The Effects of Subsidizing Antimalarials and Rapid Diagnostic Tests: Results from an Individual-Based Model of Malaria Transmission

Abstract

In this thesis I set out to investigate the effects of subsidizing malaria rapid diagnostic tests on malaria related deaths, overtreatment, and total subsidy costs. This is an important problem in public health today because scholars have estimated a global need for 655 million malaria rapid diagnostic tests in 2013 in order to cut down the 437 million antimalarials that are used each year by malaria negative individuals (J. M. Cohen et al., 2012). Presumptive treatment of malaria is damaging because febrile patients are not being treated for the true cause of their illness, limited global funding and drug supplies could be better directed to individuals who truly need the drugs, and overtreatment may play a role in favoring the emergence and spread of antimalarial drug resistance. To investigate my thesis question, I developed an individual based model of malaria transmission that incorporated a model of antimalarial demand, a model for treatment management of febrile illness, and a model for valuation of malaria rapid diagnostic tests. My model demonstrates that mRDT price subsidies: (1) Can be used to increase mRDT usage and thereby reduce the overtreatment of malaria. (2) Are costly, and reductions in overtreatment costs are not great enough to outweigh the additional costs associated with subsidizing diagnostic tests when there are low levels of compliance with mRDT results.