The goal of Project DIAMETER (Diagnostics for Malaria Elimination Toward Eradication) is to define the diagnostic needs unique to malaria elimination settings with sufficient clarity so that all stakeholders can act with confidence to develop, commercialize, and efficiently implement the most promising, cost-effective, and impactful technologies for malaria elimination.

Recent progress in malaria control has enabled countries to reduce malaria transmission rates. Existing diagnostic technologies—microscopy and rapid diagnostic tests (RDTs)—have played a critical role in this success by enabling many regions to achieve transmission rates near the threshold that defines the elimination phase. However, it is not clear whether these same tests are the most efficient and cost-effective tools to achieve accurate infection detection at low levels of parasitemia, which is critical to achieving elimination goals. Furthermore, there is a lack of clarity and agreement on the use scenarios, target product profiles (TPPs), standardized methods of assay validation, and market potential for the malaria diagnostic tools best suited for cost-effective detection in elimination settings. The resulting ambiguity hinders the development of new infection detection technologies as well as strategic application of existing and nearly ready tools.

PATH has developed a rigorous approach to identifying the most promising solutions to diagnostic challenges in low-resource settings. This involves aggregating and analyzing user needs, market needs, and technical requirements to generate the comprehensive evidence base necessary to inform product development, commercialization, and strategic program operations. Thus, through extensive field research and collaboration with malaria elimination experts, the DIAMETER team will evaluate and hone the use scenarios and TPPs for infection detection in elimination settings. To this end, stakeholder interviews will be conducted in a selection of countries in Asia, Africa, and South America that are nearing malaria elimination. Information gathered will be collated to inform product development of new diagnostics and areas where further research is required. This report presents findings from stakeholder interviews conducted in Zambia in August 2013.