What India can learn from a malaria-free Sri Lanka
Sri Lanka has become malaria-free. It is the second country in the region, after Maldives, to earn this distinction.
The country was formally certified as malaria-free by the World Health Organisation (WHO) last week at the meeting of health ministers from the Southeast Asian region.
Elimination of a major communicable disease is a remarkable achievement for both Sri Lanka and Maldives and for the developing world because just a handful of low and middle income countries have been able to reach this milestone.
While this is so, India continues to struggle to end communicable diseases. The deaths due to malaria reported from the national capital recently and cases from elsewhere are a pointer to this.
In such a scenario, the success of Sri Lanka holds many lessons for India.
The battle with malaria in the island nation is very long and has been won against several odds, including the two-decade-long civil war.
| Sri Lanka recorded its last case of indigenous malaria in October 2012. (Photo credit: Reuters) |
After several decades of malaria control campaigns that mainly relied on spraying of DDT, Sri Lanka adopted an integrated strategy in the 1980s, which also included vector control in major irrigation and agriculture projects, rigorous entomological surveillance leading to targeted spraying in high-risk areas, new classes of insecticides for indoor spraying, insecticide-treated nets and larval control, and improved surveillance of parasites for active case detection.
Most important, these efforts were introduced and scaled up by the Anti-Malaria Campaign Directorate in conflict-affected districts also in partnership with national and international NGOs as well as Sri Lankan military.
With their ranks affected by malaria, the LTTE assured AMC that they would support malaria control measures, points out a commentary by Sri Lanka's health minister Rajitha Senaratne and regional director of WHO Poonam Khetrapal Singh, in medical journal The Lancet.
Sri Lanka recorded its last case of indigenous malaria in October 2012.
India has a lot to learn from Sri Lanka, despite obvious differences such as size and population. Malaria cases in India have dropped from two million in 2000 to 1.1 million in 2015, but this is still 70 per cent of total number of cases in WHO's southeast Asia region.
At present, 80 per cent of the cases occur among 20 per cent of people classified as "high risk".
Most of these people live in forest-rich districts also affected by the Naxalite problem.
This is where India can learn from Sri Lanka, by reaching out to marginalised communities living in inaccessible areas and also to Naxal cadres with the help of civil society.
Improving public health system and rolling out malaria control interventions in these areas is critical if India wants to eliminate malaria by 2030, as laid out in the national framework for malaria elimination (2016-2030).
Another point of focus should be malaria control in border districts in the north and the north-east. The emergence of antimalarial drug and insecticide resistance is yet another problem.
All this can work only with a strong political will to strengthen public health system at all levels, translated into enhanced financial and managerial support.
(Courtesy of Mail Today.)