Recently, the World Health Organization (WHO) released the World Malaria Report (WMR) 2020. This vital document offers an exhaustive update about global and regional malaria data and trends. It covers a wide array of subjects, including prevention, diagnosis, treatment, elimination, and surveillance. Interestingly, the report points out that India has made significant strides in reducing its malaria burden.
Global Malaria Analysis
According to WMR 2020, the estimated number of malaria cases worldwide stands at about 229 million, a figure that has remained relatively unchanged over the past four years. The disease claimed approximately 409,000 lives in 2019, slightly less than the 411,000 reported in 2018. The report further highlights that 11 countries – Burkina Faso, Cameroon, the Democratic Republic of the Congo, Ghana, India, Mali, Mozambique, Niger, Nigeria, Uganda, and Tanzania – account for 70% of the global estimated case burden and 71% of global estimated deaths from malaria. Countries in South-East Asia have made particularly commendable progress, with reduction rates at 73% and 74% for cases and deaths, respectively.
Indian Analysis: Progress in Malaria Control Efforts
India is the only high endemic country that reported a decline of 17.6% in 2019 compared to 2018. Moreover, the Annual Parasite Incidence (API) fell by 18.4% in 2019. Impressively, India has maintained an API of less than one since 2012. With a drop in cases from about 20 million to roughly 6 million, India has contributed to the largest drop in cases region-wide. The country recorded a reduction of 83.34% in malaria morbidity and 92% in malaria mortality between 2000 and 2019, thereby achieving Goal 6 of the Millennium Development Goals (MDGs). Unfortunately, the states of Odisha, Chhattisgarh, Jharkhand, Meghalaya, and Madhya Pradesh still accounted for nearly 45.47% of malaria cases in 2019, with 63.64% of malaria deaths also reported from these states.
Malaria Elimination Target: A Realistic Goal
The significant decrease in malaria over the past two decades indicates that the malaria elimination target of 2030 looks achievable.
Initiatives to Curb Malaria
India began its efforts towards malaria elimination in 2015. These efforts were intensified after the launch of the National Framework for Malaria Elimination (NFME) by the Ministry of Health and Family Welfare in 2016. The National Strategic Plan for Malaria Elimination (2017-22), which provides year-wise elimination targets depending on the endemicity of malaria, was launched in July 2017. The High Burden to High Impact (HBHI) initiative started in West Bengal, Jharkhand, Chattisgarh, and Madhya Pradesh in July 2019, and it has since made significant gains in India, with reductions of 18% in cases and 20% in deaths over the last two years.
Contributing Factors to the Decline of Malaria
The Government of India’s provision of microscopes, rapid diagnostics, and Long Lasting Insecticidal Nets (LLINs) to high burden areas has led to a reduction in endemicity in these high-risk states. LLINs, nets treated with an insecticide incorporated into the fabric, have been widely accepted by the community and are one of the main contributors to the drastic decline in malaria in India.