Vaccines may be the way forward for malaria eradication in India

Dr Dharminder Nagar offers 5-point agenda to take immunisation programmes in India to the next level

Himachal Pradesh receives Centre's nod for pneumonia vaccine

Last Updated : May 23 2017 | 5:20 PM IST

Malaria is reportedly one of the oldest diseases known to mankind. In India, it poses a significant cause for concern as it is an ongoing national health burden, particularly as other mosquito borne diseases like dengue and chikungunya also plague the population. As a serious step to curb the increasing health burden globally, the World Health Organization (WHO) is poised to introduce the first vaccine created to prevent malaria. The organisation announced the launch of the vaccine on April 24, 2017, the eve of World Malaria Day this year.

While this development sets a milestone from a clinical perspective, it also evokes a few pertinent questions - is the Indian medical community well prepared for the execution of a vaccination programme for malaria? What are the future possibilities of new vaccines penetrating in the Indian market? Can immunisation with newly invented vaccines lead to complete eradication of malaria or other diseases in the future?

Addressing the malaria mayhem in India

Globally, more than 429,000 people lost their lives to mosquito-borne illnesses in 2015, and millions are affected by the malarial infection every year, the outcome of which indicates patients who may not even recover completely for a considerable period of time. This is contributing to the overall burden of healthcare in India. From 2000 to 2015, a 62 percent reduction in malaria deaths has been noted, says WHO. The implementation of the urban malaria scheme (UMS) in 1971-72 and the modified plan of operation (MPO) in 1977 had helped in improving the malaria situation considerably. However, almost 22 percent of India’s population live in high transmission areas, and 67 percent live in low transmission areas, reveals the World Malaria Report 2014.

Focused awareness campaigns at regular intervals by doctors, healthcare workers, NGOs across India have proven to be impactful. But eradicating malaria and other tropical diseases in endemic countries such as ours needs a paradigm transformation in the way the disease is to be dealt with. Broadening the spectrum of universal immunisation coverage will surely play a significant role in achieving this goal with a long-lasting, tangible impact for improving health outcomes in the treatment of this disease.

Gearing up for immunisation: The road Ahead

Timely and efficient immunisation drives result in saving millions of lives every year. Vaccines are widely recognised globally by health experts as one of the world’s most successful and cost-effective interventions for health. It is unfortunate that even with the availability of advanced and affordable vaccines there are 19.4 million children world over who remain under-vaccinated or unvaccinated. The bottom-line is - immunization matters now more than ever, and needs to be seen as a development priority in Indian healthcare.

Dr Dharminder Nagar

Indian’s vaccine market remains small and under penetrated as compared to the global peers. The Government has to realise that adding new vaccines to the National Immunization Programme results in creating immense value creation. The African nations to receive the malaria vaccine by next year are Kenya, Ghana and Malawi. With the official nod for India awaited, it is just a matter of time before India follows suit.

The World Health Organization has defined an ambitious goal to eliminate malaria by 2030. Similarly, the Union Ministry of Health & Family Welfare of Government of India had launched the National Framework for Malaria Elimination in India last year. A holistic effort approach needs to be taken not just by government officials, but medical practitioners and citizens also to eradicate this disease, especially after the vaccine is introduced in India.

Here is the 5-point agenda to scale up immunisation programmes in India to the next level of success:

Value-added disease surveillance initiatives must be taken up by the healthcare communities, especially healthcare players to measure and assess the current burden of the disease on communities and the process of dealing with it.
The biggest burden of malaria in India is borne by the economically backward, poor and remote parts of the country, with more than 90-95 percent cases reported from rural areas. Formulation of an evidence-based nationwide protocol for all stakeholders for doing research on new vaccines and implementing them at the ground-level should be done.
A new vaccine is of ill use if practitioners are not able to use it safely and effectively. Building a motivated workforce to promote education and communication about the new vaccine therefore, becomes important, and the government and authorities must invest in the same.
India lags behind when it comes to cold chain management and last mile delivery of vaccines. Putting up an efficient logistics and distribution network for upcoming vaccines and setting up safe cold stores to protect these vaccines will ensure uninterrupted availability.
The performance and management accountability responsibilities must be defined in a clear-cut manner, and periodic monitoring and evaluation should be done in the first five years after the introduction of the new vaccine in the country.

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Dr Dharminder Nagar is the managing director of Paras Healthcare