Economics research promotes malaria testing

In poor coun­tries where malaria is preva­lent but access to health care is lim­ited, many people mis­tak­enly treat the common cold or other serious ill­nesses such as pneu­monia with med­ica­tions for the mosquito-​​borne disease.

North­eastern econ­o­mist William Dickens, a Uni­ver­sity Dis­tin­guished Pro­fessor of Eco­nomics and Social Policy and a non­res­i­dent senior fellow at the Brook­ings Insti­tu­tion, and a team of researchers is trying to combat this problem. Late last year, the researchers pub­lished a sem­inal research study in the PLOS ONE open-​​assess journal, which found that pro­viding sub­si­dies and edu­ca­tion can influ­ence more people in poor coun­tries like Uganda to get tested for malaria. Upping the avail­ability of malaria tests increased the like­li­hood that infected people would take the appro­priate med­ica­tion and decreased the like­li­hood of taking unnec­es­sary, costly, and poten­tially harmful med­ica­tions, which are often sold at drug stores without a prescription.

Artem­i­nisin is the only avail­able drug that is broadly effec­tive against malaria, which has adapted to resist ear­lier forms of treat­ment, but it is also very expen­sive. Sub­si­dies make it pos­sible for people to pur­chase the drug, Dickens explained, but also lead to its overuse. This, in turn, can increase the cost of malaria treat­ment pro­grams and raise the risk that those who take Artem­i­nisin inap­pro­pri­ately can build par­a­site immu­nity and suffer con­se­quences from delayed treat­ment of other serious illnesses.

"The big problem right now in fighting malaria is that the par­a­sites have become resis­tant to all of the cheap old cures to malaria," Dickens said.

Sub­si­dizing the costs of malaria tests, he noted, makes them more afford­able for both drug stores and patients, and thus more acces­sible, Dickens said. He added that stores often don't pro­vide these tests if they must pay full price, citing a fear of being unable to sell them.

"Overall, we proved that you could dis­tribute the tests through the pri­vate sector," Dickens said, noting that hos­pi­tals and public health orga­ni­za­tions tra­di­tion­ally per­form the tests. "This was a very effec­tive way to get more tests out."

Dickens pre­sented the find­ings last weekend at the annual meeting of the Amer­ican Eco­nomic Asso­ci­a­tion. He hopes that the study, which was con­ducted by researchers from insti­tu­tions including North­eastern, Johns Hop­kins Uni­ver­sity, and the Har­vard School of Public Health, will help shape the poli­cies of orga­ni­za­tions such as the Global Fund and U.S. Agency for Inter­na­tional Devel­op­ment, both of which have major cam­paigns against malaria.

"These find­ings can make a very real dif­fer­ence in how global devel­op­ment orga­ni­za­tions fight malaria," he said.