Nossa Senhora de Fatima is a remote village located in the middle of the Brazilian Amazon. In addition to being one of the most beautiful places in Brazil, the Amazonian region also accounts for 99.5% of all national malaria cases.

Raquel da Silva lives in Nossa Senhora de Fatima with her family. For Raquel, the burden of P. vivax malaria is heavy. Not only has she been ill with P. vivax malaria many times, but she has to care for each member of her family who have been infected one after the other. “My family and I had malaria five times, for 5 consecutive months last year,” she says. “When I got malaria, my baby was 6 months old, so I couldn’t take the full treatment regimen for 7 days. I took just enough so my symptoms would improve, so it always relapsed. My husband works so he had to leave the house and I didn’t have the energy to do anything. It was hard.”

In addition to transmission through mosquito bites, P. vivax malaria can relapse causing multiple episodes of malaria from a single infectious mosquito bite. It impacts efforts to achieve global goals like zero poverty and gender equality. Research shows that each episode of malaria requires at least two days of care, the burden of which is almost always borne by women and girls, preventing them from pursuing economic and social activities like going to work and school.

There is an urgent need to improve access to new tools for relapsing P. vivax malaria in these remote villages so that Raquel, and women like her, are relieved of the burden of care, and children can go to school and play fearlessly.

The Ministry of Health, in partnership with MMV, plans to conduct a study to understand the feasibility of implementing quantitative point-of-care G6PD testing with tafenoquine in real-world settings before treatment is made available in Brazil. This study, known as Tafenoquine Roll-oUt Study (TRuST), is due to take place in 2021. Mathematical modelling work conducted by the Pasteur Institute in partnership with the Oswaldo Cruz Institute in Brazil estimates that single-dose tafenoquine could lead to a 38% reduction in transmission and over 214,000 cumulative averted cases within the first five years of introduction in Brazil.