Performance of forecasting, warning and detection of malaria epidemics in the highlands of western Kenya.

On the 4th July 2002 a leading national newspaper in Kenya, the Daily Nation, ran the headline 'Minister sounds alert on malaria' in an article declaring the onset of epidemics in the highlands of western Kenya. There followed frequent media coverage with quotes from district leaders on the numbers of deaths, and editorials on the failure of the national malaria control strategy. The Ministry of Health made immediate and radical changes to national policy on treatment costs in the highlands by suspending cost-sharing. Development partners and non-governmental organisations also responded with a large increase in the distribution of commodities (approximately 500,000 US dollars) to support preventative strategies across the western highland region. What was conspicuous by its absence was any obvious effort to predict the epidemics in advance of press coverage.