Context

• The recently released World Malaria Report 2023 shows that the number of cases and deaths due to the mosquito-borne infection India have continued to decline.

Key Findings of World Malaria Report 2023

Indian Scenario

• With an estimated 33.8 lakh cases and 5,511 deaths, India saw a decline of 30 per cent in malaria incidence and 34 per cent in mortality in 2022, compared to the previous year.
• India’s downward trend was reflected in the larger WHO South East Asian region that remained on track to achieving the 2030 target of reducing cases and deaths by 90 per cent.

• Behind India’s success story

  • A focus on providing primary healthcare to the remotest areas, surveillance that is now being backed by digital data, and better handling of extreme weather events such as cyclones have been key to India’s success as per experts.
  • Good preventive practices, use of effective tools to keep the mosquito population in check, use of point of care tests for quick diagnosis, and good management of the malaria cases have been key to reducing cases and deaths due to malaria over the years.
  • There has been a lot of investment in insecticide mosquito nets, antimalarial drugs, and point of care tests to quickly detect the disease.
  • Urbanisation also reduces incidence of malaria by reducing breeding grounds for most mosquitoes that spread the disease.

Global Scenario

• The number of malaria cases had dropped from 243 million to 233 million globally between 2000 and 2019.
• However, there was an increase of 11 million cases in 2020.
• They remained stable in 2021, before seeing another increase of 5 million in 2022 to 249 million.
• The number of malaria deaths also remained higher than the pre-pandemic levels.
• There were 608,000 deaths reported in 2022 as compared to 576,000 cases in 2019.  

Climate change and malaria

• The malaria parasite and mosquito are both extremely sensitive to temperature, humidity, and rainfall, leaving experts worried about expanding reach of the disease.
• The report says that climate change can not only directly increase geographies for malaria spread, but also indirectly affect the impact of the disease by reducing access to healthcare facilities and timely treatment.
• Climate change is likely to lead to an increase in temperatures, with newer areas especially in the Himalayan belt suitable for the spread of the disease.
• High risk zones will also emerge in states that face very high rainfall periodically.
• Almost half of the five million additional malaria cases reported globally in 2022 — 2.1 million — were from Pakistan that witnessed an extreme flood.
• The standing water after the floods became ideal breeding ground for mosquitoes and led to a five-fold increase in malaria cases in the country.

Challenges ahead

• The biological threats include drug resistance, insecticide resistance, gene deletions in parasites which make diagnosis difficult.
• Another challenge is vivax malaria, which accounts for over 40 per cent of malaria cases in India.
  • The vivax plasmodium is known to hide in the liver and cause recurrent infections.

Way Forward

• Need for improved surveillance
• It was important to have real-time digital data of these cases to help local administrations better plan the interventions.
• The last mile is always the most difficult. To achieve the malaria elimination target of 2030, there has to be emphasis on strengthening of surveillance as well as tailoring of malaria interventions at sub-national level which should be data driven.
• In addition updating policies and adopting new tools as per national and subnational need in line with WHO guidance is critical.

Source: IE

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