Members of the WWARN Clinical Group at the First World Malaria Congress, Melbourne. Photo credit: Jutta Murfart, Menzies School of Health Research

Spotlight on P. vivax at the First Malaria World Congress

2 July 2018

WWARN’s Clinical Group led by Professor Ric Price joined government ministers, international institutes, malaria experts and civil society organisations in Melbourne Australia for the First Malaria World Congress 1-5 July 2018. Discussions focussed on elimination efforts, cross-sectoral collaboration and the financial commitments still needed to drive forward the global fight against malaria.

The conference began with a keynote speech from Australia’s Minister for Foreign Affairs Julie Bishop MP who announced support for five research projects including a Menzies School of Health Research project to strengthen responses to multidrug-resistant malaria and tuberculosis in Indonesia and Papua New Guinea. Australian stakeholders are playing a leading role in supporting malaria elimination efforts, with the government investing $300 million into its Health Security Initiative for the Indo-Pacific. This funding follows recent commitments from the Commonwealth Malaria Summit in London where government leaders committed to work together to halve the number of malaria cases within five years.

WWARN’s Clinical Group is based in Australia and led by Prof Ric Price. Ric was joined by group member’s Dr Kamala Ley-Thriemer and Dr Rob Commons who presented a number of sessions focussing on p. vivax malaria and radical cure treatments.

Prof Ric Price reflects on the congress, ‘The WWARN Clinical Group is working on a number of projects to support elimination of malaria in the Asia Pacific region including a Vivax After Falciparum Study Group and a recently published IPD meta-analysis on treatment strategies for P. vivax. The Congress was a great platform to raise awareness of these findings and to discuss future strategies to end malaria.’

An estimated 2.48 billion people were at risk of Plasmodium vivax in 2010, with a large majority living in Central and South East Asia. There is increasing evidence that P. vivax results in significant morbidity and associated mortality. Primaquine can reduce parasite transmission, morbidity and mortality. But in patients with a G6PD deficiency, primaquine can cause a risk of haemolysis that can leave healthcare providers reluctant to prescribe the drug. Without primaquine patients often fail to complete a full course of treatment.

On the opening day of the conference, Prof Ric Price chaired a panel discussing the latest data on the risks and benefits of primaquine and its role in global elimination efforts. Clinical Group members Dr Kamal Ley-Thriemer and Dr Rob Commons presented alongside Professor Kevin Baird, Head of the Eijkman Oxford Clinical Research Unit and Dr Rini Poespoprodjo from the University of Gadja Mada.

WWARN’s Clinical Group championed their recommendation that eliminating malaria outside of sub-saharan Africa requires widespread implementation of a 'radical cure' using drugs like primaquine, particularly in the Asia-Pacific region. A paper, published shortly after the Congress in the Lancet Infectious Diseases, shares the full findings of a Study Group entitled 'The effect of chloroquine dose and primaquine on Plasmodium vivax recurrence: a WWARN systematic review and individual patient pooled meta-analysis.

On Day 2, Dr Rob Commons presented early findings from the Plasmodium vivax parasitaemia after Plasmodium falciparum infection Study Group, “We were able to present early findings of a systematic review and meta-analysis demonstrating that a radical cure approach has the potential to reduce all-cause recurrent pf and pv parasitaemia and facilitate global efforts to eliminate malaria.” 

 a systematic review and meta-analysis’ Elke Wyndberg presenting her poster at the First Malaria World Congress

Dr Rob Commons presenting the Clinical Groups work on ‘The risk of Plasmodium vivax parasitaemia after Plasmodium falciparum infection: a systematic review and meta-analysis’ (left). Elke Wyndberg presenting her poster at the First Malaria World Congress (right)

Dr Rob Commons also presented at a poster session entitled ‘Community engagement, P. vivax and G6PD: addressing roadblocks to elimination’ on Wednesday 4th July. Elke Wyndberg, MSc student in International Health & Tropical Medicine at Oxford University, presented an analysis “Estimating Malaria Parasite Density using the Assumed White Blood Cell (WBC) Count of 8,000 cells/μL”.

The Asia Pacific Leaders Malaria Alliance (APLMA) and Asia Pacific Malaria Elimination Network (APMEN) held a joint dialogue for regional leaders and malaria partners to discuss strategies to end malaria for good. The discussion focussed on what still needs to be done to reach the ambitious 2030 goal of eliminating malaria in Asia and the Pacific. 

Dr Ben Rolfe, CEO of APLMA, reflects on the discussion, “We are thrilled to have had an opportunity to share APLMA and APMEN’s efforts in supporting leaders’ visionary commitment to an Asia-Pacific region free of malaria. We value the candid discourse with Congress attendees and appreciate the community’s insights, thoughts and ideas for moving forward. Excitingly, by the end of the Dialogue most participants believed that it is likely that we will eliminate malaria from Asia and the Pacific by 2030.”said 

The conference closed with an expert-led Questions & Answers session on “Ending Malaria”. Ric Price was on the panel alongside Maelle Ba from Speak Up Africa, Peter Sands, Executive Director at The Global Fund to Fight AIDS, Tuberculosis and Malaria, Olivia Ngou Zangue, Deputy Director Africa, Malaria No More and Sherwin Charles, CEO and Co-Founder of Goodbye Malaria.

Prof Ric Price and other malaria experts during the Q&A session on Ending Malaria

Prof Ric Price and other malaria experts during the Q&A session on Ending Malaria

The final plenary focussed on “Moving towards Elimination and Eradication: Roadmap for the future” led by Pedro Alonso, Director of the WHO Global Malaria Programme.