India has a high incidence of malaria and it is committed to eliminate malaria by 2030.
Public private partnership is required to achieve the malaria elimination target.
What is malaria?
A disease caused by a plasmodium parasite, transmitted by the bite of infected mosquitoes (usually female anopheles mosquitos).
The severity of malaria varies based on the species of plasmodium.
Symptoms of the disease includes chills, fever and sweating, usually occurring a few weeks after being bitten.
It is preventable through a Malaria vaccine and it is curable disease.
What is the status of Malaria in India?
Malaria exists in all States in India, and 95 per cent of Indians are at risk.
Most cases are reported from Chhattisgarh, Jharkhand, Madhya Pradesh and Odisha.
North-Eastern states like Arunachal Pradesh, Meghalaya, Mizoram and Tripura also have high transmission.
However, the scale and distribution of this devastating disease is not well documented.
Estimates range from 1 million to 18 million cases and from 400 to 48,000 deaths per year.
What are the challenges in eliminating the disease?
Majority of malaria in India is diagnosed and treated (or commonly misdiagnosed and mistreated) in the private sector.
Private Doctors and clinics have no obligation to follow government guidelines, use recommended drugs, or report malaria cases to State authorities.
In 2015, 86 million malaria treatments were procured in the private sector, compared to just 2 million in the public sector.
Each year, the private sector procures nearly 10 million injections of Artemisinin Monotherapy, a treatment that is strongly discouraged in India and elsewhere because it accelerates the development of deadly drug resistance.
The misuse of malaria drugs in India is an irony, given that India is by far the largest supplier of high-quality approved malaria drugs to the rest of the world.
What measures needs to be taken?
In 2017 India launched national strategic plan for malaria elimination, awareness about the plan needs to be created through campaigns.
National initiatives must promote innovative strategies, incentivise the appropriate use of diagnostics, drugs and insecticides, and ensure that all malaria cases are reported.
The most affected States must aggressively bring their malaria down using effective vector-control and case management practices, combined with robust surveillance systems.
States will have to tailor their programmes to achieve elimination, especially in tribal areas where the burden of malaria is often the highest.
A single approach to malaria elimination will not work in any large country, especially in India where the biology, entomology and epidemiology of the disease vary considerably.
Thus partnership between communities, civil society, private sector, and public health agencies is required.
