The availability of high-quality, inexpensive RDTs in the public sector has significantly improved and expanded diagnostic testing. However, in the private sector, where a large proportion – over 40% – of the population in endemic countries seeks care and treatment for febrile illness, RDTs are either non-existent or more expensive than artemisinin-based combination therapies (ACTs).

Success of malaria control will depend on effective diagnosis and treatment strategies in the private sector, including the introduction of malaria RDTs. These are being considered for use in a diverse private for-profit sector consisting of hospitals and clinics, local pharmacies, drug shops and itinerant drug sellers.

However, there is presently little evidence or experience to guide countries on what is required to provide locally applicable systems and regulation to scale-up malaria RDTs in private sector outlets. Furthermore, control over test sensitivity, storage and transport, and assurance that tests are working correctly, will frequently be more difficult to assess.

WHO participated in a systematic review that draws together published and unpublished studies on malaria RDT introduction in private sectors in 12 countries. WHO also collaborated with Population Services International, Malaria Consortium and the Foundation for Innovative New Diagnostics (FIND) in a 5-country project testing different approaches to stimulate the creation of a private sector market for malaria RDTs. The 3-year project was implemented in 5 target countries: Kenya, Madagascar, Nigeria, Tanzania (mainland) and Uganda and concluded in 2016.

Findings and lessons learned are summarized in a roadmap document jointly prepared by the project partners and found here: https://www.psi.org/publication/a-roadmap-for-optimizing-private-sector-malaria-rapid-diagnostic-testing/