Colombo’s successful fight against malaria is a reminder to India that ending this deadly disease is within our reach, even if the complexity of the task is different
As as child, I saw malaria as an unavoidable part of people’s life in Sri lanka. Born in Sri lanka but raised in Australia, I have vivid memories of my return visits. I remember the excitement of sleeping under what seemed to be a gigantic net. In later visits, I remember wondering why there seemed to be smoke being sprayed in the towns and villages. The answer was that malaria was rampant, and family and friends, suffering with fever and pain, were commonplace. The Government was dealing with the problem with the tools at hand.
The country had nearly eliminated malaria in 1960s, but by the end of the decade, a disastrous resurgence brought the disease roaring back. The challenges only intensified as the country plunged into a civil war. Sri lanka, it seemed, would struggle with malaria forever. However, the island-nation made history last week as it became the second country in the Southeast Asia region to be certified as malaria-free. On September 6, the World Health Organisation recognised this huge public health achievement at an official ceremony in Colombo. From over 400,000 cases in 1991, the disease has been reduced to zero in October 2012. The country has not had a single death from malaria since 2007.
At the 2015 East Asia Summit, 18 Asia Pacific countries committed to ending malaria in Asia by 2030. The world must take note of Sri lanka's success. It is a shining example of what is possible as global momentum builds to end one of the world's deadliest diseases. Sri lanka has a long and complicated history with malaria. Its historic recognition follows decades of progress, setbacks and persistence. In the mid-1930s, there was a massive malaria epidemic with millions of cases and 80,000 deaths — all during a span of nine months. Thanks to an aggressive malaria programme in the 1960s, Sri lanka reduced this to fewer than 20 cases per year, nearly eliminating the disease. The Government thought the job was finished and scaled the programme back. But by 1969, Sri lanka was battling a deadly resurgence of more than half a million cases a year. Once again, the country undertook a massive effort to eliminate the disease.
This time, Sri lanka has achieved the goal, despite a nearly 30-year civil war between the liberation Tigers of Tamil Eelam and the Government of Sri lanka, which devastated infrastructure and healthcare delivery in many parts of the country. leadership from the Government's anti-malaria campaign, strong programme management and an emphasis on surveillance, were the key factors in Sri lanka's success. The strategy targeted high-risk populations with aggressive prevention, diagnosis and treatment programmes. The country also invested in healthcare infrastructure. Funding from Government administrations and the Global Fund to Fight AIDS, tuberculosis and malaria was critical to sustain the efforts. In 2011, the Global Fund awarded the Sri lanka Ministry of Health a grant of $15.5 million to substantially improve public health infrastructure, which aided malaria elimination efforts. The challenge now will be to maintain the elimination and prevent resurgence.
India has already set itself on a similar path towards malaria elimination. With 70 per cent of the region's malaria burden, the country will play a critical role in the regional and global efforts to end malaria. It will also become the frontline if drug resistance spreads West from Myanmar. Earlier this year, the Union Government took an ambitious step of endorsing a national framework to eliminate malaria by 2030. The commitment shows that India is serious about improving health and addressing the needs of its people. The task won't be easy. Malaria ignores country borders and often preys on marginalised populations in remote areas.
Investing in malaria elimination is a smart long-term strategy that will boost business, economic development and tourism, and improve health security across the region. More importantly, it will save lives, reduce suffering and enable people to reach their full potential. All of us should cheer Sri lanka's success. It reminds us that ending this deadly disease is within our reach.
(The author is chief executive officer, president and a member of the Board of Directors of Alere Inc. He is also a member of the board of Malaria No More)