Malaria can be eliminated from India and the South Asia region by 2030, claims the Asia Pacific Leaders Malaria Alliance (APLMA), marking World Malaria Day. This positivity may be overshadowed by the spread of drug resistant malaria in a number of south Asian countries.
Though not yet spread to India, there are reports of Artemisinin-resistant strains of malaria present in other south Asian countries such as Cambodia, Vietnam and Thailand. If these strains spread to India, widely used anti-malarial medications will be useless.
The implication of this is that the elimination (reduction to zero of local occurrence, eradication being the worldwide reduction to zero) of malaria is an ever more pressing issue, with the potential to become more severe as drug resistance — as is the case in many other diseases — becomes more common. Dr Benjamin Rolfe, APLMA’s Executive Director comments on the issue:
“Drug resistant malaria is a health crisis that could drastically impact the hard-fought success achieved in the fight against this disease. If the most important treatment for malaria becomes ineffective, we will surely see a devastating rise in malaria mortality, mostly among children,”
India has however made some progress towards this goal in the last few years. The National Vector Borne Disease Control Programme framed a comprehensive National Framework for Malaria Elimination in India (2016-2030) programme, which was announced by the Union Health Minister J. P. Nadda in February 2016. This programme established several objectives to aid in the goal of malaria elimination (.
The objectives largely revolve around the categorisation of states based on their overall malaria burden. This allows for benchmarks to be set out to eliminate the disease in low burden states at earlier dates, which will then allow for the focus to be placed on prevention of the re-establishment of local transmission.
A critical factor in the elimination of malaria is diagnosis and communication between hospitals. With better communication, a more accurate insight into prevalence and outbreak locations can be achieved, which would aid in effective treatment. One factor holding India back has been the disparity and lack of communication between government run and private hospitals.
A declaration by the state government of Nagaland has made it mandatory for private hospitals to report cases of malaria to the health authorities. This is a worthwhile endeavour as it allows for a better degree of collaboration between government and private hospitals — used by a majority of Indians.
The South Asia region has shown a huge degree of success in combatting malaria, cutting its prevalence and associated deaths by half over the last 15 years. Some Indian states such as Assam are even declaring themselves to be in the pre-elimination phase, with malaria numbers showing a consistent decline. This is encouraging progress, though many areas are not showing such a large degree of success.
The fight against malaria still has many years to go, and as south Asia closely follows Africa as the second most prevalent area for malaria, it is a healthcare priority for the region. The APLMA remains optimistic though, with Dr Nafsiah Mboi, Leaders’ Envoy and Board Chair saying:
“We believe that we can win the fight against malaria. However, we must not lose focus in Asia and the Pacific – and particularly in India – where the malaria burden remains a significant weight on families, communities, national economies and national health systems,”