India’s past learnings can help it eradicate malaria
Data indicates that it is headed in the right direction, but the last mile is the hardestUpdated: Jun 06, 2019 20:20 IST
India has sustained significant decline in malaria cases, halving numbers to 5.1 million in 2018 from 9.6 million the year before. This followed a 24% decline in 2017, according to the World Malaria Report 2018. This year, the cases have fallen across all states except Himachal Pradesh, Tripura, Uttar Pradesh and Lakshadweep. Despite the success, it is early days yet to declare that the country is on track to reach its goal of zero indigenous cases by 2027.
The learnings from the polio eradication drive that led to India being declared polio free by the World Health Organisation in 2013 show that the last mile is the most difficult, when missing a single case can lead to outbreaks that infect dozens before they are contained. In the early 1990s, polio paralysed an average of 500-1,000 children every day, but mass vaccination campaigns using the highly effective oral polio vaccine brought cases down to 265 by 2000. But just when the eradication goal was in sight, the numbers jumped to 1,600 in 2002 and infection registered highs of 866 and lows of 66 over the next decade until eradication in 2014.
Vaccination made eradicating polio and smallpox possible, but malaria is a more complicated case. Malaria, which is a parasitic infection that spreads between people through the bite of the infected female anopheles mosquito and causes symptoms like fever, headache, chills and vomiting, can be eliminated only by stopping indigenous transmission of the infection. Rapid diagnostic tests make it possible for trained health workers to test all cases of fever in makeshift camps and treat everyone with malaria. This, along using insecticidal bed-nets, has helped states to reduce numbers, but to achieve elimination, tracking and testing of all fever cases have to be scaled up to stop importation, include monitoring everyone who is from, or has visited, a malaria endemic country. India has a long way to go, but the data indicates it is headed in the right direction.