India unlikely to cut malaria by half in 2020: WHO

A worker fumigating the area as a part of precautionary measures against dengue, malaria during the monsoon season. (Photo for representational purposes)

India accounted for 6% of global malaria cases and 7% of deaths caused by it in 2016, according to a report released on Wednesdayby the World Health Organisation (WHO). This is in the same ballpark as last year, though the WHO figures also suggest that India is unlikely to reduce its case burden beyond 40% by 2020. In contrast, Maldives, Sri Lanka and Kyrgyzstan achieved malaria-free status in 2015 and 2016 respectively. There were an estimated 445,000 deaths from malaria globally in 2016, compared with 446,000 estimated deaths in 2015. About 80% of the deaths were accounted for by 15 countries, namely, India and 14 countries in Sub-Saharan Africa.

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A key impediment to eliminating malaria is a weak surveillance system. India and Nigeria, two major contributors to the global burden of malaria, were able to detect only 8% and 16% of cases, respectively, via the system.

Moreover, 51% of plasmodium vivax cases — the milder cousin of the p. falciparum — were traced in India. This could at least be partially explained by resistance to chloroquine, the first line treatment to p. vivax infections that has been detected in pockets of the country earlier this decade. For a long time, p falciparum dominated India’s case burden and, though its share has decreased, there is a slight increase in malaria cases by other parasites.

Bhutan, Nepal, Thailand, Bangladesh, Myanmar and Indonesia, says the WHO, are among the countries poised to reduce malaria incidence by over 40% by 2020. India — due to low funding per person at risk and resistance to certain frontline insecticides — is only expected to achieve a 20%-40% reduction.

In 2016, an estimated ₹13,000 crore was invested in malaria control and elimination efforts globally by governments of malaria endemic countries and their international partners. The majority (74%) of investments in 2016 were spent in the WHO’s Africa region, followed by the WHO regions of Southeast Asia (7%), the Eastern Mediterranean and the Americas (each 6%), and the Western Pacific (4%).