India is ranked fourth in the world with regards to the number of malaria cases reported per year. A three-day meeting encompassing the 30th National Congress on Parasitology and 1st Global Summit on Malaria Elimination (NCP-GSME) was organized in New Delhi to discuss some latest advances and translational aspects of parasitology research, including strategies for malaria elimination.
The aim of NCP-GSME was to bring scientists, clinicians, and policymakers working in the field of parasitology, particularly malaria, on a single platform to discuss the translational aspects of the field. In his inaugural address, M. Jagadesh Kumar, Vice-Chancellor, JNU, encouraged social science students to attend similar science conferences, understand real-world problems, collaborate, and come up with innovative solutions. Applying a bottom-up approach to the problem of malaria, Kumar explained that societal awareness and malaria surveillance are highly important. If done properly, these steps can also reduce the pressure on the drug development pipeline.
The congress covered almost all areas of parasitology research and included sessions on aquatic parasitology, host-parasite interaction, parasite and vector biology, protein-based drug therapeutics, plasmodium parasite biology, immunity, epigenetic tools, molecular epidemiology, alternative medicinal approaches, and the infobiome. Covering these areas in the light of malaria, leishmaniasis, and filariasis, the congress was graced by four curtain-raiser lectures, eighteen plenary talks, one honorary talk, and sixty-one speaker sessions.
Shailja Singh, Convenor of the conference and Associate Professor, SCMM, JNU says, “The conference is a checkpoint for all of us to take a break from our routine bench work, know what is happening around in the field with different perspectives, and assess ourselves about the directions in which we are heading and plan better and quality research for ourselves in the future.”
There is a need to bridge the gap between science and management especially in the area of malaria vaccine development. Administrative hurdles in the basic and translational aspects of vaccine development were discussed by VS Chauhan, visiting scientist, International Centre for Genetic Engineering and Biotechnology (ICGEB).
As a part of the conference, the 1st Global Summit on Malaria Elimination was conducted in the memory of late Neeru Singh, Director, National Institute of Research in Tribal Health (NIRTH), Madhya Pradesh on 27 September 2019. The summit brought together public and private organizations to discuss their areas of focus, projects undertaken, progress made and future plan of action for malaria elimination from India by 2027. Strategies underway for malaria elimination, eradication, treatment, and prevention were also highlighted.
A unique strategic intervention made in the routine malaria eradication program via the DAMaN program has led to a sharp decline in the number of malaria cases in the villages of Orissa, the state with the highest malaria burden in India. The program simultaneously targeted the malaria-causing parasite (by antimalarial treatment to both symptomatic and asymptomatic villagers) and the mosquitoes (by using sprays and nets) in a few remote and inaccessible locations in Orissa. Madan Pradhan, Govt. of Orissa elaborated on the interventions that led to an 80% reduction in malaria cases and deaths.
Recognizing the communication gap and research duplication between various organizations, the Indian Council for Medical Research (ICMR), New Delhi has launched the Malaria Elimination Research Alliance (MERA) India initiative. MERA provides a common platform to promote harmonization and shared learning.
Recommendations for Malaria Elimination
With a vision of a world free from malaria, milestones have been set for 2020, 2025 and 2030 by RBM Partnership to End Malaria to reduce mortality rates and incidence by 40%, 75%, and 90% respectively (relative to 2015 numbers). The strategy plan includes improving management and implementation of malaria programs and making better use of new technologies, investment in new surveillance tools, diagnostics, drugs, and vector control technologies with strong leadership and accountability. In this regard, Altaf Ahmed Lal, Senior Advisor for Global Health and Innovation, Sun Pharmaceuticals Industries Limited, India discussed the recommendations of Lancet commission on the eradication of malaria published in September 2019.
As the number of malaria cases declines gradually, there is a dire need for more sensitive malaria diagnostic tools. “This can be improved by building a better capacity to process a large number of samples, point of care tests, active serological screening and screening at entry in states,” recommended Anup Anvikar, National Institute of Malaria Research (NIMR), New Delhi. An efficient IT-based surveillance system to ensure detection (including cases in the private sector), treatment, tracking, and reporting of malaria cases on a real-time basis, as well as high-quality monitoring from peripheral to State /Central level, is also an urgent need.
At the policy level, commitment towards Malaria Elimination needs to be strengthened. For this, setting up a parliamentary standing committee, featuring malaria in NITI Aayog’s Health Index, the inclusion of malaria prevention and control interventions in POSHAN Abhiyaan to combat the malaria-malnutrition problem were put forward. The prioritization of Urban Vector-Borne Disease Scheme with emphasis on Plasmodium vivax control along with malaria prioritization under Tribal Sub-Plan and elimination under National Urban Health Mission were also discussed at the meeting.
In terms of cash influx, in 2017, an estimated US$ 3.1 billion was invested in malaria globally. In order to achieve the global 2030 target, at least US$ 6.6 billion needs to be invested annually by 2020(according to the World Malaria Report, 2018).Raising relatively stable global funding for malaria remains a common challenge for all public, private and non-profit organizations.
The three-day event familiarized the attendees with the challenges faced in the field of parasitology, directions in which parasitologists are working, strategies that have been adopted for malaria elimination at public and private levels, areas that need improvement, and recommendations for future.
Rahi, Manju, et al. “MERA India: Malaria Elimination Research Alliance India.” Journal of vector-borne diseases56.1 (2019): 1.
Feachem, Richard GA, et al. “Malaria eradication within a generation: ambitious, achievable, and necessary.” The Lancet (2019).
Lal, Altaf A., et al. “Malaria elimination: Using past and present experience to make malaria-free India by 2030.” Journal of vector-borne diseases56.1 (2019): 60.