The Department of Health of the Central Tibetan Administration is observing World Malaria Day today on 25 April 2015 with the theme of World Health Organization (WHO) “Invest in the future: Defeat malaria”. Malaria is a deadly disease that has always been prevalent in tropical and subtropical regions of the world because of rainfall, consistent high temperatures and high humidity, along with stagnant waters in which mosquito larvae readily mature, providing them with the environment they need for continuous breeding. Malaria is more common in rural areas than in cities. Currently, we do possess effective tools to prevent and treat Malaria. Yet however, the challenge is to deliver these tools to those who really need it, and to channelize more funds to combat emerging drug and insecticide resistance.
According to WHO, there were about 198 million cases of malaria in 2013 and an estimated 584,000 death. The majority of cases (65%) occur in children under 15 years old. Malaria is associated with up to 200,000 estimated infant deaths yearly. India is a Malaria endemic country and about 2 million confirmed malaria cases and 1,000 deaths are reported annually. India contributes 77% of the total malaria in Southeast Asia.
Looking at our Department of Health (DOH) health information system 2014 data, Malaria has been reported from health centers of seven Tibetan settlements in India namely; Odisha Phuntsokling, Mainpat Phendeling, Miao Choepheling, Tezu Dhargeyling, Mundgod Doeguling, Delhi Samyeling and Bylakupee Tibetan settlement. The Indian states of Odisha, Madya Pradesh, Karnataka and the North-East India states, in which these Tibetan settlements lie, have the highest endemicity of Malaria in India and contribute about 90% of the total Malaria burden of the country. In 2013, there were a total of 214 reported malarial cases from our Tibetan settlement health centers with 119 cases alone from Odisha. In 2014, however, 197 cases of Malaria have been reported from our Tibetan settlements health centers, of which 170 cases were reported alone from Odisha Phuntsokling.
Looking at the high burden of malaria in Odisha Phuntsokling settlement, a needs assessment survey was conducted in 2013 in collaboration with Johns Hopkins University of the USA. It was found that people had good knowledge of preventative measures and on treatment options; however, people lacked the means through which they could get hold of tools for preventing themselves against malaria. The DOH thus launched its “Malaria Control Project” focusing mainly in Odisha, followed by Mainpat, Miao, Tezu, Tuting and Bhandara from 2012 to 2014. The project was funded by our donor partner Norwegian Church Aid (NCA). The main beneficiary of the project were the destitute, school children, old aged people and the general public of the settlements, and was aimed at reducing the burden of malaria. Long Lasting Insecticide Treated Nets (LLIN) to be used for protection against mosquito bites were widely distributed free of cost in the old aged homes, poor families and to school children. For the rest of the general population, these nets were sold at a discount rate of 50%. At the same time, rigorous health education was given by the health workers with regard to prevention and prompt effective treatment of the disease at our health centers. Widespread awareness campaigns were held so that people can be aware and be safe against malaria. The department is very grateful for the funding assistance received from the donor NCA and hopes to further strengthen this benevolent bond with NCA so as to tackle further malarial burden in our Tibetan settlements.
Tackling malaria in the high endemic Tibetan settlements has been a major challenge for our department over the years. Despite widespread health education on prevention and preventative measures, every year we still have a large number of cases reported. This shows that we need to invest more in the future so that we can defeat malaria.