Bastar wins over challenge on malaria as annual parasite incidence reduces to historical low

Express News Service
TIRUCHY: While the country has been busy fighting COVID-19 in the past year, another important disease, which cannot be ignored, is malaria. Although India has reported a large reduction in cases, it still has a long way to go. On World Malaria Day, the theme this year is ‘Reaching the zero malaria target’. The New Indian Express speaks to Sarthak Das, CEO, Asia Pacific Leaders Malaria Alliance about combating malaria when all the focus is on COVID-19.

The Union health minister said that 116 districts in India have reported zero malaria cases in 2020. What is the current status of malaria cases and deaths in India? How do they compare to the previous years? How many cases do we see in a year?

India reported the largest reduction (60%) in confirmed malaria cases in 2019 compared to 2017 — one of the few high burden countries globally showing a consistent decline in the malaria burden at a time when global progress against malaria has been plateauing, according to the WHO (2019- 338494 vs 2017 844558 malaria cases).

Despite the successes in the region, there is no room for complacency. 2.5 billion people in the Asia Pacific continue to remain at risk of malaria, with 90% of the case burden in just 5 countries — India, as well as Papua New Guinea, Indonesia, Pakistan and Afghanistan. While being mindful of the current serious and devastating context of COVID-19 in India and the region, these countries will need to stay focused on strengthening the malaria response and broader health systems.

It is not a choice between saving lives from COVID-19 versus malaria — we need to fight both diseases together. In India alone, tribal communities account for 30% of all malaria cases and nearly 50% of malaria deaths.

How did COVID-19 impact access to care and treatment of malaria?

In 2020, fragile health systems faced the dual burden of combating malaria infections as well as managing new COVID-19 infections. This has continued into 2021 in India, as the country responds to the devastation COVID-19 is causing.

The latest data by the Global Fund to Fight AIDS, Tuberculosis and Malaria shows that for April to September 2020, compared to the same six-month period in 2019, malaria diagnoses fell 56% and malaria treatment services plummeted by 59% in India, with the deepest disruption reported in rural areas where the more vulnerable and harder-to-reach communities live.

How do you combat a pandemic like COVID-19 and continue to sustain efforts to control malaria?

While we cannot take the focus away from the already seen devastating impact of COVID-19, ending endemic diseases like malaria support responses to pandemics like COVID-19. In fact, efforts to combat COVID-19 and sustain malaria control are inextricably linked – COVID-19 shares 7 out of 10 primary symptoms with malaria.

If there are any lessons to be learned from COVID-19 for malaria, TB and other emerging communicable diseases, it is optimizing surveillance and real-time data to inform program planning at local and district levels. This must be combined with a sustained emphasis on district level long-term capacity building for disease program management. To reach the last mile in malaria elimination for India, this is critical.

A malaria vaccine has proved to be 77% effective in early trials and could be a major breakthrough against the disease. How big is this development and what would the effect be in India?

While we are encouraged by the early results, we await full results of next phase trials before commenting on the potential of this vaccine.

How does the Asia Pacific Leaders Malaria Alliance (APLMA) think that India can reach the ‘Zero Malaria target’? What steps is the alliance taking and what steps does the government need to take?

We must protect and accelerate gains against malaria and leverage malaria investments to fight COVID-19 and other emerging diseases in India. Investing in capacity building for district level management, equipping local public health staff with training and tools to make better use of real-time data, and ensuring that malaria remains part forward delivery and planning as part of health systems strengthening and pandemic preparedness moving forward will be critical.

An increasing proportion of malaria cases are now found in India’s remote and hard-to-reach areas – rural, tribal, border, hilly and forested – often with weak health systems, severe operational challenges, scattered populations, and limited capacity. Ensuring that tribal health and tribal populations are engaged with solutions that are tailored for their context will be critical for India moving forward.