Context:

• Among the 11 nations with 70% of the world’s burden of malaria, only India has managed to reduce its disease burden, registering a 24% decrease between 2016 and 2017, according to the World Malaria Report 2018.

Facts & Figures:

• With about 9.5 million malaria cases in 2017, down 3 million cases since 2016, India is no longer among the top three countries with the highest malaria burden. However, 1.25 billion Indians–94% of its population–are still at risk of malaria, the report noted.
• Globally, the progress made against malaria has stalled for the second consecutive year: The annual report produced by the World Health Organization (WHO) revealed a plateauing. In 2017, there were an estimated 219 million cases of malaria, compared to 217 million the year before. Previously, people contracting malaria globally had been steadily falling, from 239 million in 2010 to 214 million in 2015.
• India has set 2030 as the target year for eliminating malaria. It currently accounts for 4% of global malaria cases and 52% of malaria deaths outside the African region.
• India’s success is “largely due to substantial declines of the disease in the highly malarious state of Odisha, home to approximately 40% of all malaria cases in the country”, said the WHO spokesperson in an emailed interview.
• Odisha reported an 80% decline in malaria cases and deaths in 2017. Reported malaria cases in the state also declined from 347,860 in 2017 to 55,365 in 2018 (January to September) and deaths dropped from 24 to four during the same period, according togovernment data.

Odisha took the battle against malaria to remote forests

• As we said, Odisha accounted for 40% of India’s malaria burden, and its remote, heavily-forested regions with scattered tribal populations were the most vulnerable.
• The state had seen early success in malaria reduction between 2010 and 2013 but cases started increasing again and the state recorded the highest number of cases–444,843–in 2016.
• Around the same time in 2016, the state government started implementing a programme called Durgama Anchalare Malaria Nirakaran (elimination of malaria in inaccessible regions), in short DAMaN.
• The programme was implemented in eight of the state’s most high-burden districts and involved mass screening for malaria. Positive cases were treated and supervision intensified, mosquito control measures were adopted and regular health education activities were held throughout the year.
• “Odisha government showed political commitment by allocating resources and working with development partners in looking at the big picture and ensuring last-mile connectivity,” said H S D Srinivas, head-Health, Tata Trusts, a charity that partnered with the state government in the programme.

India needs to tighten malaria surveillance, invest more in campaign

• Since 2000, India has reduced malaria deaths by two-thirds and reduced reported malaria cases by almost half.
• In 2017, India launched its five-year National Strategic Plan for Malaria Elimination. The plan is a landmark in India’s fight against the disease that shifted focus from malaria “control” to “elimination”. The plan provides a roadmap to end malaria in 571 of India’s 678 districts by 2022.
• With 24% decline in malaria cases, India is on track to reduce malaria cases by 20-40% by 2020, said the World Malaria Report 2018.
• However, there are many road-blocks. India has “weak” malaria surveillance and only 8% of its estimated cases are reported in the national system–second worst in the world–as per the World Malaria Report 2017.
• Further, India’s spending on malaria is amongst lowest in South East Asia, less than $1 per person at risk according to the 2018 report.
• Lessons from Odisha can easily be replicated in other malaria-endemic regions of the country and it is important that the fight against the disease is not allowed to lose its momentum, according to experts. “There have been many ups and downs when it comes to malaria,” said Pradhan, invited to present his findings at the launch of the report at Mozambique. “We need to keep up the efforts [to control malaria] for five years at least to reach the elimination goal.”

Source:Business Standard