Mao, malaria and Modi: How they're connected
It's 1967, during the height of the Vietnam war. The North Vietnamese are engaged in a bitter and protracted fight with the Americans. In addition to battling each other, both sides are also fighting to stay alive from malaria. With more North Vietnamese dying from malaria than the actual fighting, they turn to Chairman Mao for help in finding a cure - and "Project 523" is born. This project led to Tu Youyou's discovery of artemisinin as a key ingredient in combating malaria - for which she will be awarded the Nobel Prize in medicine this December.
The historic awarding of the Nobel Prize in medicine to Tu follows the launch of the Global Goals by the United Nations in September, which specifically target an end to malaria under Goal 3: Good health and well-being. Although malaria mortality rates have dropped by 47 per cent globally since 2000, it still results in far too many deaths, particularly in Africa and South East Asia. In Africa, a child dies every minute from malaria. The latest estimates indicate there are between 124 and 283 million cases of malaria every year.
Historically, chloroquine was an effective malaria treatment, until some 40 years ago, when malaria developed resistance to it in South East Asia. The resistance spread to Africa and set off a massive increase in the disease globally. Now, experts fear history may repeat itself. Artemisinin has saved millions of lives, but tragically, poor quality medicines derived from it is leading to resistance. In the border areas of Mekong, the tiny parasites that cause the disease are becoming immune to artemisinin. Experts conclude that malaria elimination is the only way to confront this menace, which threatens to turn back the clock to the days where it was the major cause of death in the region.
Artemisinin resistance was first recorded in 2006, on the Thai-Cambodia border, and it has been emerging to the west. While resistance is confined to the Mekong region for now, if it continues to spread, it could prove to be a tipping point that leads to another global outbreak. There would be a surge in deaths and illness, plus a devastating blow to India's economy and healthcare system.
Malaria control in India is a success story, albeit erratic. In 1961, malaria was reduced to 50,000 cases across the country; however, malaria cases began to increase in 1965 and peaked at 6.5 million cases in 1976. Today, it has dropped to 880,000 cases a year. Deaths have dropped markedly in tandem, to about 440 a year. There is now a unique opportunity for strong leadership, to finish the job and eliminate malaria forever.
In November 2013, leaders from 18 countries gathered at the East Asia Summit and established APLMA (the Asia Pacific Leaders' Malaria Alliance), which subsequently committed to ending malaria in the Asia-Pacific region by 2030. The ambitious alliance was lauded as a game-changer, with Bill Gates himself acknowledging that the region's goal in becoming malaria-free would be key in eradicating malaria worldwide.
Prime Minister Modi's Swachh Bharat programme cannot only be about sweeping - it must also be about life saving interventions that improved sanitation provide. Poor household sanitation, coupled with inadequate waste water management, provide a breeding ground for malaria transmitting mosquitoes.
At this year's East Asia Summit, taking place in Kuala Lumpur from November 21-22, Summit leaders will be asked to endorse a Malaria Elimination Roadmap that will outline the pathway to achieve this goal. Given that India has the highest malaria burden in the Asia Pacific, it is vital that Prime Minister Narendra Modi wholeheartedly supports the roadmap, and in so doing, bring India closer to realising the Swachh Bharat vision, and move the global community tantalisingly closer to a malaria free world.