Ayodhia Pitaloka Pasaribu, Vincent Jimanto, Framita Ainur, Novita Rohdearni Saragih, Halik Hadi, Dedi Sahat Parningotan Siagian, Budi Junaraman Sinaga, Ari Winasti Satyagraha, Ferdinand J. Laihad, Ajib Diptyanusa, Reynold Rizal Ubra, Obet Tekege, Lusi Darmayanti, Herdiana Herdiana, Jacklyn Adella, Kylie Mannion, Ella Curry, Jeanne Rini Poespoprodjo, Enny Kenangalem, Faustina Helena Burdam, Inge Sutanto, Erni Juwita Nelwan, Gabriel Jason Ganadhi, Bijaya Shrestha, Hellen Mnjala, WILLIAM A. HAWLEY, Hellen Dewi Prameswari, Minerva Theodora, Fadjar Surya Mensing Silalahi, Hermawan Susanto, Febry Immanuella, Riskha Tiara Puspadewi, Sri Budi Fajariyani, Iriani Samad, Dedy Supriyanto, Nurul Muhafilah, Rahmad Isa, Ric N. Price, Kamala Thriemer
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.