Dissemination of EFFORT trial results in Indonesia: a stakeholder meeting report on tafenoquine and primaquine for radical cure of Plasmodium vivax
The EFFORT clinical trial was conducted in four countries (Cambodia, Ethiopia, Indonesia, and Pakistan) to evaluate the safety and effectiveness of high-dose primaquine (7 mg/kg over 7 days) and single-dose tafenoquine (300 mg) compared with the standard 14-day low-dose primaquine regimen for the radical cure of patients with Plasmodium vivax malaria. In Indonesia, both regimens were co-administered with dihydroartemisinin-piperaquine. This paper reports on a national stakeholder meeting held in May 2025 to disseminate Indonesia-specific findings and discuss their implications for malaria control and elimination policy. Discussions centred on (i) the evidence gaps regarding tafenoquine when combined with artemisinin combination therapies (ACTs), (ii) the feasibility of implementing high-dose primaquine in Indonesia as a near-term option, and (iii) the need for subnational strategies that reflect the country's diverse epidemiological context. Stakeholders highlighted the need for further studies on tafenoquine with ACTs, while recognising high-dose primaquine as an immediately implementable option pending strengthened G6PD testing. The discussion emphasised the importance of tailoring strategies to Indonesia's diverse settings, supported by strong political commitment to elimination.
Authors
- Herdiana Herdiana (ORCID: https://orcid.org/0000-0002-7260-3682)
- Halik Hadi
- Kylie Mannion (ORCID: https://orcid.org/0000-0003-4446-6112)
- Dedy Supriyanto
- Hermawan Susanto
- Nurul Muhafilah
- Ayodhia Pitaloka Pasaribu (ORCID: https://orcid.org/0000-0002-3830-8073)
- Reynold Rizal Ubra
- Inge Sutanto (ORCID: https://orcid.org/0000-0003-2488-5133)
- Sri Budi Fajariyani
- Rahmad Isa
- Enny Kenangalem (ORCID: https://orcid.org/0000-0002-0481-7435)
- Hellen Mnjala
- Erni Juwita Nelwan (ORCID: https://orcid.org/0000-0003-4064-5412)
- Jeanne Rini Poespoprodjo (ORCID: https://orcid.org/0000-0003-1573-734X)
- Hellen Dewi Prameswari
- Ajib Diptyanusa (ORCID: https://orcid.org/0000-0002-1860-0923)
- Faustina Helena Burdam
- Ari Winasti Satyagraha (ORCID: https://orcid.org/0000-0003-3237-2194)
- WILLIAM A. HAWLEY
- Riskha Tiara Puspadewi
- Kamala Thriemer
- Framita Ainur (ORCID: https://orcid.org/0009-0003-6180-4969)
- Jacklyn Adella
- Vincent Jimanto (ORCID: https://orcid.org/0009-0008-3609-6813)
- Gabriel Jason Ganadhi
- Dedi Sahat Parningotan Siagian
- Lusi Darmayanti
- Bijaya Shrestha
- Novita Rohdearni Saragih
- Febry Immanuella
- Budi Junaraman Sinaga
- Ric N. Price
- Obet Tekege
- Fadjar Surya Mensing Silalahi
- Iriani Samad
- Ella Curry
- Ferdinand J. Laihad
- Minerva Theodora
Institutions
- Lampung University (ID)
- World Health Organization - Pakistan (PK)
- Universitas Gadjah Mada (ID)
- State University of Papua (ID)
- Barts Health NHS Trust (GB)
- Mahidol University (TH)
- Universitas Sumatera Utara (ID)
- Eijkman Institute for Molecular Biology (ID)
- University of Indonesia (ID)
- Charles Darwin University (AU)
- University of Oxford (GB)
- Menzies School of Health Research (AU)
- Badan Penelitian dan Pengembangan Kesehatan (ID)
- Mahidol Oxford Tropical Medicine Research Unit (TH)
- Orangutan Information Centre (ID)
- Universitas Bandar Lampung (ID)
- Kementerian Kesehatan Republik Indonesia (ID)
- WWF-Indonesia (ID)
- National Research and Innovation Agency (ID)
Publication Details
- Journal
- Malaria Journal
- Published
- 2026-05-27
- DOI
- https://doi.org/10.1186/s12936-026-05948-3
- Primary Topic
- Malaria Research and Control
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Bill and Melinda Gates Foundation
- Medical Research Council
- National Health and Medical Research Council