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Therapeutically‐rational exchange (T‐REX) of Gerbich‐negative red blood cells can be evaluated in Papua New Guinea as “a rescue adjunct” for patients with Plasmodium falciparum malaria

“Conventional exchange transfusion”—that delivers nondescript “standard issue” units of red blood cells (RBCs)—is used worldwide to rescue dying Plasmodium falciparum (Pf) malaria patients. Recently, exchanging special malaria‐resistant RBCs (T‐REX) has been recommended to prevent random delivery of malaria‐susceptible RBCs that promote Pf infection. Fortunately, Papua New Guinea (PNG) is well positioned to help optimize exchange as “a rescue adjunct” because (a) Gerbich‐negative (GN) RBCs that resist Pf invasion are prevalent in PNG; (b) with international support, PNG has conducted outstanding malaria research; (c) PNG's scientists feel studies of GN RBCs can advance malaria therapeutics; and (d) with blood‐bank support, evaluating exchange of GN RBCs is feasible in PNG. An exchange‐transfusion study of GN RBCs might attract international sponsorship given the threat of expanding drug‐resistance as well as growing recognition that advancing transfusion medicine and expanding blood donation could especially help Pf‐infected children—immediately.