Malaria Free China

• 07 Jul 2021

Why in News

The World Health Organization (WHO) has declared China as “malaria-free”.

• It is a result of a seven decade-long, multi-pronged health strategy that was able to entirely eliminate indigenous cases for four straight years.

Key Points

• About Malaria Free Status:
  
  • Certification Process: Certification of malaria elimination is the official recognition by WHO of a country’s malaria-free status.
    • WHO grants the certification when a country has demonstrated with rigorous, credible evidence that the chain of indigenous malaria transmission by Anopheles mosquitoes has been interrupted nationwide for at least the past three consecutive years.
    • A country must also demonstrate the capacity to prevent the re-establishment of transmission.
    • The final decision on awarding a malaria-free certification rests with the WHO Director-General, based on a recommendation by the independent Malaria Elimination Certification Panel (MECP).
  • Western Pacific Region: China is the first country in the WHO Western Pacific Region to be awarded a malaria-free certification in more than 3 decades.
    
    • Other Countries: In Western Pacific region the countries that have achieved this status include Australia (1981), Singapore (1982) and Brunei Darussalam (1987).
  • Global Status: Globally, 40 countries and territories have been granted a malaria-free certification from WHO – including, most recently, El Salvador (2021), Algeria (2019), Argentina (2019), Paraguay (2018) and Uzbekistan (2018).
• Disease Burden (Global):
  
  • According to the World Malaria Report, 2020, the number of malaria cases worldwide in 2019 was around 229 million, with 4,09,000 lives lost to the mosquito-borne disease.
  • Majority of cases were reported in Africa, while India and Southeast Asia recorded a significant drop.
    
    • Cases in India fell from approximately 20 million to 6 million.
    • India is the only high endemic country which has reported a decline of 17.6% in 2019 as compared to 2018.
• China's Malaria Strategy:
  
  • Started in 1950s: The efforts began in the early 1950s, a time when China was reporting millions of cases annually, starting with a multi-pronged approach of providing anti-malarial medicines while targeting mosquito breeding grounds and using insecticide spraying.
  • The 523 Project: It led to the discovery of artemisinin in the 1970s.
    
    • Artemisinin is the core compound of artemisinin-based combination therapies, the most effective antimalarial drugs available today.
  • Insecticide-treated Nets: In the 1980s, China began using insecticide-treated nets widely, distributing 2.4 million nets by 1988.
  • 1-3-7 Strategy: The strategy refers to:
    
    • A one-day deadline to report a malaria diagnosis,
    • Confirming a case and determining the spread by the third day, and
    • Measures taken to stop the spread by the seventh day, along with continued surveillance in high-risk areas.
  • Global Fund: With assistance from the Global Fund to Fight AIDS, Tuberculosis and Malaria starting in 2003, China “stepped up training, staffing, laboratory equipment, medicines and mosquito control.”

Malaria

• Malaria is a life threatening mosquito borne blood disease caused by plasmodium parasites.
• It is predominantly found in the tropical and subtropical areas of Africa, South America as well as Asia.
• The parasites spread through the bites of infected female Anopheles mosquitoes.
• After entering the human body, parasites initially multiply within the liver cells and then attack the Red Blood Cells (RBCs) resulting in their rupture.
• There are 5 parasite species that cause malaria in humans, and 2 of these species – Plasmodium falciparum and Plasmodium vivax – pose the greatest threat.
• Symptoms of malaria include fever and flu-like illness, including shaking chills, headache, muscle aches, and tiredness.
• It is preventable as well as curable.
• The RTS,S vaccine trains the immune system to attack the malaria parasite Plasmodium falciparum, the most deadly species of the malaria parasite.

Recent Initiatives of WHO

• The WHO has also identified 25 countries with the potential to eradicate malaria by 2025 under its ‘E-2025 Initiative’.

Initiatives to Curb Malaria in India

• In India, malaria elimination efforts were initiated in 2015 and were intensified after the launch of the National Framework for Malaria Elimination (NFME) in 2016 by the Ministry of Health and Family Welfare.
  
  • NFME is in line with WHO’s Global Technical Strategy for Malaria, 2016-2030, which guides the WHO Global Malaria Programme (GMP), responsible for coordinating WHO's global efforts to control and eliminate malaria.
• The National Strategic Plan for Malaria Elimination (2017-22) was launched in July 2017 which laid down strategies for the following five years.
  
  • It gives year wise elimination targets in various parts of the country depending upon the endemicity of malaria.
• Implementation of the High Burden to High Impact (HBHI) initiative was started in four states (West Bengal, Jharkhand, Chhattisgarh and Madhya Pradesh) in July 2019.
• Distribution of Long Lasting Insecticidal Nets (LLINs) to high burden areas has led to a reduction in endemicity in these otherwise very high endemic states.
• The Indian Council of Medical Research (ICMR) has established Malaria Elimination Research Alliance-India (MERA-India) which is a conglomeration of partners working on malaria control.

Source: TH