Voices of Indigenous Papuans: Gender, disability and social inclusion shaping malaria vulnerability

Despite decades of control efforts, the island of New Guinea remains one of the world’s last malaria frontiers. This island which spans Indonesian Papua and Papua New Guinea, is where ecological connectivity, human mobility and shared sociocultural networks sustain transmission beyond political boundaries. Indonesian Papua, which consists of six provinces, accounts for over 90% of national malaria cases, disproportionately affecting Indigenous Papuans (Orang Asli Papua, OAP). Using the Malaria Matchbox Tool, we examined how gender, disability and social exclusion shape malaria vulnerability and access to care among OAP communities. Malaria was widely normalised as a routine illness, with spiritual beliefs shaped care-seeking. Service access was constrained by remoteness, high transportation costs, commodities stockouts, administrative hurdles, and language barriers. Women bore caregiving responsibilities with limited decision-making authority, while persons with disabilities and elderly were largely overlooked. These findings highlight the need for GEDSI-informed community-based strategies to address barriers in underserved settings.