An uphill fight

Health ministry’s plan to wipe out malaria by 2027 is welcome. But it needs to address manpower shortages, beef up research

By: Editorial | Published:July 18, 2017 12:00 am
Union Ministry of Health and Family Welfare, Malaria, Eliminate Malaria, WHO, World Health Organisation, India News, Indian Express, Indian Express News Express Photo

The Union Ministry of Health and Family Welfare’s plan to eliminate malaria by 2027 is significant for several reasons. Unveiled last week, it aims to eradicate the mosquito-borne disease from India three years ahead of the global deadline set by the World Health Organisation (WHO). It is the country’s first time-bound malaria elimination programme since the National Malaria Eradication Programme was aborted in the late 1960s. Since the 1970s, the thrust of India’s anti-malaria programme has been on controlling the disease. The National Vector and Disease Control Progamme, 2004, the plan’s predecessor, too aimed at “controlling” malaria. The new plan ticks a few other right boxes. There are time-bound targets for all districts, based on their vulnerability to malaria. Moreover, the plan lays emphasis on awareness programmes, entomological surveillance and outbreak warning systems — methods that have contributed to eradicating malaria in several parts of the world, including Sri Lanka.

Yet, the challenges will be tough. For starters, the health ministry will have to address the manpower shortage which has virtually crippled a large number of the country’s primary health centres. According to the ministry’s own admission, there are about 40,000 multi-purpose health workers against the approximately 80,000 sanctioned posts in the 1,50,000 malaria subcentres. This shortage not only jeopardises early detection and treatment of the disease, but is also a cause for a large number of cases going unreported. According to the WHO, the country nearly halved the number of reported malaria cases between 2000 and 2015, from 2 million to 1.1 million. However, studies note that under-reporting of malaria makes it difficult to accurately estimate the burden of the disease.

Compared to several other communicable diseases, malaria is not a particularly complex disease. In theory, all one needs to do is to stop mosquitoes from transmitting the parasite or make the parasite ineffective. In the last decade, studies have shown why this is easier said than done — the malaria parasite has been particularly resilient for centuries. Some of these studies have highlighted India’s vulnerability in this respect. Last year, a paper by an international group of scientists revealed that the Plasmodium vivax parasite responsible for almost 50 per cent of India’s malaria burden has adapted to anti-malarial drugs. This calls for beefing up indigenous research on the disease. The new plan, however, offers very little in this respect. These shortcomings must be urgently addressed.

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