Almost 90 per cent of malaria cases, often called the disease of the poor, occur in Africa where a lack of health resources and facilities is the main hurdle in eliminating this preventable disease.

The disease is also rapidly becoming a challenge in Pakistan, where 0.5 million cases occur every year, particularly in rural areas. These areas have a lack of proper sanitation, which is an ideal setting for the Malaria vectors. In addition, the absence of health care facilities poses yet a greater crisis.

Flood water in Pakistan is still a menace where ponds of stagnant water have now turned into breeding grounds of the killer insect. The upcoming monsoon season will further fill these ponds and worsen the situation. Pakistan faces an increase in the spread of malaria after monsoons, mainly from July to November every year.

Another important challenge of malaria in Pakistan was first highlighted in the “Annals of Tropical Medicine and Parasitology”. A 10 years study published in 2007 which shows that falciparum malaria has become resistant to chloroquine in Pakistani and Afghan refugee populations across Pakistan. Chloroquine is a common, first line treatment of malaria, but in some cases across the country the disease is now resistant to this drug. After five years of this discovery, the matter needs further investigation.

To tackle these challenges Pakistan needs an early diagnosis, prompt treatment and specially designed insecticide-treated bed nets. The long-lasting, insecticide-treated bed nets (LLINs) have proven an effective measure against malaria prevention. The LLINs could also play a pivotal role in the recent outbreak of the dengue epidemic in Pakistan.

On the global scenario, however, there is some good news. Fewer deaths have been reported from malaria in recent years. The UN secretary-general’s special envoy for malaria, Ray chambers while quoting the figures of 2010 in a press conference on Monday said that malaria deaths have decreased by a third since 2010 mainly due to the distribution of at least 160 million additional bed nets.

On the eve of World Malaria Day 2012, WHO Director-General, Margaret Chan says that an increased investment in malaria prevention and control has saved more than a million lives.

The threat is unfortunately still rampant as malaria is still transmitting in 99 countries, killing one child every minute.

The UN is also trying to roll back malaria till 2015 and this target needs an additional $3.2 billion to reach the target of “near zero” deaths from malaria. The agency has also launched a new initiative Test, Treat and Track also dubbed as the T3. WHO urges donor states and malaria endemic countries to contribute more for the universal access of diagnostics and treatment of malaria.

Under the T3 strategy, WHO says the endemic countries make sure to test every suspected malaria case. Then each subject is treated with quality medicines, and finally every treated patient is to be tracked with precise surveillance. The agency has also published the detail guidelines for the T3 programme for practitioners.

“Until countries are able to test, treat, and report every malaria case, we will never defeat this disease,” says Dr Margaret Chan.

The need of the T3 programme is currently the only strategy on the scenario. According to WHO, 80 per cent of malarial cases in Africa are still being treated without proper diagnostics.

In Pakistan, special attention and an organised approach are needed to contain the disease. Working on proper sanitation is a fundamental step, also the T3 approach needs to be imperatively applied, however, unless these facilities are absolutely free of cost, the poor will continue to fall victim to this killing menace.

Pakistan is among the top most vulnerable countries due to climate change, the floods and erratic patterns of rains in the past few years bear witness to this. We have also observed resistance in the mosquito with the common anti-malaria drugs. Floods and the monsoons henceforth could further trigger the challenges of malaria, particularly in Sindh and Balochistan.


The writer is a Multimedia Content Producer at Dawn.com

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