India to be Malaria- Free by 2027
Three Pronged strategies shall be put into practice to achieve desired targets – says Dr.Ashwani Kumar
The Voice of Chandigarh News | H.C.Gera(Special Correspondent)
India will be Malaria-Free by 2027. These are the claims made by The Union Ministry of Health and Family Welfare. A National Strategic Plan (NSP) for Malaria Elimination was unveiled which indicated year 2027 as the deadline for Malaria in India. WHO’s Global Technical Strategy for Malaria 2016-2030 has already
supported the campaign. Hopefully India will be free from Malaria by 2027 and certified malaria free by WHO.
The details of the strategic plan for the same were shared by Dr. Ashwani Kumar holding the current position as Scientist G (Director Grade) with varied research experience for over 30 years in the field of Malaria, applied and operational Research Projects.
Dr. Ashwani Kumar is the author of four books and an advisor WHO (Vector Control Advisory Group) Geneva. Dr. Ashwani Kumar who has attended several international trainings in London School of Hygiene and Tropical Medicine, U.K., German Centre for Biotechnology, Braunshweig, Germany, IS Global Course organised in Barcelona and Sitges, Spain and Vector control operations in California.
According to Dr. Ashwani Kumar, the National Strategic Plan (NSP) is a year-wise road-map for Malaria Elimination across the country. This plan envisaged universal case detection and treatment services in Malaria endemic districts to ensure 100 per cent diagnosis of all suspected cases with an aim to provide complete treatment to all confirmed cases. The basic aim is to interrupt transmission so as to attain and maintain malaria free status.
The team of The Voice of Chandigarh interacted with Dr. Ashwani Kumar as to how India shall be attaining the status of Malaria Free on the Global map. The Excerpts:-
Dr. Ashwani let me know the basic difference between Malaria Eradication and Malaria Elimination?
As per WHO, Malaria Eradication means the ending of the transmission of malaria and elimination of the reservoir of infective cases. This is to be achieved in a limited time frame and is carried out with such a degree of perfection that when it comes to an end, there is no resumption of transmission. Whereas Malaria elimination is the interruption of local transmission (reduction to zero incidences of indigenous cases) in a defined geographic area. To attain this specific target continued measures are required to prevent re-establishment of transmission.
What is the Malaria Situation in India as of now before we talk about Malaria Free India?
Malaria Morbidity and Malaria mortality are normally mentioned when we talk about the disease burden in India. Varied data has been given by different agencies about the Malaria situation and deaths due to Malaria. As per National Vector Borne Disease Control Programme (NVBDCP) of GOI the estimated morbidity due to Malaria is 1-2 million cases in the last one decade. Whereas the deaths due to Malaria are ~300-1000 (Reported) cases. But it is a fact that sufferings due to Malaria and Productivity loss are enormous wherever Malaria has not been eliminated across the world. There are short term and long term ill-effects of malaria to fetus and pregnant mothers in high burden areas. Malaria elimination when achieved in these areas will prevent such effects.
I understand that GOI has fixed certain targets for the states and Union territories to attain the goal of elimination. What are those targets?
Yes you are right. Govt. has fixed targets for states & union territories based on the technical data what we call API (Annual Parasitic Incidence). This is criteria fixed for various states. Fifteen states and UTs where API (Malaria cases per 1000 population) is less than 1 in all the districts the target year for malaria elimination will be 2020. Likewise malaria elimination target for other 10 states where some districts have API more than 1 is 2022 while in the remaining states where burden of malaria is high and API in all districts id more than one the target years will be 2027. The third category is important because of poor socio- economic factors. It is widely believed that malaria is one of the many factors responsible for poverty and backwardness.
How are we going to attain these targets in the given circumstances? Or in other words what measures will be initiated to meet these targets?
As per National Strategic Plan, three pronged strategy shall be put into practice to achieve the desired targets. Stress will be laid on Vector Control, Disease Surveillance and finally IEC/ BCC(Educating the masses). All these will be accelerated to achieve malaria elimination. Each strategy is important in itself but the same is to be implemented with zest & zeal ensuring maximum coverage and compliance. Vector management will be done by using various Chemical and Biological methods with a stress on source reduction of vectors. For disease surveillance the motto is simple Test, Treat and Track the cases. Under the third strategy we need to change the Behaviour of community for their active involvement.
Don’t you think that there is a role of research in the elimination of disease especially Malaria?
The role of research is of utmost importance. We need to have epidemiological studies, Sero-epidemiological studies, research in Health systems and performance besides research on evaluation of newer approaches in the field of Vector management and other entomological research work which needs to be taken up on priority.
What is situation in the neighboring countries?
You will be surprised to know that Sri Lanka is already Malaria free country; Bhutan has only 19 cases and Nepal 1469 cases. Even Pakistan is having few cases but Myanmar is endemic to malaria with floating population which could pose a threat because of uncontrolled movement of population across the border.
What are the challenges which could hamper our objectives of elimination?
Challenges always exist. But we have to learn from the past experiences as well. The six states namely Odisha, Chhatisgarh. Jharkhand, Meghalaya, Arunachal Pradesh and Mizoram are the states witch contribute and report most of the Malaria cases in the country. To my mind it could be due to system- failure or inadequate response to achieve malaria elimination in these high burden states. Another challenge could be due to interruption in supply chain because of insurgency in the states targeted for elimination in 2027. At the same time this could be tackled through strong political commitment.
Dr. Ashwani with concerted efforts of the GOI and the respective states we hope to have India as Malaria Free India by 2027. What will be our expectations and aspirations once we achieve the target of ‘Malaria free India’?
We shall have more productivity in the areas of Agriculture and Industry. GDP will be (higher by up to1%) and lesser Health expenditure. India will have lesser poverty and the overall economy of the country shall increase to newer heights. India will witness a greater Social and Infra- development once we achieve the status as ‘Malaria Free India’