Lessons for malaria elimination from covid-19
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We are amid a pandemic at a scale never seen before, and this offers us an opportunity to reflect on how we could tackle an infectious vector-borne disease such as malaria. Dr. Arun Kumar, Head of Environmental Science, Bayer South Asia shares his reflections on the occasion of World Malaria Day on April 25, 2020.
Much has been written in the last few weeks about India’s response to the novel coronavirus. We continue to see and hear amazing stories from across the country on various aspects of public health management: raising awareness, prioritizing prevention, identifying affected patients, ensuring treatment and close monitoring. On World Malaria Day today, it seems appropriate to distill learnings and best practices from the current COVID-19 response and consider what might be relevant in our battle against malaria, another significant burden to public health.
Use of data and analytics to drive rapid decisions
In its COVID-19 response, India has taken to data in a very positive way. Bengaluru, Surat, Nagpur, Chennai and many other cities have deployed tools that help track health status of people under home quarantine, the movement of healthcare workers and the general public using GPS (like with the Aarogya Setu app) and draw up contact tracing or containment plans. Whether repurposed or developed from scratch, the apps have enabled collection of data from the field that is updated in real-time, resulting in decisions that are made in hours, if not minutes.
It is not difficult to re-imagine malaria tracking and response with appropriate modifications on one of these platforms, guided by relevant data and with commensurate data privacy considerations. For instance, if all suspected malaria cases could be reported in this way, the affected households could be targeted as part of neighborhood-wide intervention measures such as bed nets and residual sprays for indoor treatment of houses, to reduce risk of further transmission. Further, geotagging of houses/ locations where interventions have been conducted can provide a means for monitoring of the effectiveness of these control mechanisms. This could be especially valuable where implementation is more difficult, such as in rural communities, which currently face the highest burden of malaria.
Use of the latest tools and science-based approaches
Understanding of the novel coronavirus is evolving continuously and it is heartening to see measures to tackle it percolate rapidly through the public health system in India. Evidence-driven approaches have led to adoption and refinement of relevant measures such as disinfection protocols, usage of masks and social distancing to reduce virus transmission. Drug therapy is also being optimized according to the latest science and guidance from noteworthy institutions such as the Indian Council of Medical Research (ICMR). Such approaches applied to malaria control could benefit India’s malaria elimination target of 2030.
Our existing arsenal for malaria prevention is over a decade old and current challenges such as resistance of mosquitoes indicate a need for new products. These new products also need to be evaluated rapidly, and upon approval, their use must be mainstreamed. We must acknowledge and accelerate adoption of the latest World Health Organization (WHO) pre-qualified vector control tools for indoor residual spraying and long-lasting bed nets. Exploration of new strategies such as biocontrol-based mosquito control should also be encouraged. The scientific, regulatory and operational communities have shown their ability to work well together during this pandemic. India needs such political will and engagement for malaria prevention.
Innovation in business models and private sector engagement
When the Indian Government suggested a self-imposed Janata curfew and when the lockdown was subsequently put in place and extended, ordinary citizens and the private sector actively engaged in the effort to control further spread of COVID-19. Public Private Partnerships have resulted in rapid deployment of apps and analytics tools. Corporates have stepped in to provide personal protection equipment to frontline health workers in hospitals, municipalities and to farmers keeping essential agricultural operations running. Pest control operators and drone startups have stepped up to assist disinfection of large areas to complement the efforts of sanitation workers. This offers the learning that the public health system can be strengthened and augmented by private sector involvement.
Openly embracing innovation and participation from society, such as the Malaria Quest challenge launched by the India Health Fund can drive identification, assessment, adoption and rapid scale-up of new solutions. Additionally, philanthropic and corporate social responsibility (CSR) contributions in India have seen a tremendous uptick during this pandemic. Similar measures should also be encouraged to help communities affected by vector-borne diseases such as malaria.
In human history, we have eradicated smallpox and are on the verge of eliminating polio. There are still many challenges to overcome, however the elimination and eradication of malaria is possible. The last few years have seen India make great progress in reducing the number of malaria cases, yet it still ranks among the top ten countries globally in terms of disease incidence. India has demonstrated its ability to bring together all its brain and brawn within a very short time to fight an unknown disease such as COVID-19 and hopefully we will overcome it soon. It is now a matter of strong resolve to take the learnings of this new pandemic to eliminate the ancient scourge of malaria.