives

R4D is a globally recognized leader for designing initiatives that connect implementers, experts and funders across countries to build knowledge and get that knowledge into practice.