Malaria in India

Recent report on the malaria situation in India show a remarkable improvement in the total number of cases of laboratory diagnosed malaria from 3.0 million in 1996 to 1.78 million in 2003. Unfortunately, these figures are not complete because they are collected by the government NMCP health workers and do not take into account the number of cases that are treated as malaria without lab diagnoses and those treated in private clinics and NGO's.
Reporting in India is not perfect especially with the enormous private sector health service it becomes very difficult to measure and record health statistics.

Globally we find that less than 20% of the world's population suffer from 80% of the world's malaria and HIV. In India, the situation is exactly the same. Orissa is burdened with 23% of the total case load in the country.

Is the governance of a state indicated by its health indicators? Most people agree that good governance is often reflected in improvement of its citizen's health. Funnily enough of the 23 states that are malaria endemic in India only Maharashtra, Gujarat, Rajasthan and Tamil Nadu show an increase in the number of cases between 2001 and 2003. Does that mean anything?
Gujarat can't even blame development as a cause of increased malaria (areas of development often show an increase in malaria incidence because of human migration,altered ecosystems, increasing population density and the presence of a naive population.

On the whole, most areas of the country have shown a decrease in malaria cases. Funding for malaria has also increased, not just from the MoH which spent $49 million in 2003, but also from the World bank which gave the Enhanced Malaria Control Project $23 million last year. Also, the EMCP is due to get a large grant from the Global Fund against TB,HIV and Malaria.

There are a number of critics of the Indian public health system and believe that it is completely useless. I disagree quite strongly. I have seen the importance of having PHC's,CHC'c and Village Health workers in rural areas. The problem is not that we should not spend on our public health sector, but we must make it more efficient and consumer friendly.
Let me give you an example of how good it is. The active case detection ( that is when workers go from door to door to collect blood samples) for malaria is so efficient that it collected over 100 million samples. Admittedly, a number might have been duplicate. However, think out of the 100 million collected only 1.78 million were positive. 1 in every 100 were positive, despite which our health workers go out and collect samples.

Another stat - 47% of positive cases sought treatment from the fever treatment depots set up for malaria control, 36% from primary health care workers and only 13% from the private sector.

ok, enough malaria. Good news. Roll no.41 has got married in a whirlwind romance...8 months of dating in the UK, one holiday abroad, GP rotations for both of them and within the next two weeks they are married.

Talking about marriage, sister dear is planning engagement on the 24th but is still confused. Poor thing, she gets some real creeps. Wish her the best and hope everything works out.