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New partnership launched to accelerate elimination of relapsing P. vivax malaria that poses a risk to an estimated 2.5 billion people worldwide

July 14, 2021 by PATH

The Partnership for Vivax Elimination (PAVE) will support endemic countries in achieving their Plasmodium vivax (P. vivax) malaria elimination goals.

PAVE will advance the development of quality-assured, child-friendly treatments for relapse prevention, and generate and consolidate evidence to support malaria-endemic countries in developing and implementing new strategies to eliminate P. vivax malaria.

Geneva/Seattle, 14th July 2021

The new Partnership for Vivax Elimination (PAVE) launching today, will support countries in the elimination of P. vivax – a complex and persistent type of malaria that poses a risk to more than one-third of the world’s population.

As part of PAVE, Medicines for Malaria Venture (MMV), PATH, Menzies School of Health Research, and Burnet Institute will work with in-country partners to conduct feasibility studies looking at the best way to use different P. vivax relapse treatments and diagnostics at different levels of the health care system in endemic countries including Brazil, Ethiopia, India, Indonesia, Papua New Guinea, Peru and Thailand.

PAVE will also continue to support countries, including Cambodia, Colombia, Lao PDR, and Vietnam, with market analytics and readiness planning for new tools and approaches as they seek to optimize P. vivax case management according to World Health Organization (WHO) guidance and accelerate progress towards their malaria elimination goals.

PAVE is led by MMV and PATH and combines a new investment of USD 25 million from Unitaid with work under existing grants from the Bill & Melinda Gates Foundation (BMGF), the UK Foreign, Commonwealth and Development Office (FCDO) and MMV core funding. Consolidating these projects under PAVE will ensure coordination of efforts and clear communications with partners around the world. Recognizing that even more work is needed, PAVE will provide a vehicle for advocacy to bring further attention and resources to the challenge of eliminating P. vivax malaria.

Accounting for between 5.9 and 7.1 million estimated clinical cases every year, P. vivax is the most common type of malaria outside of sub-Saharan Africa. It presents a major challenge to achieving global malaria targets because of the difficulties in eliminating hypnozoites, a form of the parasite that remains in a person’s liver even after successful blood-stage treatment, leading to malaria relapses and contributing significantly to transmission.

Tackling P. vivax, by treating both the blood- and liver-stages of infection – known as radical cure – is essential to achieve the WHO 2030 targets of reducing global malaria case incidence by at least 90% and eliminating malaria transmission in 35 countries; as well as target 3.3 of the Sustainable Development Goals: end the epidemics of AIDS, TB and malaria by 2030.

PAVE will continue to work closely with WHO, National Malaria Control Programmes, and country-based partners to support the introduction and use of effective diagnostics and treatments for P. vivax malaria, including shorter-course primaquine and single-dose tafenoquine liver-stage treatments and better point-of-care glucose-6-phosphate dehydrogenase (G6PD) diagnostics needed to identify patients that are at risk of having adverse reactions to the class of drugs currently used for liver-stage treatments. Patients with the genetic disorder known as G6PD deficiency need to be screened because they are at risk of developing haemolytic anaemia when taking these drugs.

GSK and MMV have developed a paediatric version of tafenoquine, which is currently under review by regulators. PAVE aims to add to this and complete the full set of relapse prevention treatments suitable for children by supporting, with funding provided by Unitaid, the development of a quality-assured, child-friendly formulation of primaquine.

“Malaria elimination is one of the main objectives of the Ministry of Health of Peru. For this reason, MINSA appreciates the support of the PAVE initiative to find new tools for an optimized radical cure for the treatment of P. vivax malaria. This will contribute to the National Malaria Elimination Program’s “Plan Malaria Cero”. Said Veronica Soto Calle, Executive Director of the Directorate for the Prevention and Control of Metaxenic Diseases and Zoonoses, Ministry of Health of Peru (MINSA). “In this sense, we salute the launch of PAVE, an expansion of the VivAccess initiative, and its commitment to supporting endemic countries in their efforts to eliminate malaria.”

“With COVID-19-related interruptions threatening progress against malaria, investing in game-changing innovations remains one of our best chances to advance the frontier towards the elimination of malaria in all countries. By accelerating the adoption of a shorter radical cure and better diagnostics, we can reduce the burden of P. vivax malaria and draw the line against this disease,” said Philippe Duneton, Executive Director of Unitaid.

“We are thrilled to further expand this important work,” said Elodie Jambert, Director, Access and Product Management at MMV. “Families and communities affected by relapsing malaria have been suffering for too long. The new paediatric treatment options, and the real-world evidence that we will generate as part of PAVE, will represent a big step forward in eliminating this disease.”

“By combining efforts with the National Malaria Elimination Program as well as the National Malaria Elimination Strategy, PAVE will help shift the paradigm for P. vivax case management.”
— Tirsit Grishaw, PATH's Ethiopia Country Director

“PATH is excited to continue our close engagement with MMV started under the VivAccess grant in working to generate evidence that will support scale-up of life-saving drugs and diagnostics for P. vivax malaria” said, PATH’s Ethiopia Country Director, Tirsit Grishaw. “By combining efforts with the National Malaria Elimination Program as well as the National Malaria Elimination Strategy, PAVE will help shift the paradigm for P. vivax case management.”

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About the Partnership for Vivax Elimination (PAVE)

PAVE combines a new investment of USD 25 million from Unitaid with existing work led by MMV and PATH to increase access to radical cure for P. vivax malaria; most notably the five-year VivAccess initiative funded by the Bill and Melinda Gates Foundation (BMGF) and launched by PATH and MMV in 2019, and involving the Clinton Health Access Initiative, Global Health Strategies, and Population Services International as implementing partners. PAVE also encompasses operational research funded by the UK Foreign, Commonwealth and Development Office (FCDO) currently ongoing in Lao PDR and Vietnam; as well as feasibility studies on the use of tafenoquine and point-of-care G6PD testing planned in Thailand and Brazil and funded with MMV core funds. These studies known as TRuST and ARCTIC are planned to be conducted in 2021.

About Unitaid

Unitaid is a global health agency engaged in finding innovative solutions to prevent, diagnose and treat diseases more quickly, cheaply and effectively, in low- and middle-income countries. Its work includes funding initiatives to address major diseases such as HIV/AIDS, malaria and tuberculosis, as well as HIV co-infections and co-morbidities such as cervical cancer and hepatitis C, and cross-cutting areas, such as fever management. Unitaid is now applying its expertise to address challenges in advancing new therapies and diagnostics for the COVID-19 pandemic, serving as a key member of the Access to COVID Tools Accelerator. Unitaid is hosted by the World Health Organization. www.unitaid.org

About MMV

Medicines for Malaria Venture (MMV) is a leading product development partnership (PDP) in the field of antimalarial drug research and development.

Its mission is to reduce the burden of malaria in disease-endemic countries by discovering, developing and facilitating delivery of new, effective and affordable antimalarial drugs. Since its foundation in 1999, MMV and partners have built the largest portfolio of antimalarial R&D and access projects ever assembled, have brought forward 11 new medicines and have assumed the access stewardship of a further two. An estimated 2.7 million lives have been saved by these medicines.

MMV's success is based on its extensive partnership network of around 150 currently active partners, including from the pharmaceutical industry, academia and endemic countries.

MMV's vision is a world in which innovative medicines will cure and protect the vulnerable and under-served populations at risk of malaria and help to ultimately eradicate this terrible disease. www.mmv.org

About PATH

PATH is a global non-profit dedicated to health equity. With more than 40 years of experience forging multisector partnerships, and expertise in science, economics, technology, advocacy, and dozens of other specialties, PATH develops and scales up innovative solutions to the world’s most pressing health challenges. www.path.org

Media contacts

Hervé Verhoosel, Unitaid, Geneva – tel. +44 77 29 618 634, verhooselh@unitaid.who.int

Thalia Bayle, Unitaid, Geneva – tel. +41 79 660 56 37, baylet@unitaid.who.int

Akolade Omishope, MMV, Geneva – tel. +41 79 896 20 61, omishopea@mmv.org

Katy Athersuch, MMV, Geneva – tel. +33 61 999 56 21, athersuchk-consultant@mmv.org

Lindsay Bosslet, PATH, Seattle- lbosslet@path.org or media@path.org