A new drug, tafenoquine, offers hope of battling the resurgence of malaria on Australia’s doorstep

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Malaria rates have soared among some of Australia's closest neighbours as complacency risks undoing a decade of sustained and extraordinary progress towards eradicating the disease, experts warn. In 2016 there were an estimated 216 million malaria cases globally. Papua New Guinea recorded a staggering 400 per cent surge in malaria between 2010 and 2016, WHO figures show, with an estimated 1.4 million malaria cases and 3000 deaths in 2016. 

Solomon Islands recorded a 40 per cent rise in cases of the disease transmitted by the bite of mosquitoes infected with a plasmodium parasite. The rise was partly due to inadequate access to services and improved surveillance, according to WHO.

Drug-resistant malaria in some parts of Vietnam and Cambodia was responsible for 30 per cent and 60 per cent treatment failure rates respectively.

There are very few "combination drugs" left to treat malaria in the region and time is running out. If drug-resistant malaria spreads across Myanmar into India and Africa the global death toll would be immense.

Thankfully, a relatively new anti-malarial drug, tafenoquine – currently under review for approval by Australian and US drug regulators – “has the potential to revolutionise we way we treat latent malaria”, said CEO Asia-Pacific Leaders Malaria Alliance (APLMA), Dr Ben Rolfe. 

This medicine provides a radical cure for recurring malaria, moving from the current 12 dose course to a single tablet. Tafenoquine is taken over two consecutive days, compared to 12 days for the first-line drug primaquine (increasingly ineffective against drug-resistant malaria), and should improve treatment compliance, Dr Rolfe said.

Relapsing malaria accounts for half the Asia Pacific's malaria burden, so draining this reservoir of infection is an important step towards malaria elimination. Its likely approval would be particularly useful in the Pacific.

The Commonwealth recently announced a significant investment in medicine approval systems across the Asia Pacific. By sharing its technical expertise, Australia can help make tafenoquine available where it is needed. This will lead to faster uptake of drugs like tafenoquine.

Rapid diagnostic testing is the other side of the innovation equation, allowing a potential case to be diagnosed in under 15 minutes. Australia is helping to make these available, but we can and should accelerate progress.


Australia isn't immune and can't afford to be complacent


In wealthy, developed Australia, it is comforting to think we are immune to such outbreaks. However, in a globally connected world, this might be a foolhardy assumption. Just last September, for example, a four-year-old girl died of cerebral malaria in northern Italy.

Every year we don't eliminate malaria is another year of unfulfilled human and economic potential.

Malaria's effect on education, training and productivity in our own region is an economic deadweight on our collective prosperity. Eliminating malaria from the Asia Pacific by 2030 will provide savings in health care costs, lost wages and productivity of about US$90 billion. A study of Latin America and the United States found the average yearly income of those born after malaria eradication campaigns increased about 25 per cent, on a like for like basis.

It is in all our interests to maintain progress towards malaria elimination.

 

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