Standby emergency treatment of malaria for travellers to low transmission destinations. Does it make sense or save lives?

The recommendation for carriage standby emergency treatment (SBET) for malaria is now becoming more widespread across Europe. This follows as a replacement to the withdrawal of recommendations for use of malaria chemoprophylaxis, predominantly therefore to falling transmission of Plasmodium falciparum malaria on the successful malaria control programmes across South East Asia and South America.1 Travellers are prescribed SBET antimalarial medication to carry during their journey. The policy is aimed at travel to areas of low falciparum malaria transmission in the above continents, not at travellers to Sub Saharan Africa. They are advised to use the medication when malaria is suspected and prompt medical attention is unavailable, but ideally, to attend a medical centre within 24 h of onset of symptoms for a diagnosis, and if malaria is confirmed, use the medication secure in the knowledge that it is not counterfeit.