Screening for malaria is important: Dr AC Dhariwal

The Union Health Ministry recently launched the National Framework for Malaria Elimination in India 2016-2030 that aims to eliminate malaria by 2030. The Ministry of Health and Family Welfare insists that it’s intensifying public health action to tackle the vector-borne disease in high burden areas. DNA speaks to Dr AC Dhariwal, Director, National Vector Borne Disease Control Programme (NVBDCP) about the recently formulated Malaria Elimination Programme 2017-2022.

What has the trajectory of malaria cases been in recent years?

We have witnessed a decrease in malaria cases by 50 per cent in the last decade. We have also been able to reduce deaths due to malaria. In 2006, it was responsible for two million deaths, and by 2016, this number had come down to 1.6 million. A survey commissioned to an international agency confirmed these figures. Our research institutes also found an overall drop in parasite density.

How is your department ensuring that all states are on board the elimination programme?

We have been sensitising states and union territories to run their own malaria elimination programmes. High-burden states like Punjab, Haryana, Gujarat, Karnataka, and Chandigarh have begun their individual programmes; others are soon to follow. Operational guidelines for malaria elimination and a manual on integrated vector management has been prepared and shared with all states.

How effective was the Strategic Plan for Malaria Control 2012-2017?

Almost all targets have been met. New interventions for case management and vector control such as rapid diagnostic tests, artemisinin-based combination therapy and Long Lasting Insecticidal nets were introduced under the plan.

What is the status of the Strategic Plan for Malaria Control for 2017-2022?

Malaria is particularly entrenched in low-income rural areas of eastern and north-eastern states. Central and more arid western parts of the country also need attention. Under the new five year plan we’ve decided to take up concerted efforts at the district level and push for a micro-level approach. Case detection and management, and community outreach services will be carried out by ASHA workers and community health volunteers of various NGOs. They will also be given medicine stocks to administer medicines as soon as they detect malaria.

What is the most important task ahead according to you?

We intend to push for screening of all fever cases suspected of malaria. We have observed that in endemic areas, doctors simply start with malaria treatment when a patient comes with fever, whether or not s/he may have it. We are sensitising doctors to just screen. The aim is to ensure that 60 per cent are screened through quality microscopy and 40 per cent by Rapid Diagnostic Test.