Brazil’s success in preventing malaria relapse using new single-dose treatment

On 5 June 2023, Brazil became the first country in the world to approve the new single dose P. vivax treatment, tafenoquine, for nationwide rollout in the public health system. P. vivax malaria is the most geographically widespread of the two parasites and is the predominant species in most countries in Asia-Pacific and Latin America as well as in other areas on the cusp of malaria elimination.

Transmission is driven by the parasite’s ability to cause relapses – patients suffer recurrent malaria episodes from just one infectious mosquito bite, and human-to-human transmission occurs when a mosquito feeds on the blood of an infected person and transmits the parasite to family members, friends, and neighbours. 

To stop the relapses, both the blood- and liver-stages of the P. vivax infection must be treated, providing what is known as ‘radical cure’. Until now, this involved blood-stage treatment with chloroquine for three days and liver-stage treatment with primaquine for seven or 14 days. But there are huge issues with treatment adherence. Most patients will not complete the full 7-14 day treatment course, and so risk suffering relapses which in turn fuel further P. vivax malaria transmission.

Read the full op-ed on the Health Policy Watch website.