Malaria has been a global scourge for millennia. This is especially true of India. For as long as the country has been an independent nation, malaria has posed a major threat to the health of the nation. In 1947, an estimated 75 million Indians were infected with malaria – more than a fifth of the country’s then 330 million strong population.
Initiatives undertaken by the Indian government such as the National Malaria Control Programme and the subsequent, more ambitious National Malaria Eradication Programme secured a dramatic reduction in cases, even as the population swelled. By 1961, the number of cases was less than 50,000.
Over the following decades, however, incidence of the disease grew at an exponential rate. The number of cases re-entered six digits and, at the turn of the millennium, numbered 2 million.
In April 2015, the World Health Organisation (WHO) wrote that India had made substantial progress towards eradicating the disease. It noted that, in 2013, the number of cases had been more than halved since 2000, to 882,000. It also assessed India to be in the control phase of the WHO’s four-step malaria eradication programme and could expect to move into the next phase, pre-elimination, by 2017. The head of India’s National Vector Borne Disease Program, Dr. Akshay Dharival, has said that he hopes to make India free of malaria by 2027.
Nevertheless, the 2015 WHO World Malaria Report – published later that year – still found, that India has much work left to do. In the south-east Asia region, India accounts for 70 percent of malaria cases, more than any other country. The report also noted that, whilst the population in India is at the most risk from malaria, funding to combat the disease was low. It also highlighted India as one of three countries in the region – the others being Indonesia and Nepal – that did not provide the quantity of antimalarial medicine needed to treat all reported cases in public health facilities.
As Health Issues India has written before, mosquito borne diseases have been on the rise in India this past year, with a rise in infections of dengue and chikungunya. Malaria has been making similar headlines in the state of Jharkhand recently, with outbreaks and fatalities being reported in villages in the Simdega and Seraikela-Kharwasan districts.
This does not mean that India should not be optimistic about the real and indisputable progress it has made. This, in turn, does not mean it should become complacent. Rather, health sector officials and policymakers should now double down on their efforts, now that the elimination of malaria is arguably closer within reach than ever before.
To this end, the Times of India recently reported on the potential of new antimalarial drugs, stating that India can expect an antimalarial drug, Tafenoquine, by 2018. More broadly speaking, the article wrote that spending on the treatment of malaria has increased more than tenfold since 2000 and is currently estimated to be $2.7 billion per year compared to $130 million at the beginning of the century. As a result of this, the number of antimalarial research projects has doubled since 2008. Now, with Tafenoquine in stage three trials and two other drugs – artefenomel and KAF156 – “in advanced stages of development”, the ToI state that researchers expect “a positive outcome over the next five years.”