India’s malaria surveillance system ranks among the worst in the world according to the World Health Organization’s (WHO) World Malaria Report 2017. Documented within the report is a claim that the surveillance system uncovers only eight percent of all malaria cases within the country.
This opens up the possibility that statistics for malaria within India are hugely underreported. A correlation is drawn between nations with weak surveillance systems and those with high disease burdens. India was found to share six percent of the global disease burden. Nigeria, with a comparable 16 percent of cases uncovered by their surveillance system, shared 27 percent of the global disease burden.
India was found to have the highest burden of malaria outside of Sub-Saharan Africa, which shared the brunt of the disease burden. In the South East Asia region India accounts for 90 percent of malaria cases, followed by Indonesia, with nine percent, and Myanmar with the remaining one percent of cases.
India has suffered from regional outbreaks of the disease in recent years. The state of Odisha has seen its incident rate doubled since 2013. This makes the state India’s most highly endemic region. It has also contradicted the trend of the South East Asia region in seeing a rise of cases, compared to reductions elsewhere.
Despite a relatively bleak outlook from the WHO report, Union Health Minister JP Nadda remains optimistic for India’s fight against malaria. He has made repeated mention on Twitter that India has brought down new cases of malaria by a third, keeping it in line with 2020 goals of disease burden reduction.
Globally the number of deaths is not falling by a significant degree. There were an estimated 445,000 deaths from malaria globally in 2016, this compares to 446,000 estimated deaths in 2015. Despite countries such as Maldives, Sri Lanka and Kyrgyzstan being declared free of malaria, the global burden is not reducing by the rate the WHO intended.
Around 80 percent of malaria related deaths occur within 15 countries, India is included among them, along with 14 nations in Sub-Saharan Africa. Reduction in numbers and elimination in low burden nations, while positive to the global fight against malaria, does little to reduce the overall global figure.
In order to continue to effectively reduce the malaria burden across the globe, funding needs to be allocated accordingly. The WHO report states that compared to the funding available per malaria patient globally reduced across the 2014 to 2016 period compared to 2011 to 2013.
Lack of global aid funding will considerably hamper efforts to curb disease numbers. Of the 41 countries considered to be high burden, 34 rely on external funding for their malaria programmes.