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Time of India
26 April 2010
By Subodh Varma

Study: 2.43cr Confirmed Cases In ’09, 8.6L Died; 90% Infections In Africa
The news from the frontline is mixed on World Malaria Day today. While the UN affiliated World Health Organisation (WHO) and several private agencies are cautiously optimistic because of recent decline in reported malaria cases and an increased flow of funds for fighting malaria, others, including the leading health journal Lancet are pointing at the looming clouds of drug resistance and lack of suitable vaccine for this ancient killer disease.

Malaria, along with tuberculosis, continues to be one of the world’s most lethal diseases with half the world’s population — about 3.3 billion people — at risk from it, according to the latest World Malaria Report 2009, released by WHO last December. Over 243 million (2.43 crore) confirmed cases of malaria were reported from across the world, of which an estimated 8,63,000 died. The biggest burden of malaria is borne by Africa with nearly 90% of cases, most being children below 5 years.

In India, while there has been proportional reduction in the number of cases, the numbers are still huge. From over 2 million reported cases in 2000, confirmed malaria cases dropped to about 1.51 million in 2007, but then showed an upward tick in the next two years to reach 1.53 million in 2009, according to provisional estimates of National Vector Borne Diseases Control Programme of the health ministry. Experts believe that these are gross underestimates because the reach of testing facilities is limited and large numbers are going unreported.

In the World Malaria Report, WHO director general Margaret Chan struck an optimistic note saying that global funding for fighting malaria had jumped from a commitment of $300 million in 2003 to $1.7 billion in 2009. As a result, coverage with insecticide treated nets (ITN) increased from 17% to 31% while population covered by indoor residual spraying of insecticide increased from 14 million to 59 million. Testing for malaria and treatment with the new artemisinin combination therapy (ACT) too has increased substantially. In 2006, WHO issued new guidelines for tackling malaria that include mandatory testing before prescribing drugs. This is to prevent the growing threat of resistance of the malarial parasite to these drugs if given indiscriminately. Quinine based drugs have already gone out of favour because of widespread resistance to it.

In India too, one variety of malarial parasite was found to have developed resistance to chloroquine in 117 highly endemic districts of 7 North Eastern states and AP, Chhattisgarh, Jharkhand, MP and Orissa.

In various countries, resistance to the new artemisinin based drugs has been reported. According to an editorial in Lancet, “There is currently no new drug class for treatment in advanced development”.

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