Increased investment in public health, better drugs help govt achieve this feat

After grappling with the twin stings of malaria and dengue, there seems to be some respite at last, as data from various agencies suggest that India is making good progress against vector–borne diseases, especially malaria.

Though there has been an inexplicable spurt in dengue cases in the past couple of years, the number of malaria cases and malaria–related deaths across the country has actually declined. Doctors and public health experts attribute this to increased investment in public health, better drugs, use of bed–nets, and general socio–economic development.

"The sewage and drainage system has improved. Also, implementation of anti–malarial precautions prescribed by the WHO has helped contain the severity of the disease," said Dr Khusrav B Bajan, consultant physician at Mumbai’s PD Hinduja Hospital.

Figures show that malaria–related deaths have come down to 519 in 2012 from 1,144 in 2009. Till August, the number of reported deaths stood at 185. There has also been a sharp drop in the number of reported malaria cases, which has fallen from 15 lakh in 2009 to 10 lakh in 2012, according to provisional figures available with the National Vector Borne Diseases Control Programme (NVBDCP), an agency that monitors viral diseases .

Experts say that despite the risk of underreporting, the numbers prove that the severity of the disease is definitely coming down. In the past year, barring a few states, the mortality numbers have also dropped. But in Gujarat, for instance, the number of malaria–related deaths has gone up to 19 in 2013, from 16 in 2012.

"In the past decade, there has been a lot of work done to prevent malaria: the distribution of insecticide–treated nets (2.25 million), use of improved anti–malarial or artemisinin–based combination therapy and easy access to Rapid Diagnostic Test have helped in keeping the disease under check," said GS Sonal, additional director of NVBDCP. He added that if the numbers begin to go up, it’s going to be a matter of concern.

The most severe form of malaria is caused by the plasmodium falciparum virus which thrives in stagnant water. The malaria caused by falciparum virus affects 65% of India’s cases and possible deaths.

Along with TB, HIV, AIDS and malaria are the main worries of developing countries, and have attracted huge funds from philanthropic institutions. Malaria has got close to . 600–crore funding from the Global Fund, the largest donor that helps fight diseases like HIV and tuberculosis also. The government, through NVBDCP, has chipped in about . 30 crore for combating malaria. However, despite these efforts, there is some scepticism about the numbers, since state governments often tend to under–report instances of the disease, and there’s no way of cross–checking them.

"There are declines, but they have not been significant in many places. In many states, you will find a surgeon or obstetrics treating malaria cases rather than appointing experts from the field," says a researcher from the National Institute of Malaria Research.