Economic Highlights
New Delhi, 1 August
2022
Malaria Comeback
REQUIRES $80 BILLION
FUNDING
By Shivaji Sarkar
Dreaded malaria can
make a comeback amid global warming-heavy rains and needs three times more
allocations a year. India suffers a severe economic hardship, wage and
production loss as it accounts for 83 per cent of malaria cases and 82 per cent
deaths in South-East Asia regions in 2021, says the World Health Organisation.
The South East Asia
region has 4.2 million cases and 7341 deaths. Climate change and warming can
accentuate the problem, according to Soumya Swaminathan, Chief Economist of WHO
amid global commitment to eliminate malaria by 2030.
Annually India spends
about $1.94 billion on malaria or over Rs 11000 crore, according to an estimate
in 2017 by Indrani Gupta and Samik Chaudhury of Ambedkar University. But it may
have to increase allocations as the WHO finds that its own estimates needs at
least three times rise a year. Meeting global targets need robust funding. According
to the WHO report, current funding levels (estimated at US$3.3 billion in 2020)
will need to more than triple, reaching US$ 10.3 billion per year - $ 80.24
billion by 2030, target date for elimination of the disease. Malaria can
strain national economies, impacting some nations’ gross domestic product by as
much as an estimated 5–6 per cent. It includes 75 per cent losses on
productivity/wages and the rest on treating the disease, says Gupta.
The WHO funding raise
is important as it targets malaria elimination by 2030. India has also
committed to it. It needs enormous budgetary allocation, a severe strain for a
government under financial constraint. It is said that malaria is manageable
and controllable. The 15th Finance Commission recommends
unconditional grants of Rs 1 lakh crore for the health sector for five years
and told the States to spend 8 per cent of their budget on health. The Economic
Survey 2020-21 says that out of pocket expenses by households on health is one
of the highest in the world more so if treated in private sector.
Mumbai warns of
malaria spread as in June 2022 itself it detected 57 cases and 119 cases in the
first week of July. Assam has recently issued a warning on vector borne
diseases as 74 encephalitis cases have been detected. North-East has very high
incidence and malaria related anaemia. Similarly, Delhi reports detection of
126 dengue cases in June itself but is silent on malaria. In western Uttar
Pradesh, medical officer Dr Avanindra Kumar issues alert and creates special
malaria-dengue wards at 10 primary health centres early July. Rajasthan has
heavy rains this year. The incidence of malaria in 2021 had increased
marginally to 649 cases from 449 cases in 2020 and dengue case 1022 cases from
717 cases foods.
The Union Health
Ministry says despite powerful drugs to treat malaria, the last two years of
covid pandemic has thrown up challenges for diagnosing malaria. Several
symptoms are so common and adds, “it has become harder for medical
professionals to discern from initial symptoms leading to misdiagnosis or worse
no diagnosis”. No wonder that there remains a gap between Indian national data
and that of the WHO.
Various data and
information from Purulia, Jalpaiguri in West Bengal, Kheda in Gujarat and WHO
may be an indicator of the losses because of the vector-borne disease. New data
from the WHO reveals that the COVID-19 pandemic has disrupted malaria services,
leading to a marked increase in cases and deaths. According to its
latest World Malaria Report 2021, there were estimated 241 million malaria
cases and 627,000 malaria deaths worldwide in 2020. This represents about
14 million more cases in 2020 compared to 2019, and 69,000 more deaths.
Approximately two-thirds of these additional deaths (47000) were linked to
disruptions in the provision of malaria prevention, diagnosis and treatment
during the pandemic.
Malaria cases and
deaths remain unacceptably high and are resurgent in several settings, though
recent developments inspire optimism. The report also states between 2.7 and
5.9 million cases for India in 2020, whereas the official data records about
187,000 cases. Director of Malaria No More, Pratik Kumar, says that one of the
reasons for disparity remains malaria burden diverted to the private health
sector, which now are catering to a large segment of healthcare facilities. The
disparity is also noticed in the numbers, 10.9 lakh malaria cases reported in
2016 while the sales of anti-malaria drugs were ten times more. Acknowledging
the factor Odisha Chief Minister Naveen Patnaik has asked private healthcare
facilities to report such incidence.
Despite gains over the
last 15 years, malaria control has stagnated, with resurgence and rising
morbidity in several highly endemic countries exacerbated by service
disruptions due to the COVID-19 pandemic, says a study ‘Malaria in 2022:
Increasing challenges, cautious optimism’ by Prasanna Jagannathan & Abel Kakuru in Nature Communications.
Indrani Gupta notes
that an analysis of the trend and patterns in public expenditure by the
National Vector Borne Disease Control Programme shows a declining focus of the
central government on vector-borne diseases. Also, allocation of financial
resources among States does not reflect the burden of malaria, the major
vector-borne disease in the country.
Data reporting in
public domain seems to be less during the past few years. It is stated that
since larger numbers are treated in private hospitals and clinics data
prospecting has suffered. “The fight
against malaria has recorded immense progress in the recent years. However, as
seen in the past, malaria has a history of bouncing back with a vengeance.
Through active media attention, key gaps and issues can be regularly
highlighted, ensuring that those are addressed in strategic and policy
decisions. This will help India expedite efforts towards malaria elimination,”
says Kirti Mishra, chief technical officer, Odisha, Malaria No More.
The 2020 report of the
WHO Strategy Advisory Group on malaria eradication has looked at this in detail
and does provide useful information, especially with respect to malaria
transmission and the vulnerability of populations to malaria as 95 per cent of
Indians live in malaria-prone areas.
Chief Economist of
WHO, Soumya Swaminathan says, the basic WHO position is that climate
change is likely to increase rather than decrease the risk of malaria
transmission. The WHO is testing genetical modification of mosquitoes to
counter malaria but warns that India should not use it as field trials are
several years away.
Malaria manifests in
several forms and often goes unreported due to misattribution. Committing to
eliminate it by 2030 after a 70-year crusade is not easy, and the world may
have to wait for some more years.---INFA
(Copyright, India News
& Feature Alliance)
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