Brazilian children from the Yanomami indigenous community will be the first in the world to get a single-dose paediatric treatment for relapsing malaria.

The introduction of paediatric tafenoquine, developed by Medicines for Malaria Venture (MMV) and pharmaceutical  company GSK, marks a “major step” towards closing the treatment gap for children at risk of relapsing Plasmodium vivax (P. vivax) malaria, according to MMV.

Tafenoquine only needs to be taken once, replacing older medicines taken daily for seven days. This is especially important in remote areas, where following through with longer regimens can be challenging.

Brazil incorporated a child-friendly formulation of tafenoquine into its public health system in mid-2025. It is approved for children from two years of age, and taken in combination with chloroquine to cure P. vivax malaria,  the less deadly but most widespread malaria species.

Illegal mining, deforestation drive malaria

Malaria cases in the Yanomami Indigenous Territory have surged 300% between 2016 and 2022, where illegal mining has driven deforestation and a dramatic resurgence of the disease carried by mosquitoes. The Yanomami are the largest indigenous people in the country, living in villages within the Amazon rainforest on the border of Venezuela and Brazil. 

Brazil declared malaria a public health emergency in the area in 2023.

“The rollout of paediatric tafenoquine addresses a long‑standing gap in malaria care for children, particularly in remote and underserved settings. This initiative strengthens our national elimination efforts while centring children’s health,” said Alex Vargas from Brazil’s Ministry of Health.

“Between 2019 and 2022, over 21,000 malaria cases were recorded among Yanomami children under the age of five, alongside a sevenfold increase in malaria‑related child deaths over four years,” according to MMV.

“In a population of around 30,000 people, these figures underscore the devastating impact of malaria and the urgent need for a well‑tolerated, effective treatment for the youngest and most at risk.”

 MMV CEO Dr Martin Fitchet said that, ‘for too long, younger patients have remained vulnerable to debilitating relapse simply because existing treatments were hard to complete.

“The rollout of paediatric tafenoquine among the Yanomami marks a major step toward more equitable access to effective malaria treatment.”

If someone is infected with P. vivax and does not receive liver-stage treatment, they will be at risk of repeated clinical relapses. 

But tafenoquine can cause haemolytic anaemia in people with glucose-6-phosphate dehydrogenase (G6PD) deficiency, so G6PD testing must be performed before it is prescribed, which complicates the rollout.

Tafenoquine is the first new drug to be developed in over 60 years to treat relapsing malaria. Brazil was the first malaria-endemic country to adopt tafenoquine for adults into its public health system in 2023.

Rollout to adults began in June 2024. and by April 2025, it covered 49 municipalities from six states and nine Special Indigenous Health Districts (DSEIs).

In the first quarter of 2025, Brazil recorded a 26.8% drop in all malaria cases. Rondônia, one of the first states to introduce tafenoquine treatment, saw a 47% decrease in malaria cases during the first four months of 2025 compared to the same period the previous year, and 95% of all its malaria cases during this period were P. vivax.

Image Credits: Nathalie Brasil/ MMV.