{"id":"F2026L00151","name":"Statement of Principles concerning malaria (Balance of Probabilities) (No. 26 of 2026)","slug":"statement-of-principles-concerning-malaria-balance-of-probabilities-no-26-of-2026","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":443159,"registerId":"F2026L00151-fast-fetch-1775958068237","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning malaria (Balance of Probabilities) (No. 26 of 2026)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n![RMA Australian Government Coat of Arms](image.001.jpeg)\n\n \n\nStatement of Principles\n\nconcerning\n\nMALARIA  (Balance of Probabilities)\n\n(No. 26 of 2026)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n \n\nDated 20 February 2026\n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\nProfessor Terence Campbell AM\n\nChairperson\n\nby and on behalf of\n\nThe Repatriation Medical Authority\n\nContents\n\n1 Name\n\n2 Commencement\n\n3 Authority\n\n4 Repeal\n\n5 Application\n\n6 Definitions\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n8 Basis for determining the factors\n\n9 Factors that must exist\n\n10 Relationship to service\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nSchedule 1 - Dictionary\n\n1 Definitions\n\n \n\n \n\n\n\n\n1.                Name\n\n\nThis is the Statement of Principles concerning malaria (Balance of Probabilities) (No. 26 of 2026).\n\n1.                Commencement\n\n\n              This instrument commences on 23 March 2026.\n\n1.                Authority\n\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning malaria (Balance of Probabilities) (No. 47 of 2017) (Federal Register of Legislation No. F2017L01061) made under subsection 196B(3) of the VEA is repealed.\n\n1.                Application\n\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004 applies.\n\n1.                Definitions\n\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n1.                Kind of injury, disease or death to which this Statement of Principles relates\n  1.           This Statement of Principles is about malaria and death from malaria.\n\n\nMeaning of malaria\n\n1.           For the purposes of this Statement of Principles, malaria means an infection that is due to one of the human malaria species Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale or Plasmodium malariae, or infection with Plasmodium knowlesi or other simian malaria species.\n\n\nNote 1: Malaria typically presents with prostration, fever, chills, sweats, headaches, nausea, body aches and general malaise. Physical findings may include elevated temperature, perspiration, weakness, enlarged spleen or liver, jaundice, and anaemia.\n\nNote 2: Malaria due to Plasmodium vivax or Plasmodium ovale may relapse due to reactivation of a dormant liver phase.\n\n1.           While malaria attracts ICD‑10‑AM code B50, B51, B52, B53 or B54, in applying this Statement of Principles the meaning of malaria is that given in subsection (2).\n2.           For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.\n\n\nDeath from malaria\n\n1.           For the purposes of this Statement of Principles, malaria, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's malaria.\n\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n1.                Basis for determining the factors\n\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that malaria and death from malaria can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.\n\nNote: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary.\n\n1.                Factors that must exist\n\n\nAt least one of the following factors must exist before it can be said that, on the balance of probabilities, malaria or death from malaria is connected with the circumstances of a person's relevant service:\n\n1.           being exposed to Plasmodium malariae, Plasmodium falciparum or simian malaria species at least 4 days, but less than 1 year, immediately preceding clinical onset, by:\n  1.           being bitten by a mosquito infected with Plasmodium malariae, Plasmodium falciparum or simian malaria species; or\n  2.           having percutaneous (intravenous, intramuscular, subcutaneous, intradermal) exposure to blood infected with Plasmodium malariae, Plasmodium falciparum or simian malaria species; or\n  3.           having a solid organ transplant (excluding corneal transplant), stem cell transplant, or bone marrow transplant where the organ or tissue is infected with Plasmodium malariae, Plasmodium falciparum or simian malaria species; or\n  4.           receiving a transfusion of blood or blood products (including red blood cells, platelets, plasma), where the blood or blood product is infected with Plasmodium malariae, Plasmodium falciparum or simian malaria species.\n\n\nNote: Examples of circumstances where percutaneous exposure may occur include sharing of contaminated needles in drug users, needlestick injuries, flushing intravenous catheters with contaminated heparin or saline, and contaminated syringes.\n\n \n\n1.           being bitten by a mosquito infected with Plasmodium vivax or Plasmodium ovale at least 4 days, but less than 5 years, immediately preceding clinical onset;\n2.           being exposed to Plasmodium vivax or Plasmodium ovale at least 4 days, but less than 1 year, immediately preceding clinical onset by:\n  1.           having percutaneous (intravenous, intramuscular, subcutaneous, intradermal) exposure to blood infected with Plasmodium vivax or Plasmodium ovale; or\n  2.           having a solid organ transplant (excluding corneal transplant), stem cell transplant, or bone marrow transplant where the organ or tissue is infected with Plasmodium vivax or Plasmodium ovale; or\n  3.           receiving a transfusion of blood or blood products (including red blood cells, platelets, plasma), where the blood or blood product is infected with Plasmodium vivax or Plasmodium ovale.\n\n\nNote: Examples of circumstances where percutaneous exposure may occur include sharing of contaminated needles in drug users, needlestick injuries, flushing intravenous catheters with contaminated heparin or saline, and contaminated syringes.\n\n1.           inability to access appropriate chemoprophylaxis for malaria in accordance with contemporary medical standards before clinical onset;\n2.           having infection with human immunodeficiency virus or asplenia (functional or surgical) at the time of clinical onset or clinical worsening;\n3.           being pregnant in the 6 months immediately preceding clinical onset or clinical worsening;\n4.           inability to obtain appropriate clinical management for malaria before clinical worsening.\n\n\n1.            Relationship to service\n  1.           The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.\n  2.           The clinical worsening aspect of factors set out in section 9 apply only to material contribution to, or aggravation of, malaria where the person's malaria was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n2.            Factors referring to an injury or disease covered by another Statement of Principles\n\n\nIn this Statement of Principles:\n\n1.           if a factor referred to in section 9 applies in relation to a person; and\n2.           that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(3) of the VEA;\n\n\nthen the factors in that Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.\n\n \n\n \n\nSchedule 1 - Dictionary  \n\nNote:               See Section 6\n\n1               Definitions\n\nIn this instrument:\n\n                               malaria—see subsection 7(2).\n\n                             MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n                             relevant service means:\n\n(a)          eligible war service (other than operational service) under the VEA;\n\n(b)          defence service (other than hazardous service and British nuclear test defence service) under the VEA; or\n\n(c)          peacetime service under the MRCA.\n\nNote: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\n                             terminal event means the proximate or ultimate cause of death and includes the following:\n\n(a)           pneumonia;\n\n(b)           respiratory failure;\n\n(c)           cardiac arrest;\n\n(d)           circulatory failure; or\n\n(e)           cessation of brain function.\n\n                             VEA means the Veterans' Entitlements Act 1986.\n\n \n\n \n","sortOrder":0}],"analysis":{"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This is a straightforward update of an existing Statement of Principles. It maintains the same scope as its 2017 predecessor—determining medical factors for malaria compensation claims. The content reflects updated medical knowledge (including simian malaria species and refined timeframes) but does not expand beyond the original purpose of establishing service connection criteria for malaria."},"complexity_factors":["Multiple time-based conditions (4 days to 1 year vs 4 days to 5 years depending on malaria species)","Cross-references to other Statements of Principles for related conditions","Technical medical terminology requiring definitions (Plasmodium species, percutaneous exposure, chemoprophylaxis)","Nested definitions in Schedule 1 (malaria, relevant service, terminal event)","Dual legislative framework application (VEA and MRCA with different service definitions)","Distinction between clinical onset and clinical worsening with different applicable factors"],"plain_english_summary":"The Repatriation Medical Authority has issued updated medical guidelines (replacing the 2017 version) for deciding when malaria or death from malaria is service-related, effective 23 March 2026. They affect veterans and current/former defence personnel claiming under the Veterans' Entitlements Act or Military Rehabilitation and Compensation Act, setting medical thresholds (timing, exposure, risk factors, and treatment) that must be met to establish service connection."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":false,"description":"The instrument repeals the 2017 Statement (s.4) and restates the factors the RMA uses to link malaria or death from malaria to relevant service for VEA/MRCA claims (s.5, s.8–s.11). The text does not itself state an expansion or contraction of eligibility beyond setting specific species, exposure pathways and time-windows; no explicit change of scope from the prior instrument is asserted in this document."},"complexity_factors":["Statutory evidential standard: applies the balance of probabilities to medical causation (s.8).","Medical specificity: defines malaria by Plasmodium species and includes simian species and death from a terminal event (s.7(2); s.7(4)).","Species-specific latency/time windows: different temporal thresholds for P. falciparum/P. malariae/simian species (4 days–<1 year) versus P. vivax/P. ovale (4 days–<5 years for mosquito bite) (s.9(1)–(2)).","Multiple exposure pathways: mosquito bite, percutaneous blood exposure, organ/stem-cell transplant, and transfusion (s.9(1)(a)–(d); s.9(2)(a)–(c)).","Service-connection requirement: any listed factor must be related to the person's relevant service under VEA/MRCA (s.10(1)).","Clinical-worsening carve-out: worsening material contribution rules only apply where disease was suffered or contracted before or during but not arising out of service (s.10(2)).","Interaction with other Statements: factors that refer to other injuries/diseases invoke those Statements of Principles (s.11).","Defined terms and coding references: reliance on Schedule 1 definitions (relevant service, terminal event, VEA, MRCA) and ICD-10-AM codes (Schedule 1; s.7(3)–(4)).","Operational impact on claimants: requires factual proof of exposure, prophylaxis access, comorbidity status, pregnancy or access to clinical management — evidentiary and administrative burden on applicants (s.9(5)–(8)).","Instrument replacement: repeals a prior 2017 Statement, requiring administrators to adopt the new text (s.4)."],"plain_english_summary":"This instrument sets the medical tests the Repatriation Medical Authority uses to decide, on the balance of probabilities, whether malaria or death from malaria is connected with a person's service for the purposes of VEA and MRCA claims. It tells claimants and decision-makers which species, exposure pathways and time-windows count, and requires that an identified exposure be related to the person’s relevant service. The RMA’s formulation determines entitlement outcomes for veterans and former members when assessing claims under the VEA and MRCA."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-malaria-balance-of-probabilities-no-26-of-2026","history":"/api/acts/statement-of-principles-concerning-malaria-balance-of-probabilities-no-26-of-2026/history","analysis":"/api/acts/statement-of-principles-concerning-malaria-balance-of-probabilities-no-26-of-2026/analysis","conflicts":"/api/acts/statement-of-principles-concerning-malaria-balance-of-probabilities-no-26-of-2026/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-malaria-balance-of-probabilities-no-26-of-2026/important-cases","documents":"/api/acts/statement-of-principles-concerning-malaria-balance-of-probabilities-no-26-of-2026/documents"}}