{"id":"F2026L00149","name":"Statement of Principles concerning malaria (Reasonable Hypothesis) (No. 25 of 2026)","slug":"statement-of-principles-concerning-malaria-reasonable-hypothesis-no-25-of-2026","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":443160,"registerId":"F2026L00149-fast-fetch-1775958068263","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning malaria (Reasonable Hypothesis) (No. 25 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  (Reasonable Hypothesis)\n\n(No. 25 of 2026)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) 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 (Reasonable Hypothesis) (No. 25 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(2) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning malaria (Reasonable Hypothesis) (No. 46 of 2017) (Federal Register of Legislation No. F2017L01049) made under subsection 196B(2) of the VEA is repealed.\n\n1.                Application\n\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 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\nThe Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that malaria and death from malaria can be related to relevant service rendered by veterans, members of Peacekeeping Forces, 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 as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting malaria or death from malaria 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\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 a substantially compromised immune system at the time of clinical onset or clinical worsening due to any of the following:\n  1.           asplenia (functional or surgical);\n  2.           haematological or solid organ malignancy;\n  3.           infection with human immunodeficiency virus;\n  4.           severe malnutrition (protein-calorie malnutrition associated with a Body Mass Index (BMI) of less than or equal to 18.5 kg/m2);\n\n\nNote: Body Mass Index (BMI) is calculated as W/H2 where:\n\n(a) W is the person's weight in kilograms; and\n\n(b) H is the person's height in metres.\n\n1.           solid organ, stem cell or bone marrow transplantation;\n2.            taking one of the following immunosuppressive medications:\n  1.             corticosteroids other than inhaled or topical corticosteroids;\n  2.          drugs used to prevent transplant rejection;\n  3.        tumour necrosis factor-α inhibitors;\n  4.         chemotherapeutic agents used for the treatment of cancer;\n\n\n1.           being pregnant in the 6 months immediately preceding clinical onset or clinical worsening;\n2.           for malaria due to Plasmodium vivax or Plasmodium ovale only, having a systemic infectious disease in the 3 months immediately preceding reactivation or relapse of the dormant liver phase of Plasmodium vivax or Plasmodium ovale;\n\n\nNote: systemic infectious disease is defined in the Schedule 1 - Dictionary.\n\nNote: The symptoms of reactivation or relapse of malaria due to Plasmodium vivax or Plasmodium ovale are essentially the same as the original malaria episode, but may be milder or more severe.\n\n1.           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(2) 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)          operational service under the VEA;\n\n(b)          peacekeeping service under the VEA;\n\n(c)          hazardous service under the VEA;\n\n(d)          British nuclear test defence service under the VEA;\n\n(e)          warlike service under the MRCA; or\n\n(f)           non-warlike service under the MRCA.\n\nNote: MRCA and VEA are defined in the Schedule 1 - Dictionary.\n\n                               systemic infectious disease means an infectious disease that causes systemic symptoms such as fever, and includes infection with Plasmodium falciparum and typhoid fever.\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":{"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This is a standard replacement of an existing Statement of Principles (No. 46 of 2017). The scope remains consistent with the original intent: establishing medical criteria for linking malaria to military service. The 2026 version updates the scientific understanding (adding simian malaria species and Plasmodium knowlesi) and adjusts timeframes based on current medical evidence, but does not expand beyond the original purpose of determining service-relatedness for veterans' compensation claims."},"complexity_factors":["Multiple time-based thresholds that vary by Plasmodium species (4 days to 1 year vs 4 days to 5 years vs 6 months vs 3 months)","Nested sub-factors with multiple exposure pathways (mosquito bites, percutaneous exposure, transplants, transfusions)","Cross-references to other Statements of Principles for related conditions (section 11)","Dual legislative framework application (VEA and MRCA with different service definitions)","Technical medical terminology requiring definitions (ICD-10-AM codes, percutaneous exposure, chemoprophylaxis)","Conditional logic for clinical worsening vs initial onset (section 10)","Specific exclusion in transplant definition (corneal transplants excluded)"],"plain_english_summary":"This instrument updates the Repatriation Medical Authority’s Statement of Principles for malaria, setting the medical circumstances that create a “reasonable hypothesis” that a veteran’s malaria (or death from it) was caused by service. It applies to veterans and current/former defence members (and their families for death claims) under the VEA and MRCA.\n\nWhy it matters: proving one of the specified service‑related factors shifts the onus—if met, the law treats the disease as service‑related, and the government must rebut that connection for compensation to be denied."},"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the 2017 Statement of Principles (see 'Repeal') and replaces it with the current Statement. The new instrument specifies which Plasmodium species are covered (s7(2)), sets species-specific exposure time windows and exposure routes, and enumerates risk and access factors (chemoprophylaxis, immunosuppression, pregnancy, transplantation, inability to obtain clinical care) that may raise a reasonable hypothesis linking malaria to relevant service (s9, s10, s11)."},"complexity_factors":["Multiple Plasmodium species treated differently (definition and species list in s7(2)); species-specific latency/time windows (e.g. 4 days to <1 year vs 4 days to <5 years) (s9(1)–s9(3)).","Multiple exposure routes with distinct rules (infected mosquito bite; percutaneous exposure; transfusion; solid organ/stem cell/bone marrow transplant) (s9(1)–s9(4)).","Medical-condition and treatment modifiers that alter causal assessment (asplenia; malignancy; HIV; severe malnutrition with BMI ≤18.5; pregnancy; transplantation; specific immunosuppressant classes) (s9(6)–s9(12)).","Non-clinical access factors as determinative elements (inability to access appropriate chemoprophylaxis or clinical management) which require proof of opportunity and standards contemporaneous with onset (s9(5), s9(13)).","Differentiation between contracting during service and clinical worsening of pre-existing malaria (relationship-to-service rules and clinical-worsening limitation) (s10).","Cross-application to other Statements of Principles when a listed factor refers to another disease (s11).","Requirement to apply ICD-10-AM coding contextually but not as sole definition (s7(3)–(4)), creating interaction between clinical records/coding and statutory definitions.","Evidentiary and administrative burden on claimants to demonstrate specific exposure timing, route, or inability to obtain prophylaxis/management (s9 and s10)."],"plain_english_summary":"This Statement sets the medical rules the Repatriation Medical Authority uses to decide when malaria (specific Plasmodium species) or death from malaria can be reasonably connected to a person’s relevant service. It applies to claims under the VEA and MRCA (s3, s5). Claimants must establish at least one listed exposure, time window or risk factor (s9) — for example an infected mosquito bite, transfusion or transplant, immune compromise, pregnancy, or lack of prophylaxis — to raise the reasonable hypothesis."},"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"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-malaria-reasonable-hypothesis-no-25-of-2026","history":"/api/acts/statement-of-principles-concerning-malaria-reasonable-hypothesis-no-25-of-2026/history","analysis":"/api/acts/statement-of-principles-concerning-malaria-reasonable-hypothesis-no-25-of-2026/analysis","conflicts":"/api/acts/statement-of-principles-concerning-malaria-reasonable-hypothesis-no-25-of-2026/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-malaria-reasonable-hypothesis-no-25-of-2026/important-cases","documents":"/api/acts/statement-of-principles-concerning-malaria-reasonable-hypothesis-no-25-of-2026/documents"}}