Malaria Disease_00.1
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Malaria Disease

Relevance

 

  • GS Paper 2: Governance, Administration and Challenges- Issues relating to development and management of Social Sector/Services relating to: Health.

 

Context

  • The World Health Organization (WHO) declared China as “malaria-free” which followed a seven decade-long, multi-pronged health strategy that was able to entirely eliminate indigenous cases for four straight years.
  • “Malaria-free” certificate by WHO requires four consecutive years of no malaria cases in the concerned country which is to be verified by an independent panel.

 

About Malaria

  • Malaria is a potentially life-threatening disease caused by parasites (Plasmodium vivax, Plasmodium falciparum, Plasmodium malariae and Plasmodium ovale) that are transmitted through the bite of infected female Anopheles mosquitoes.
  • Symptoms: usually appear 10–15 days after the infective mosquito bite.
    • The first symptoms – fever, headache, and chills – may be mild and difficult to recognize as malaria. If not treated within 24 hours, P. falciparum malaria can progress to severe illness, often leading to death.
    • Children with severe malaria: frequently develop one or more of the following symptoms- severe anaemia, respiratory distress in relation to metabolic acidosis, or cerebral malaria
  • Geographical spread: It is predominantly found in the tropical and subtropical areas of Africa, South America as well as Asia. It is preventable as well as curable.
    • In 2019, The WHO African region was home to 94% of malaria cases and deaths.
  • Severity of the disease: The World malaria report 2020 estimates
    • In 2019, there were an estimated 229 million cases of malaria worldwide.
    • The estimated number of malaria deaths stood at 409 000 in 2019.
    • Children aged under 5 years are the most vulnerable group affected by malaria; in 2019, they accounted for 67% (274 000) of all malaria deaths worldwide.

Malaria in India

  • WHO South-East Asia Region (accounts for 3.4% of the cases globally): the main contributor being India (58%), followed by Indonesia (30%) and Myanmar (10%).
  • Performance of India: The World Malaria Report 2020-
    • India showed a reduction in reported malaria cases of 49% and deaths of 50.5% compared with 2017.
    • The estimated malaria cases were reduced by 24% in 2017 compared to 2016 and 28% in 2018 compared to 2017.
    • Malaria cases reduced by 73% in the region, from 23 million in 2000 to about 6.3 million in 2019.
    • Malaria deaths in India declined from about 29,500 in 2000 to about 7,700 in 2019.

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Steps taken to eliminate malaria:

  • By WHO:
    • WHO Global technical strategy for malaria 2016-2030: provides a technical framework for all malaria-endemic countries and intended to guide and support regional and country programmes as they work towards malaria control and elimination.
      • The Strategy sets ambitious but achievable global targets, including:
      1. reducing malaria case incidence by at least 90% by 2030;
      2. reducing malaria mortality rates by at least 90% by 2030;
      3. eliminating malaria in at least 35 countries by 2030;
      4. preventing a resurgence of malaria in all countries that are malaria-free.
    • WHO Global Malaria Programme: coordinates WHO’s global efforts to control and eliminate malaria.
      • It is supported and advised by the Malaria Policy Advisory Committee (MPAC), a group of global malaria experts appointed following an open nomination process.
    • E-2025 Initiative: based on the successes of the E-20 initiative (aimed at eliminating malaria in 21 countries across five regions).
      • Aim: WHO identified 25 countries having the potential to stamp out malaria within a 5-year timeline (by 2025).
  • By India:
    • National Strategic Plan for Malaria Elimination (2017): shifted focus from Malaria control to elimination and provided a roadmap to end malaria in 571 districts out of India’s 678 districts by 2022.
    • Malaria Elimination Research Alliance-India (MERA-India): a conglomeration of partners working on malaria control (established by the Indian Council of Medical Research (ICMR)).

Malaria Disease_50.1

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Ways to eliminate malaria disease

  • Prevention:
    • Insecticide-treated nets (LLINs) by people at risk and indoor residual spraying (IRS) with insecticide to control the vector mosquitoes are useful.
    • RTS,S vaccine (branded as Mosquirix): found to be safe and reducing the risk of malaria by nearly 40%, the best ever recorded. It has been approved by the European Medicines Agency in 2015.
      • It trains the immune system to attack the malaria parasite (Plasmodium (P.) falciparum, the most deadly species of the malaria parasite).
  • Treatment: best available treatment is artemisinin-based combination therapy (ACT).
  • Early diagnosis and complete treatment: of malaria reduces disease and prevents deaths along with reducing malaria transmission. Increased malaria prevention and control measures have dramatically reduced malaria in India.

 

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