For the last year, global attention has been fixated on the mosquito-borne Zika virus. India has had a degree of panic regarding the disease, justifiably so as the strain of mosquito responsible for spreading the virus thrives in the geographical conditions present in India. Despite this the Zika virus has not yet proven to be any real concern in India, with no reported cases so far.
Though the global concern of the Zika virus has not posed any threat, mosquito borne illnesses are still thriving in India. Despite being late in the year with temperatures dropping, malaria outbreaks are still commonplace. Outbreaks such as those in the Chandil villages of the Seraikela-Kharswan district have required teams of doctors and medical staff to be dispatched to assess the extent of the outbreak.
This, however, is by no means limited to rural areas, metropolitan areas such as New Delhi have become ideal breeding grounds for mosquitos. This has led to rising numbers of cases of malaria, as well as dengue fever and the chikungunya virus. The problem, according to Dr Ashish Bhatia, a Delhi physiotherapist and activist, is people as well as insects, “Until about 10 years ago, nobody knew about dengue and chikungunya. Now the problem is that in the big metros there are more and more people within the same infrastructure and this has created more waste, which is not disposed of properly. This is why the mosquitoes have a very good ground for breeding. If you can’t stop mosquitos, you can’t prevent the disease from spreading,”
The city of Ahmedabad has seen a slight increase in cases of dengue since last year, with 198 cases in November 2016 compared to 191 in November 2015 according to the Ahmedabad Municipal Corporation (AMC). The rise in cases of chikungunya has seen a much more sharp increase in civic-body run hospitals, with 80 cases reported in November this year compared to only 1 from November 2015.
Health care staff are also suffering the effects of these mosquito borne illnesses, in the government run VS hospital in Ahmedabad 24 doctors tested positive for vector borne diseases such as dengue and malaria in the months preceding September.
Attempts have been taken to combat the spread of the diseases. A five-year WHO study into the use of insecticide coated nets, carried out across several countries including India showed positive results. Results indicated the nets reduced malaria infections despite mosquitos showing resistance to the insecticides.
There is a phase III trial underway in India and three other countries for an antimalarial drug Tafenoquine, expected on the market by 2018 (how the India Times concludes this is India’s “own antimalarial” in the headline is a mystery that remains unexplained in the story — the drug was discovered more than 20 years ago in the UK) . Tafenoquine would replace a current antimalarial medicine in the treatment of one form of recurrent malaria, benefitting from a one day treatment period which would greatly speed up the treatment process. Other potential treatments such as Artefenomel and KAF 156 from Novartis show promise in a much wider range of patients
We should though read press releases (above all releases from entities looking for philanthropic funding) with caution. A release from the Medicines for Malaria Venture in 2013, for example, said of tafenoquine, “The Phase III trial began in April 2014 and is expected to run until the end of 2015”. We are now at the end of 2016 but you will search the MMV site in vain for any update. Bharat Biotech, a recipient of massive funding from the Gates Foundation and other donors in recent years, announced in multiple press interviews in October a vaccine against Zika. It said that it was only waiting for Government approval to begin Phase I trials and predicted a “fast-track”. However, its CEO admitted in an interview earlier this year that it was likely to be 10 years before the vaccine came to market.
In any case, vaccines and medicines are only part of the answer. Medications may be improved over time, but the diseases themselves will persist for as long as the vectors that spread them remain a credible threat. Cities are becoming consistently more overpopulated, often without the infrastructure available to cope with this burden of people. The abundance of people, as well as structures capable of holding stagnant water provides ample food and potential breeding grounds. Mosquitos thrive in this environment, so too will the diseases they harbour.