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The delivery of safe and effective radical cure for Plasmodium vivax is one of the greatest challenges for achieving malaria elimination from the Asia-Pacific by 2030. During the annual meeting of the Asia Pacific Malaria Elimination Network (APMEN) Vivax Working Group in October 2016, a round table discussion was held to discuss the programmatic issues hindering the widespread use of primaquine (PQ) radical cure. Participants included 73 representatives from 16 partner countries and 33 institutional partners and other research institutes. In this review the key discussion points are presented and grouped into five themes: (i) current barriers for glucose-6-phosphate deficiency (G6PD) testing prior to PQ radical cure, (ii) necessary properties of G6PD tests for wide scale deployment, (iii) the promotion of G6PD testing, (iv) improving adherence to PQ regimens and (v) the challenges for future tafenoquine (TQ) roll out. Robust point of care (PoC) G6PD tests are needed, which are suitable and cost-effective for clinical settings with limited infrastructure. An affordable and competitive test price is needed, accompanied by sustainable funding for the product with appropriate training of healthcare staff, and robust quality control and assurance processes. In the absence of quantitative PoC G6PD tests, G6PD status can be gauged with qualitative diagnostics, however none of the available tests is currently sensitive enough to guide TQ treatment. TQ introduction will require overcoming additional challenges including the management of severely and intermediately G6PD deficient individuals. Robust strategies are needed to ensure that effective treatment practices can be deployed widely, and these should highlight the caveats as well as the benefits of radical cure for both the patients and the community. Widespread access to quality controlled G6PD testing will be critical.

A gravity balancer is a mechanism that compensates the weight of a mass over a range of motion. When no friction is present, this gives an energy efficient mechanism and little effort is required to move an object. Conventional mechanisms have drawbacks due to the use of conventional rigid joints. Compliant joints do not have these disadvantages, can be made from fewer parts and can increase performance compared to rigid body joints. The goal of this paper is to develop a new method for the design of single degree of freedom gravity balancers where all the rigid joints are replaced with compliant joints. The method is based on connecting rigid links with compliant joints. With a constant potential energy as an objective, the method allows new gravity balancers to be designed. The second goal is to construct a demonstrator as proof of principle. It can be concluded that for the first time a gravity balancer has been constructed where all the rigid joints are replaced with compliant joints. The gravity balancer had a peak moment reduction of 93%. The presented method is extensible and allows others to understand and further develop gravity balancers with compliant joints for other applications.Copyright © 2011 by ASME