Last Updated: 02/02/2024

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

Published: 22/12/2021

NOTE: This resource compilation can be found here in this MESA Collection. As of February 2024 all subsequent updates will be made in the collection.


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

Online tools​​​​​​

  • pfhrp2/3 Planner – Interactive web-based app that can be used to design a pfhrp2/3 deletion study and to analyse the results of such a study
  • pfhrp2/3 Deletion Risk Explorer – Interactive web-based app that allow users to explore how changes in the underlying modelling assumptions impact the risk of pfhrp2/3 continuing to spread.

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

Community of Practice​​​​​​

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:


Published: 22/12/2021

pfhrp23-deletions (quadrat)_2feb_final

THEMES: Diagnostics


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