National strategic plan for malaria elimination

• Ministry of Health and Family Welfare launched the National Strategic Plan for Malaria Elimination (2017-22).

Highlights of the plan:

• Strategies involve strengthening malaria surveillance, establishing a mechanism for early detection and prevention of outbreaks of malaria, promoting the prevention of malaria by the use of Long Lasting Impregnated Nets (LLINs), effective indoor residual spray and augmenting the manpower and capacities for effective implementation for the next five years.
• Intersectoral coordination is the key, we have to work together with the other Ministries and Municipal Corporations to achieve the desired results.
• The NSP, a year-wise roadmap for malaria elimination across the country, is based on last year’s National Framework for Malaria Elimination, which was, in turn, spurred by World Health Organisation’s Global Technical Strategy for Malaria, 2016-2030.
• The NSP divides the country into four categories, from 0 to 3. Zero, the first category, has 75 districts that have not reported any case of malaria for the last three years.
• Category 1 has 448 districts, in which the annual parasite incidence (API, or the number of positive slides for the parasite in a year) is less than one per 1,000 population. In Category 2, which has 48 districts, the API is one and above, but less than two per 1,000 population. Category 3 has 107 districts, reporting an API of two and above per 1,000 population.
• The plan is to eliminate malaria (zero indigenous cases) by 2022 in all Category 1 and 2 districts. The remaining districts are to be brought under a pre-elimination and elimination programme.
• The NSP also aims to maintain a malaria-free status for areas where transmission has been interrupted. It seeks to achieve universal case detection and treatment services in endemic districts to ensure 100% diagnosis of all suspected cases, and full treatment of all confirmed cases.
• The plan has four components, based on WHO recommendations: diagnosis and case management; surveillance and epidemic response; prevention — integrated vector management; ‘cross-cutting’ interventions, which include advocacy, communication, research and development, and other initiatives.

Analysis:

• One child dies of malaria every two minutes and the burden is the heaviest in the African region. India has the third highest malaria burden in the world. She stressed on harnessing innovation and research along with monitoring and surveillance, and community participation.
• India’s system is a little complex and have so many malaria vectors, each one has its own biological characteristics and they are all occupying different parts
• There is a need to study their biology and how we use our limited tools to control them. So, planning is very essential and that is why this new programme is needed.
• The most difficult areas are the forest areas, there is presence of good tools and medicines in India, but the problem is that these are not reaching to the people. There was strong need of community participation and this plan is doing the same.
• Biggest challenge to remove malaria in India is data discrepancy where there is no confirm data on number of death cases of Malaria.
• India has sturdy health systems with trained manpower, and the learning from the Polio and Elimination of Maternal and Neonatal Tetanus will help in eliminating Malaria too.
• It demonstrates renewed commitment and strategic thinking on India’s part, and is a significant effort for the malaria elimination efforts and goals of the region and globally also
• Eliminating Malaria will result in cutting down on expenditure on diseases control programme, and will help in reducing out-of-pocket expenditure too.
• It will also help to build systems to fight other mosquito-borne illnesses also.

By: Vishal