Experts and policymakers met to review research and plan for the pilot introduction of a new treatment protocol for P. vivax malaria in the Americas, against the backdrop of the COVID-19 pandemic.
Rio de Janeiro, Geneva, and Seattle, October 30, 2020 — Ministry of Health representatives and researchers from Brazil, Colombia, and Peru met on October 27 and 28 with officials from the Pan American Health Organization (PAHO), the Inter-American Development Bank, the Bill & Melinda Gates Foundation, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria to discuss Plasmodium vivax malaria elimination efforts in the region. The event was part of the VivAccess initiative, a global effort led by not-for-profit global health organizations PATH and Medicines for Malaria Venture (MMV), which seeks to improve the management of P. vivax malaria including through the introduction of a new generation of diagnostic and therapeutic tools.
The virtual event coincided with Malaria Day in the Americas, which was celebrated on October 28 this year. The event sought to promote collaboration on regional malaria elimination efforts, and to explore the potential of new tools to help address this major public health issue.
“We at MMV are delighted and honored to be part of the high-level discussions on malaria elimination in Latin America taking place on this year’s Malaria Day in the Americas,” said Dr. David Reddy, CEO of MMV. “Relapsing malaria takes an untold toll on the individuals, communities, and countries affected. It is hoped that the availability and rollout of the first ever single-dose medicine for relapsing malaria—tafenoquine, developed by GSK and MMV—will be a key tool in reducing that toll.”
“These meetings are paramount for advancing our knowledge and understanding of these tools that can safely and effectively cure relapsing malaria,” said Kammerle Schneider, Director of Malaria and Neglected Tropical Diseases at PATH. “Furthering advocacy efforts to encourage adoption of G6PD diagnostics and their integration into patient treatment decisions will enable safer treatment protocols for P. vivax patients. Fortunately, due to the global efforts in advancing new G6PD diagnostic tests—a device designed to be used in remote areas and small clinics, where supply of electricity and connectivity are only sometimes available—we are accelerating the path to radical cure.” During the event, participants reviewed the region’s P. vivax malaria landscape and the countries’ strategies for malaria elimination, as well as the progress toward and barriers to that goal. Ministries of Health present at the meeting highlighted the disruption to malaria control brought by the COVID-19 pandemic and the need to redouble efforts to continue to detect and treat malaria cases within this context.
“The new tools open a new horizon to eliminate malaria in Brazil, Peru, and Colombia. The feasibility study will be conducted to inform if health services can implement the new treatment scheme. If the results are as expected then we will be able to expand radical cure through these new tools,” said Alejandro Llanos-Cuentas, professor at Universidad Peruana Cayetano Heredia.
Brazil, Colombia, and Peru have embraced PAHO’s malaria elimination goals but face the challenges of advancing malaria control among hard-to-reach populations in the Amazon and other territories with limited coverage of services. In light of these challenges, there is a desire to explore new tools that may help to increase treatment effectiveness.
As of October 2020, tafenoquine has been approved by the US Food and Drug Administration; Australia’s Therapeutic Goods Administration; the Thai Food and Drug Administration; and the Brazilian Regulatory agency (ANVISA). The SD Biosensor STANDARD™ G6PD Test has already been approved in Brazil.
To help governments make decisions about how to best use these tools within their health systems, feasibility studies with tafenoquine and the G6PD test are planned and expected to start in the coming months in Brazil and Thailand.
P. vivax malaria affects 7.5 million people in the world and represents 75 percent of malaria cases in Latin America. The P. vivax malaria parasite can stay dormant in the liver, causing multiple relapses from a single mosquito bite and thus creating a challenge for malaria control efforts.
According to the World Health Organization’s World Malaria Report 2019, 138 million people in the Americas live in areas at risk of malaria. The disease affects mostly rural, remote, and poor populations in Latin America, remaining largely invisible to those living in the main urban centers. The Amazon carries the highest burden; in Brazil, 99 percent of malaria cases come from states in the Amazon, and the Peruvian Amazon region of Loreto is responsible for 98 percent of cases in the country. In Colombia, the Amazon region accounts for around 10 percent of the total malaria cases in the country but is one of the regions where P. vivax malaria is predominant. These three countries, in addition to Venezuela, were the four with the highest burden of malaria in the Americas in 2019.
VivAccess is a consortium formed by PATH and Medicines for Malaria Venture, with support from the Bill & Melinda Gates Foundation, to expand access to new and existing malaria drugs and related diagnostics in P. vivax-endemic countries. VivAccess’ main goal is to accelerate introduction and scale-up of well-tolerated radical cure of P. vivax malaria—meaning drugs for blood and liver-stage, as well as malaria and G6PD diagnostics. VivAccess works at global, regional, and country levels to jointly develop strategies with stakeholders concerned with the elimination of P. vivax malaria. The project supports and partners with representatives from the global malaria community to inform evidence-based decision-making processes.
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