Last Updated

14 Sep 2023

Resource compilation: Responding to the threat of pfhrp2/3 deletions

In May 2021, the WHO Malaria Policy Advisory Group (MPAG) released a statement for urgent action in all endemic countries to address the threat of pfhrp2/3 gene deletions and most expeditiously in the Horn of Africa.

WHO has issued guidance on investigating suspected pfhrp2/3 deletions and is encouraging a harmonized approach to mapping and reporting of pfhrp2/3 deletions. This MESA compilation brings together a list of resources available:

WHO guidance

WHO protocols

WHO has published Template protocols to support surveillance and research for pfhrp2/3 gene deletions. Two types of protocols are available:

  • Surveillance-only: Surveillance template protocol for pfhrp2/pfhrp3 gene deletions [English PDF] / [French PDF] - NOTE that this document was modified on 19 January 2023. The modifications are listed in the following file: corrigenda (surv. only)
  • Surveillance combined with biobanking: Master protocol for surveillance of pfhrp2/3 deletions and biobanking to support future research [English PDF] / [French PDF] - NOTE that this document was modified on 19 January 2023. The modifications are listed in the following file: corrigenda (surv. & biobanking)

* WHO can provide assistance in the molecular analyses through its reference laboratory network

WHO tracking

  • Pfhrp2/3 Dashboard  – WHO questionnaire to track planned and ongoing surveillance of pfhrp2/3 deletions
  • Malaria Threats Map – WHO mapping tool to track published reports of pfhrp2/3 deletions
  • WHO Systematic Review  – Prevalence of Plasmodium falciparum lacking histidine-rich proteins 2 and 3: a systematic review (Bull. WHO; 2020)

Malaria RDT products (including non-HRP2 based tests)​​​​​​

Additional references


Laboratory & screening methodologies:

  • Beshir KB et al. (2022) Malaria Journal – Screening strategies and laboratory assays to support Plasmodium falciparum histidine-rich protein deletion surveillance: where we are and what is needed

Systematic reviews & meta-analyses:



  • MESA Forum (2023): Community of Practice on pfhrp2/3 gene deletions [Forum materials]
  • MESA Forum (2022): Responding to the threat of malaria parasites evading HRP2-RDTs [Forum materials]
  • ASTMH-2020 Symposium (#167): Tracking the Threat of pfhrp2/3 Gene Deletions and Future Alternatives to HRP2-based Malaria Diagnosis [MESA Correspondents Report]
  • ASTMH-2017 Symposium (#62): Malaria Rapid Diagnostic Testing: Understanding and Managing the Threat of PfHRP2/3-Negative Plasmodium falciparum [MESA Correspondents Report + Presentation Videos]


Any problems experienced by countries concerning RDT performance can be formally communicated to WHO:



Date Published