New Delhi: The World Malaria Report 2018 released this week says that while the disease had globally been on a decline, progress “stalled” between 2015 and 2017.
Prior to this period, the World Health Organization (WHO) says that the world was seeing an “unprecedented period of success in global malaria control.” But data from 2015 to 2017 shows that “no significant progress in reducing global malaria cases was made in this period.”
India, however, gets a positive review in the report: “Of the countries hardest hit by malaria, only India showed progress in reducing its disease burden,” says the WHO.
“Nobody should die from malaria,” said WHO’s Director-General, Dr Tedros Adhanom Ghebreyesus in a statement. “As progress stagnates, we are at risk of squandering years of toil, investment and success in reducing the number of people suffering from the disease”.
This year’s report has a special focus on 11 countries – the only non-African country given a special focus in the report is India.
Just these 11 countries account for 70% of the global malaria burden – or 151 million cases and 2,74,000 deaths – in 2017. Five of these countries, including India, account for nearly half of all malaria cases worldwide – Nigeria leads at 25%, followed by the Democratic Republic of the Congo (11%), Mozambique (5%), India (4%) and Uganda (4%).
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Between 2016 and 2017, the number of estimated malaria cases globally rose – from 217 million to 219 million. There were 4,35,000 malaria-related deaths in 2017 too.
The WHO wants these countries – India, Burkina Faso, Cameroon, the Democratic Republic of the Congo, Ghana, Mali, Mozambique, Niger, Nigeria, Uganda and the United Republic of Tanzania – to lead the response to malaria.
In total, the World Malaria Report 2018 examines data from 91 countries which have an ongoing transmission of malaria. The report depends on data released by national malaria control programs and other partners who work in endemic countries.
India shows a decline in malaria
India has 4% of the global malaria burden. Between 2016 and 2017, India showed an impressive 24% reduction in malaria cases or a reduction of three million cases.
Out of all the 11 highest burden countries, India is the only one to have recorded a substantial drop.
The WHO credits the efforts in the state of Odisha for India’s impressive decline saying that the country’s drop is “largely due to substantial declines of the disease in the highly malarious state of Odisha, home to approximately 40% of all malaria cases in the country”.
The possible reasons for this success according to the WHO include “rejuvenated” political commitment, a strong technical leadership and increased domestic funding.
The WHO makes special mention of Odisha’s network of ASHA workers who help deliver anti-malaria services in rural and remote parts of the state.
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On technical leadership, the WHO says this means India’s approach in Odisha had the “right mix” of vector control measures. The WHO stresses through the report that domestic funding is key as global funding has also been plateauing. The US remains the single largest international donor, and contributed 1.2 billion USD in 2017 – one-third of all funding (3.1 billion USD) available in 2017 for control and elimination of malaria.
Odisha has scaled up efforts on prevention, diagnosis and treatment of malaria through an initiative known as DAMaN. The state has also tried to improve the skills of its healthcare workers.
In the region, China has reported no local transmission of malaria in 2017. Malaria is endemic to China as well. The WHO says this is “proof that intensive, country-led control efforts can succeed in reducing the risk people face from the disease.” Pakistan also reported a marked decrease of more than 2,40,000 cases in the same period.
In 2015, India pledged to eliminate malaria by 2030, along with 17 other countries at the East Asia Summit. In 2017, India launched a National Strategic Plan for Malaria Elimination. It details India’s roadmap for malaria elimination in 571 districts out of India’s 678 districts by 2022.
