A highly infectious numbers game
We all use numbers every day, but the people who seem to be having the most fun with them are epidemiologists. Over the past few years, estimates for almost all major killer infections - HIV that causes AIDS, tuberculosis, bird flu, swine flu, to name a just few - have been swinging between what can best be described as bipolar extremes.
There's actually a maniacal method in the madness. First, we are told millions would get infected and we'd be lucky to witness sundown. When we not only survive the day but several weeks, months and years, we are told the data-crunchers may have got it wrong. Of course, no one is blamed for flunking the math. All we're told is that a new lot have got it finally right by using improved evaluating tools and data collection techniques.
The newest disease to have its estimates revised is malaria. US researchers said on Friday it kills over 1.2 million people each year worldwide, which is double the 650,000 deaths reported in the World Health Organisation's World Malaria Report 2011. The revision, done by researchers at the University of Washington's Institute of Health Metrics and Evaluation and reported in The Lancet, is based on data collected from 1980 to 2010.
For India, their estimate of 46,970 deaths - 4,826 of them children below five years - was more than 45 times higher than the 1,023 recorded by the country's National Vector Borne Disease Control Programme.
The study contradicts another report in The Lancet printed less than two years ago. In 2010, the Toronto-based Centre for Global Health Research put malaria deaths in India at 2.05 lakh (205,000). The group analysed the cause of 75,342 deaths across the country between 2001 and 2003 and concluded malaria caused 3.6% (2,681) of all deaths. The report said Orissa alone accounted for 50,000 deaths, the highest in the country, followed by Chhattisgarh, Jharkhand, Assam and other north-eastern states.
While epidemiologists and governments quibble over data, what remains fairly unanimous across all reports is that the number of people dying of this very treatable infection is steadily falling. The reason is the use of artemisinin drugs instead of outdated medicines - such as chloroquine; combination of sulphadoxine and pyrimethamine; and mefloquine - to which the parasites have become resistant.
Malaria spreads through mosquito-bites and causes symptoms of fever, headache, vomiting and chills. If untreated, malaria kills by disrupting blood supply to the vital organs.
This month, Ranbaxy is ready to launch another new malaria drug, which is the first "new chemical entity" to have been developed by an pharma company in India.
The new molecule is arterolane maleate in combination with long-acting piperaquine phosphate that conforms to the WHO-recommended combination therapy for the treatment of uncomplicated P. falciparum malaria, the most deadly form of malaria that causes 90% of all deaths.
What works in its favour is the ingredients - arterolane maleate and piperaquine - have a synthetic source of origin, which makes it an effective alternative to artemisinin and its derivates that are made from plant-derived materials. In case of disease breakouts, the synthetic nature of the drug is expected to ensure unbroken supply and keep costs down . The drug has been developed as a once-a-day therapy to be used for three days.
Globally, malaria affects 108 countries, infecting one in 10 people in tropical countries in South Asia, south-east Asia, central America, south Pacific islands, and most parts of Africa.