India needs to do much more to eliminate malaria by 2030

Aarti Dhar, CNS Correspondent, India
[First published in theindiasaga.com]
With two malaria deaths and several patients being treated for the disease in its capital city New Delhi, India needs to do much more if it is to eliminate Malaria by the year 2030. The World Health Organisation (WHO) has set a goal of eliminating the disease from 35 countries across the world including from India and Indonesia.

Just a couple of days ago, Sri Lanka became the third country in Asia to eliminate malaria.  If the WHO target is to be achieved, funding for malaria will have to be increased from the existing $ 2.5 billion to $ 8.7 billion.

Though malaria cases have come down in India from 2 million to 1.12 million between 2000 and 2005, but the issue continues to be serious. 287 malaria deaths were reported from India last year. As much as 80% of these deaths were in the north and north-eastern part of the country. Target 3.3 of Goal 3, within the Sustainable Development Goals (SDGs) commits to end global epidemics of AIDS, TB, malaria and neglected tropical diseases by the year 2030. One of the leading cause of mortality from these diseases which does not find a mention in the SDGs is the need to address antimicrobial resistance (AMR)—the spread of strains of disease that are resistant to standard medicines. AMR has emerged as an urgent global health challenge that could prevent many countries from achieving the health-related SDGs. The UN will host a high-level meeting on AMR on 21 September, during the General Assembly, to address the challenge posed by AMR. This will be a key step for mobilizing international action against multi-drug resistant TB (MDR-TB) and drug resistant malaria, which has already recorded its presence in South East Asia.

Although TB prevalence declined by 41% between 1990 and 2013, an estimated 1.5 million people died of it in 2014. With HIV on the decline globally, TB is now the world’s deadliest infectious disease. With multi drug resistant TB (MDR-TB) on the rise, countries will have to take necessary steps toward addressing drug-resistance. One such step in the right direction is a new shortened treatment regimen for MDR-TB that has been endorsed by the WHO. This new 9-12 month treatment is substantially shorter and easier to tolerate than the current 24-month regimen. According to Dr Anna Nakanwagi Mukuwaya, Country-Director, Uganda, at The Union (International Union Against TB and Lung Diseases), the decline of TB, HIV, malaria has been slow mainly because the health systems are poor. "Disease control cannot be achieved with poor health systems. Unfortunately, a lot of attention and funding is allocated for individual diseases programmes and not on health systems strengthening," she added.

Every year, leaders from around the world descend on New York City for the United Nations General Assembly. Last year marked the historic adoption of the Sustainable Development Goals (SDGs), which replaced the Millennium Development Goals. The SDGs marked a turning point in the way broad, global issues are addressed – although it remains to be seen what impact they will have. The SDGs cover a number of important social and developmental areas, including climate change and resilience, global health, and economic empowerment. In total, there are 17 goals that include 169 targets. SDG Goal 3, with its 13 targets focuses on global health, seeking to achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all. There is a special emphasis on child and maternal health, and on ending HIV/AIDS, malaria, TB and other tropical diseases by 2030.

It also calls upon countries to strengthen the implementation of the WHO Framework Convention on Tobacco Control (FCTC) in all countries, as appropriate, and substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small islands developing States. According to the WHO, "Almost all of the other 16 goals are directly related to health or will contribute to health indirectly.”

Aarti Dhar, Citizen News Service - CNS
September 13, 2016

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