Alternative ways to develop diagnostic tools for use in resource-poor settings can, and do, exist, argue Martine Usdin, Martine Guillerm and Pierre Chirac of Doctors without Borders. When Medecins Sans Frontieres workers recognized the need for a diagnostic test for malaria suitable for use in the resource-poor conditions of the developing world, they acted on what they saw. With help from scientists in the field and from several manufacturers, an alternative test was conceived, designed and developed in just two years, and at relatively low cost. In this issue Medecins Sans Frontieres scientists describe how under-used resources in universities and industrial labs across the world could be utilized in similar projects to provide diagnostics for other ‘forgotten’ diseases.