The malaria parasite's ability to mutate into drug-resistant strains has been key to its survival. In developing countries, it has another advantage: it's too expensive to look systematically for these devastating mutations.

Anita Ghansah, a genetic epidemiologist in Ghana, is building a molecular surveillance tool that is affordable and applied nationwide while using the latest advancements in genetic sequencing.

Anita's process cuts costs by more than half and time spent by one-third. For example, instead of deploying her own team to collect samples for months at a time - a costly endeavor they can only afford to do every two years—she and her team are training health personnel to collect and send samples to her lab. Next, they will pool and run tests on as many as 100 samples at a time. Rapid pooling, which has been found to be just as accurate as when the samples are individually tested, saves time and the limited lab supplies.

"This gives low to middle income countries the opportunity to take advantage of current technologies used in developed nations to answer questions that are pertinent to us," said Anita.

Anita hopes this project will expand to encompass samples from every hospital in Ghana and generate data fast enough to identify the locations of emerging hotspots in near real-time.

Anita, who introduced the use of genomics in studying infectious diseases in Ghana, knows the importance of surveillance for antimalarial drug resistance firsthand. In 2002, she trained staff on how to use molecular surveillance. That work showed that a new strain of the falciparum malaria parasite had become impervious to chloroquine, the country's first-line antimalarial drug. Just as alarming: it had already spread throughout most of Ghana. Their findings led policymakers to replace chloroquine with artemisinin-based combined therapies (ACT). Now, as reported cases of ACT-resistant strains inch closer to Ghana, she wants the country to be prepared.

Her goal is to make routine rapid molecular surveillance a permanent fixture of the national malaria elimination campaign. Beyond malaria, the rapid screening molecular infrastructure could be adapted to rapid screen the population for other diseases like sickle cell, HIV, and tuberculosis.

"What I do is develop the tools. Once it becomes routine, I move on to new ideas on how to innovate the world. That's research," she said.