The Australian Defence Force Malaria and Infectious Diseases Institute (ADFMIDI) in Brisbane, Australia, has a long history of disease surveillance and product development to protect the Australian Army and its allies. WRAIR/AFRIMS has one officer assigned to work closely with the ADF in South Asia and coordinate projects with U.S. DOD. 

This partnership with the ADFMIDI's Drug Resistance and Diagnostic laboratory, a central laboratory for the confirmation of malaria parasites lacking HRP2, focuses primarily on the detection of Plasmodium falciparum parasites undetectable by rapid diagnostic tests. Currently, the only FDA-approved malaria RDT is BinaxNOW, which relies on the detection of the HRP2 protein to identify Plasmodium falciparum malaria infection. Since 2010, parasites lacking this protein have been reported around the world, including South America, Asia and up to 80% of patients in African countries. Early and accurate diagnosis of malaria infection is paramount to effective treatment and misdiagnosis can result in otherwise preventable severe illness or death; as such, the spread of parasites without the HRP2 protein poses a major threat to force health protection and public health in austere, resource-poor environments. 

In this study, samples that are positive by gold-standard but resource intensive microscopy or PCR but negative by RDT are sent to the ADFMIDI by contributing institutions from countries around the world including Peru, Papua New Guinea, Uganda and Eritrea. These samples allow researchers to understand the distribution and spread of parasites without HRP2 and inform the development and evaluation of novel RDTs.