Vivax Working Group
Vivax Working Group - PATH Consultation
The complete eradication of Plasmodium vivax from the human host is facilitated by the 8-aminoquinolone primaquine. Achieving the regional goal of malaria elimination by 2030 will require the broad use of 8-aminoquinolones. To date radical cure of vivax malaria is not widely deployed due to fears of severe side effects in G6PD deficient (G6PDd) individuals. Screening for G6PD in National Malaria Control Programs has been an ongoing topic of discussion and focus for the APMEN VxWG over the past few years.
In early February a consultation meeting was held that brought together Country Partners who could speak to different contexts, interested Partner Institutions and technical experts. Over the two and a half days the discussion focused on understanding the challenges of implementing routine testing for G6PDd in the context of radical cure, how countries in the region are currently managing testing needs and what test assays are currently on the market. The workshop concluded with a final half day session focused on health economics. The outcomes of the workshop were published as a report in the Malaria Journal in 2015.
APMEN would like to thank PATH and RITM for their generous support. Both organisations provided funding and technical expertise, without which the meeting would not have been possible. We would also like to thank all those who participated in the meeting Bangladesh, Cambodia, Malaysia, Vietnam, EOCRU, Burnett Institute CDC, GHG, icddr,b MORU, Malaria Consortium, Menzies School of Health Research, , Philippines New Born Screening Program, and Shoklo Malaria Research Unit.
- Outlining Key Objectives
- Setting the Context:
- G6PD testing: Why it matters in the context of P.vivax, current options, and challenges
- G6PD Testing in the Global Technical Strategy coming from WHO: What is a Likely Policy Recommendation?
- Product pipeline for G6PD testing and feedback on product pipeline
- Pharmacovigilance for radical cure
- Field evaluations in support of G6PD RDT in support of malaria elimination
- Case Study: Malaysia / Malaysia Vivax malaria map
- Case Study: Philippines
- Case Study: Cambodia
- Case Study: Bangladesh
- A framework for discussing implementation and adoption of radical cure with G6PD testing – Recap of previous sessions – setting stage for tomorrow
- Way Ahead:
- Newborn screening for G6PD deficiency, value beyond malaria
- What critical evidence needs to be generated to implement routine G6PD screening before radical cure? Discussion points:
- G6PD deficiency distribution and thresholds
- Local vivax epidemiology
- Relapse rate
- Screening algorithm
- Case management scenarios which include TQ and PQ
- What can we learn from the successes shared by other countries in Day 1?
- Summarize discussion and identify key persons already conducting priority research or developing implementation strategies for follow up.
- G6PD GeoDx Model Overview
- Facilitated discussion: Achieving scale:
- Given the product profiles for available G6PD tests, what transitions must local health systems undergo in order to adopt routine G6PD screening in support of radical cure?
- Discussion Points:
- WHO and other global stakeholder policy endorsement
- Regulatory approval and local demonstration studies for newer tests
- National level policy adoption: process, evidence needs
- Cost, resource allocation, and external financing
- Health system strengthening needs – training, quality assurance, surveillance systems, supply chain needs & linkages to radical cure supplies
- Best practices from Day 1 discussions from other countries
- Summarize discussion and identify key stakeholders already engaged in developing implementation strategies for follow up