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Lessons from the malaria fight in tackling covid-19

  • As policymakers face difficult choices in the covid battle, they can draw lessons from India's success in the fight against malaria.
  • Three factors are key. Expand research, don’t lower the guard on other diseases and fight together as a nation.

Covid-19 has hit India hard. As of 4 May, India had more than 42,500 active cases and more than 1,370 deaths. Every case and every life lost is painful. Still, given India’s population and the high infectiousness of covid-19, experts believe that India has avoided the worst so far.

Much of the credit goes to the Indian people who have supported the clarion call by Prime Minister Narendra Modi to fight covid-19. The opposition too has rallied behind the government.

We are, however, not out of the woods yet. Such crises require exceptional leadership and bold action informed by evidence. Lessons learnt in the battle against malaria can be valuable as we confront covid-19.

Understand the virus: The fight against malaria has shown us that research is a helpful ally in defeating micro-organisms. The malaria parasite is remarkably resilient. Still, many countries, including India, are gaining ground. Research has helped us develop a better understanding of the parasite, and that has been critical to our unprecedented gains.

Similarly, developing a better understanding of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes covid-19, can help us keep our head above the water. Insights into the genome sequence, a genetic “fingerprint" so to speak, can give us a leg-up in developing tests, drugs and vaccines. It can further reveal how covid-19 spreads and its impact on different populations.

The National Institute of Virology in Pune decoded the complete genome sequence of SARS-CoV-2 in early March. But viruses evolve, so India must sequence more strains in the coming months. Researchers and scientists should, therefore, be at the centre of India’s response and we must marshal all our public and private sector resources to support them.

Stay alert to new research and evidence: The history of malaria control shows us that we must continuously monitor the efficacy of drugs. There have been instances when anti-malarials have become less effective in treating the disease. Monitoring such resistance has helped us to identify new and more effective treatments and launch a more effective response.

Efforts are underway globally to develop vaccines and treatments to tackle covid-19. While possible candidate vaccines are being developed, currently there are no vaccines effective against covid-19. Similarly, there is no conclusive evidence to support specific drug treatment against the disease.

The stakes are high and India must continuously assess new evidence as it emerges from various trials including the World Health Organization Solidarity trial and the covid-19 Therapeutics Accelerator. More than 90 countries, including India, are participating in the Solidarity trial. Apart from the anti-malarial drugs chloroquine and hydroxychloroquine, the Solidarity trial includes Ebola and HIV treatments.

Continue fighting all diseases, not just covid-19: India is rightly pulling out all stops to battle the pandemic. This will inevitably put immense pressure on both financial and human resources for health. Ensuring that health services for other diseases, especially those that mostly impact the poor and vulnerable, are not disrupted should be a priority.

For example, India has made huge strides against malaria in recent years. It must sustain efforts to prevent, detect and treat malaria. There was a massive increase in malaria-related illness and deaths in West Africa during the Ebola crisis. We must not let that happen in India. When you let your guard down against malaria, it can bounce back.

Let us be ready for what is coming. While India’s health system is more resilient than other more resource-constrained economies, it is still at risk. Even better-resourced health systems have felt the strain of covid-19. Let us ensure that our malaria teams can safely carry out their duties and provide them with the resources that they need to keep malaria at bay.

India must also ensure that there is clear guidance and communication on the use of hydroxychloroquine. This anti-malaria drug is used to treat not just malaria but also rheumatoid arthritis and lupus. Ensuring sufficient availability will minimise disruptions to treatment of the aforementioned diseases and also reduce the risk from sub-standard and counterfeit alternatives.

Together we can turn the corner: As we mark World Malaria Day, let us be reminded that a ‘whole of society’ effort made success against malaria possible in India. Most recently, a group of Parliamentarians came together to advocate malaria elimination in India. We need a similar effort to thwart covid-19. The government cannot do it alone. Parliamentarians, academics and researchers, civil society and private sector, international organizations, and other key stakeholders, must also play their part. Lest we forget, the need of the hour is to prioritise research and timely evidence, minimise disruption of health services and fight together as a nation.

The authors are, respectively, member of Parliament, CEO of The Wellcome Trust/Department of Biotechnology India Alliance, director country acceleration and advisor at Asia Pacific Leaders Malaria Alliance.

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