World Malaria Report (WMR) 2020

Context: The World Malaria Report (WMR) 2020 released by WHO, indicates that India has made considerable progress in reducing its malaria burden.

Progress in India

  • India is the only high endemic country that has reported a decline of 17.6% in 2019 as compared to 2018.
  • India has also contributed to the largest drop in cases region-wide, from approximately 20 million to about 6 million.
  • India achieved a reduction of 92% in malaria mortality between the year 2000  and 2019 thereby achieving Goal 6 of the Millennium Development Goals (50-75% decrease in case incidence between 2000 and 2019).

World Indicators

  • According to this report, there were 229 million cases of malaria in 2019 compared to 228 million cases in 2018.
  • Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. It is preventable and curable.
  • Children aged under 5 years are the most vulnerable group affected by malaria; in 2019, they accounted for 67% (274 000) of all malaria deaths worldwide.
  • In 2019, 6 countries accounted for approximately half of all malaria deaths worldwide: Nigeria (23%), the Democratic Republic of the Congo (11%), United Republic of Tanzania (5%), Burkina Faso (4%), Mozambique (4%) and Niger (4% each).
  • The WHO African Region carries a disproportionately high share of the global malaria burden. In 2019, the region was home to 94% of malaria cases and deaths.
  • SDG 3 aspires to ensure health and well-being for all, including a bold commitment to end the epidemics of AIDS, tuberculosis, malaria and other communicable diseases by 2030.
  • It also aims to achieve universal health coverage, and provide access to safe and effective medicines and vaccines for all.

Analysis

All about Malaria

  • Malaria is caused by Plasmodium parasites. The parasites are spread to people through the bites of infected female Anopheles mosquitoes, called “malaria vectors.” There are 5 parasite species that cause malaria in humans, and 2 of these species – P. falciparum and P. vivax – pose the greatest threat.
  • P. falciparum is the predominant parasite in Africa and India.
  • P. vivax is the predominant parasite in the WHO Region of the Americas (North and South America)

Transmission of Malaria

  • Anopheles mosquitoes lay their eggs in water, which hatch into larvae, eventually emerging as adult mosquitoes.
  • The female mosquitoes seek a blood meal (bites into humans to seek blood)to nurture their eggs.
  • Transmission also depends on climatic conditions that may affect the number and survival of mosquitoes, such as rainfall patterns, temperature and humidity.
  • In many places, transmission is seasonal, with the peak during and just after the rainy season.
  • Malaria epidemics can occur when climate and other conditions suddenly favour transmission in areas where people have little or no immunity to malaria. They can also occur when people with low immunity move into areas with intense malaria transmission, for instance to find work, or as refugees.

Malaria control in India

  • The malaria control programme and other Vector Borne Diseases namely Kala-azar, Dengue, Lymphatic Filariasis, Japanese Encephalitis and Chikungunya were integrated into the National Vector Borne Disease Control Programme (NVBDCP) in 2002.
  • New tools for malaria prevention and control were introduced under NVBDCP i.e LLINs ; antigen detecting kits for detection of both P. falciparum and P. vivax; and newer insecticides and larvicides.

Long Lasting Insecticidal Nets (LLINs)

  • Promoted by WHO and Roll Back Malaria as a cost effective and sustainable method for protection against malaria.
  • LLINs make the insecticide last at least 20 washes in standard laboratory testing and three years of recommended use under field conditions. 
  • LLINs have a double effect, working as a physical barrier preventing the mosquitoes from reaching their pray, but also as a chemical barrier: the insecticide repels the mosquitoes or kills them when they enter into contact with the net.

National Framework for Malaria Elimination (NFME 2016- 2030)

  • The Framework has four objectives.
  1. Eliminate malaria from all 26 low (Category 1) and moderate (Category 2) transmission states/union territories (UTs) by 2022;
  2. Reduce the incidence of malaria to less than 1 case per 1000 population per year in all states and UTs and their districts by 2024;
  3. Interrupt indigenous transmission of malaria throughout the entire country, including all high transmission states and UTs (Category 3) by 2027; and
  4. Prevent the re-establishment of local transmission of malaria in areas where it has been eliminated and maintain national malaria-free status by 2030 and beyond.

Directorate of National Vector Borne Disease Control Programme (NVBDCP) 

  • It is the central nodal agency for the prevention and control of vector-borne diseases i.e. Malaria, Dengue, Lymphatic Filariasis, Kala-azar, Japanese Encephalitis and Chikungunya under the National Vector Borne Disease Control Programme (NVBDCP) in India.
  • It is one of the Technical Departments of Directorate General of Health Services, Ministry of Health and Family Welfare.

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