Progress requires research and development. ZonMw, the Netherlands Organisation for Health Research and Development, funds health research and fosters, funds health research and fosters the use of the knowledge developed, helping to improve health and healthcare in the Netherlands and in other countries. One of the studies supported by ZonMw is the RAPDIF study, which focuses on the diagnosis and treatment of infectious diseases that cause fever. Research being conducted in Burkina Faso, one of the poorest countries in the world, established whether the medication available was used appropriately and effectively. Fever is common in children under the age of five, who are a particularly vulnerable group. They are frequently prescribed antibiotics and anti-malaria medication when they present with fever, often without an accurate diagnosis. Indiscriminate use of these types of medications can lead to increased antimicrobial resistance: some microorganisms are as much as 50 to 90% resistant to many of the medicines used. This is an alarming situation, as alternative medicines are not readily available. A test is used to diagnose what is wrong when a patient has a fever. In Burkina Faso this will often be a malaria test. Even if it is conducted properly and the result is negative, doctors often prescribe both antibiotics and anti-malaria medication, with the best of intentions, because these young patients are particularly vulnerable. Health workers do not want to risk ongoing illness, or even the death of an untreated child. Social pressure to at least do something is a key factor in this decision. A lack of therapy compliance can also contribute to antimicrobial resistance. Despite community education campaigns in Burkina Faso patients or parents often stop using the medication earlier than prescribed and save what is left in case another child develops a fever. In other countries in Africa, the level of education is probably lower, so the problem is likely to be even greater. The fact that these medicines are freely available, and so are taken or administered wrongly, also contributes to antimicrobial resistance. The RAPDIF study was carried out in collaboration with local researchers in Burkina Faso. The aim was to establish, in an area where malaria and other infectious diseases associated with fever are prevalent, how reliable the diagnostic techniques used were, whether the correct medication was prescribed and what level of resistance there was to these drugs. The study is also relevant to other countries. Pathogens are spread by migration, and by holidaymakers. Diseases like malaria might even spread to your country as a result of climate change. By sharing knowledge and experience internationally, we can track and combat the spread of these pathogens. This international approach has been made possible thanks to collaboration with NWO-WOTRO Science for Global Development, which also funds international studies seeking sustainable solutions for health problems in low- and middle-income countries and elsewhere. Ways of identifying and recognising the pathogens that cause fever have been established. The RAPDIF study has shown that these pathogens exhibit a high degree of resistance to certain medication. This is to some extent because the medication is wrongly prescribed and used. A new malaria test has been developed which can also detect mutated malaria parasites, which can cause a false negative result if gone undetected. The test also includes a decision model, which helps the local healthcare professional to prescribe the right medication. One additional benefit of the project has been the opportunity for local researchers to obtain PhDs on the basis of this work. They will continue developing diagnostic tests and researching better diagnostic techniques for other diseases associated with fever at a local health centre. Thanks to RAPDIF children with fever are now treated more effectively, and steps have been taken to prevent any increase in antimicrobial resistance. Dutch researcher Henk Schallig, RAPDIF research coordinator at the university medical centre Amsterdam, is to receive a “ZonMw Pearl” for this study.