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The global anti-malaria effort is running without regional monitoring, laboratory and surveillance networks, says Mark Grabowsky in Nature.
Grabowsky says disease surveillance is the secret weapon behind the successes in polio and measles control, powering funding and informing decisions. But no such systematic surveillance data exists for malaria.
The rise of resistance to the insecticides applied to bednets and the artemisinin used for treatment makes monitoring essential, he says.
Though there are technical challenges to improving malaria surveillance — including the need to move from presumptive to laboratory-based diagnosis — most could be resolved with adequate funds, training and management.
A country-based approach will not work, he says. Regional laboratory networks are needed to support country efforts, apply standardised monitoring techniques, rapidly share findings and manage coordinated responses. This is particularly essential for monitoring drug quality.
Grabowsky puts the cost of providing monthly surveillance data and supporting regional networks at US$10 million a year — a small price to prevent the billion-dollar malaria effort "flying blind".