Time to stimulate Plasmodium vivax research in India: A way forward

India bears the largest Plasmodium (P.) vivax (Pv) malaria burden and contributes 48％ of Pv cases globally[1]. The efforts of government and private bodies to control malaria have successfully reduced the number of Plasmodium falciparum (Pf) malaria cases in several countries, including India. However, there has been a consistent increase in Pv cases, particularly in regions where both parasites coexist. Consequently, Pv presents an obstacle to elimination and is more challenging to eradicate than Pf for several reasons: 1) Pv has a wider geographic range since it can thrive in colder climes; 2) vector control methods are less effective because Pv parasite-carrying mosquitoes bite early, rest outdoors, and consume blood outdoors; 3) current diagnostic tools cannot detect low-density Pv infections and dormant hypnozoites; 4) hypnozoites can trigger multiple malaria episodes, and Pv gametocytes are produced earlier, enabling transmission even before clinical symptoms; and 5) 14-day primaquine is the only effective drug against hypnozoites; however, it can cause life-threatening haemolytic anaemia in individuals with glucose 6-phosphate dehydrogenase (G6PD) deficiency, which makes primaquine treatment difficult[2].