Gains against malaria but threat remains

 malaria
 Three out of four people are at risk of malaria in World Health Organisation’s South-East Asia Region, which is home to a quarter of the world’s population despite huge gains in tackling the disease. The WHO has urged the governments, development partners and the corporate sector to invest more to sustain the gains and eliminate malaria.

WHO’s South-East Asia Region comprises 11 member-states: Bangladesh, Bhutan, the Democratic People’s Republic of Korea (North Korea), India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste.

Even though the number of confirmed malaria cases in the region decreased from 2.9 million in 2000 to 2 million in 2012, the disease remains a significant threat to the lives and livelihoods of people.

In a statement issued here to mark the World Malaria Day, WHO said: “1.4 billion people continue to be at risk of malaria in South-East Asia. They are often the poorest, including workers in hilly or forested areas, in development projects such as mining, agro-forestry, road and dam constructions, and upland subsistence farming in rural areas and urban areas.”

According to Poonam Khetrapal Singh, WHO Regional Director for South-East Asia, nations must continue their surveillance for malaria. “Funding needs to be increased for diagnostics, drugs, insecticide-treated mosquito nets, and research and response to drug and insecticide resistance. We need to empower communities to protect themselves. Eliminating malaria will take greater political will,” she said.

Bangladesh, Bhutan, North Korea, Nepal, and Sri Lanka reduced the incidence of malaria cases by more than 75 per cent from 2000 to 2012. Thailand and Timor-Leste are on track to achieve a decrease of over 75 per cent. India is expected to decrease malaria incidence by 50-75 per cent by 2015.

Sri Lanka is in the elimination phase; the country has had no indigenous cases since November 2012, down from 2,03,000 cases in 2000. Maldives has been malaria-free since 1984.

Global efforts to control and eliminate malaria have saved an estimated 3.3 million lives. Between 2000 and 2012, malaria mortality rates have been reduced by 42 per cent and the incidence of malaria has decreased by 25 per cent globally.

But the gains in malaria control could be reversed due to increasing parasite resistance to drugs, mosquito resistance to insecticides and re-transmission in places where the disease has been eliminated.

The emergence of artemisinin resistance in Cambodia, Myanmar, Thailand and Vietnam threatens the global achievements in malaria control and elimination. Artemisinin-based combination treatment (ACT) is currently the first line treatment for the most lethal type of malaria, Plasmodium falciparum. There is an urgent need to invest in ways to contain such resistance, the WHO has said.

Another danger is that the Anopheles mosquitoes, which carry malaria parasites, are increasingly becoming resistant to insecticides, which too should be tackled.

The WHO said investments are needed to develop new tools, to conduct operational research to address bottlenecks in malaria-control programmes and to scale up and ensure rational use of existing interventions. 
 
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