Why Indian parliamentarians support the fight against malaria: analysis
A malaria free India. We will celebrate this day soon. The government of Prime Minister Narendra Modi has pledged to achieve this goal by 2030, and is accelerating efforts to end the disease. The result? Thousands of malaria cases and deaths prevented; Millions of lives saved. Today, we are presented with a historic opportunity to end the fight and end malaria forever. The failure will put millions of people at risk and will result in the waste of scarce financial resources that can target other urgent health needs. The elimination of malaria by 2030 is an attainable goal for India, but new approaches are needed. The government cannot do it alone, and we must all do our part. As parliamentarians, we are ready to support this goal.
Mosquitoes do not respect state borders or differentiate between political parties and ideologies. That is why 11 members of Parliament, belonging to different states, have come together to support India’s efforts to eliminate malaria. Together, we are committed to working with all stakeholders at the central, state and district levels to accelerate the elimination of malaria not only in the states we represent but throughout the country.
The global health community has praised India for its impressive reduction in malaria cases in the past two years: a decrease of 24% in 2017 and 28% in 2018. This is an extraordinary achievement, and it did not happen by chance . Successive Indian governments have contributed to this through progressive policies. The government of the United Progressive Alliance (UPA) launched the National Rural Health Mission (NRHM) in 2005, which helped strengthen access to quality health services for rural populations. Subsequently, during the government of the National Democratic Alliance (NDA), the high-level commitment of the prime minister in 2015 was followed by the launch of the National Framework for the Elimination of Malaria 2016-30 and the National Strategic Plan 2017-22 for Malaria Elimination.
The political commitment, combined with new financing and health programs aimed at the most vulnerable populations, has given impressive results against malaria in recent years. This must continue. An important priority should be to extend the National Strategic Plan until 2030 and increase domestic financing for malaria.
Political leadership in the states must respond with equal resolution. Odisha is a good example. The state government has expanded its efforts to prevent, diagnose and treat malaria under the “DAMaN” initiative, and has allocated significant state financial resources. The focus is on remote and inaccessible areas that are not well served by the public health system. It resulted in an 80% decrease in malaria cases in 2018. The Odisha government must ensure that it finishes work by developing its own malaria elimination strategy with the help of partners. Similarly, Madhya Pradesh is testing a novel approach through the Malaria Elimination Demonstration Project (MEDP) in the Mandla district. MEDP is an innovative public-private partnership (PPP) between the Government of Madhya Pradesh, the Indian Medical Research Council (ICMR) and the Foundation for Disease Elimination and Control (FDEC). The goal is to eliminate malaria from the Mandla district and use the lessons learned during the process to eliminate the disease from the rest of Madhya Pradesh and the country.
Other states should learn from Odisha and Madhya Pradesh. First, they must develop malaria control and elimination strategies that adapt to the local context. Second, states must be prepared to allocate their own resources to implement these strategies. Finally, state governments must lead efforts to register all cases of malaria. Most states have weak surveillance and no cases of malaria observed in the private sector are reported. We simply cannot eliminate the disease until we know the actual burden of the disease. A concerted multi-stakeholder effort is needed to improve data on malaria cases and deaths, and use it to inform the policy.
Alarmingly, malaria is rapidly retreating to hard-to-reach areas, such as tribal belts, forests, mountainous regions and border districts. Some experts believe that these will be the last frontiers for the elimination of malaria in India. Malaria thrives in places with weak health systems, where access to diagnosis and treatment is often limited. That is why tribal populations account for 30% of cases and 50% of deaths from malaria in India.
This is not to ignore the threat of urban malaria. While it has predominantly become a rural disease in most countries, India is an exception. It remains a powerful threat in cities like Mumbai and Chennai. The main culprits include water storage containers, gutters and construction sites. In this context, there is an urgent need to identify and implement innovative strategies and interventions designed to combat malaria among hard-to-reach populations, as well as in urban pockets.
India almost eliminated malaria during the 1960s. However, we let complacency overcome us. If India had succeeded, it would have prevented millions of malaria cases and thousands of deaths. It is clearly one of the greatest missed opportunities in the public health record of independent India.
We cannot simply continue with a “business as usual” approach. India still has the highest malaria burden in Asia. This is unacceptable and also inconsistent with our aspirations as a nation. We must challenge ourselves with ambitious goals and make bold commitments to fulfill them. We promise that we will eliminate malaria even in the most remote corner of India by 2030. Only when we leave no one behind will we cross the finish line.
KJ Alphons is a BJP leader and member of Parliament, Rajya Sabha, and Gaurav Gogoi is a Congress leader and member of Parliament, Lok Sabha
The opinions expressed are personal.