Mosquito Breeding Habitats in SSP in Gujarat

Relationship of Poverty with Malaria in the Indian States Below Poverty Line in 1999-2000 Total malaria cases in India % Malaria cases in BPL states % P. vivax cases in BPL states Total P. falci- parum cases in India % P.falci-parum cases in BPL states % NAMP population in BPL states at risk of malaria Total malaria cases in BPL states Total P. vivax cases in India Year 1965 28.99 99,667 29,576 29.67 73,504 29.24 26,163 30.89 1970 50.35 694,017 199,743 28.78 593,902 26.08 100,115 44.98 1975 50.01 5,166,142 1,843,681 35.68 4,436,891 29.70 729,251 72.09 1980 49.82 2,898,140 1,055,750 36.42 2,310,129 26.47 588,011 75.51 1985 49.86 1,864,380 940,788 50.46 1,319,375 39.11 545,005 77.94 1990 50.15 2,018,783 804,148 39.83 1,266,665 27.40 752,118 60.75 1995 48.47 2,296,008 1,465,078 50.06 1,503,877 37.25 792,131 70.24 2000 52.59 2,019,065 1,404,737 69.57 971,149 49.28 1,047,916 88.37

Malaria and Poverty Malaria-wheels within wheels Malaria- a development issue Malaria control should rely on poverty alleviation for human development, social security & sustainable environment

Malnad 50,000 Sq Km Area MALNAD REGION, INDIA Dense Forests were replaced by coffee plantations. An. fluviatilis transmitted malaria disappeared. Malnad is healthy. Malnad 50,000 Sq Km Area MALNAD REGION, INDIA

MALARIA IN PUNJAB Malaria epidemic in Punjab in 1908 caused 300,000 deaths in 20 million populations over a period of three years. Malaria in Punjab flares up after July-August rains. The malaria mortality figures of Punjab from 1867-1943 revealed that in 77-years majority of malaria peaks were followed by 8-year cycle. The relationship of rainfall with malaria was investigated and epidemic forecasting methods were developed in Punjab. Irrigation changed the malaria epidemiology and the region was converted to endemic malaria.

Rice Cultivation and Malaria in Punjab % Share of Cropped Area 1970-73 7.6% 1996-98 28.4%

Bioenvironmental Malaria control at the Indian Oils Ltd. Mathura, U.P.

Bioenvironmental Malaria Control in BHEL and IDPL, Hardwar, Uttranchal

Malaria Outbreak in Bargi Dam area in Narayanganj PHC, M.P. Dam impounded Dam Dam completed

Malaria Control in Karnataka in Partnership with PHC System Major silk producing region. Farmers unwilling to allow the use of DDT High malaria incidence and deaths Major Breeding habitats of An. culicifacies Wells: Species A (Vector Species) Streams: Species B (Non-Vector Species) All wells mapped and fishes released Malaria cases declined sharply

Impact of Fishes on Malaria Population 38000 in 93 villages Malaria cases Malaria cases

Rise of malaria in DDT sprayed villages Rise of malaria in DDT sprayed villages. In 1998 fishes were released in problem villages. Population 52554 38 problem villages Fishes released Malaria Cases

Impact of SP spraying (1996-98) on Malaria Impact of SP spraying (1996-98) on Malaria. In 2002 fishes were released to control mosquitoes Population in 4 PHCs 1.3 million SP Spraying No Spraying Fishes Malaria cases

SITUATION ANALYSIS OF BETUL DISTRICT, MADHYA PRADESH Total malaria cases P. falciparum cases Chloroquine Tablets in Lakhs Year DDT sprayed in mt against 200 mt % Coverage 1990       496 91 1991       949 281 1992 4.00 2.0 5.00 805 196 1993 1.60 0.8 5.10 626 213 1994 4.90 3.0 5.40 1503 602 1995 2.30 1.0 6.20 1820 739 1996 7.40 3.5 7.70 2290 662 1997 9.90 5.0 9.80 5279 1764 1998 14.9 7.5 9.60 8872 3340 1999 10.2 5.0 13.88 14133 3919 2000 18.0 9.0 20.30 16764 7126

Bioenvironmental Control of Malaria in Betul District, Madhya Pradesh Results of Monitoring Malaria Incidence in Betul District

Impact of Fishes on Malaria (Rise in 2000 was due to epidemic in adjacent villages) Population 85672 in 160 villages Malaria cases

Interventions Started in 1997 Impact of Bioenvironmental Interventions in 100 million population in Maharashtra Interventions Started in 1997 Total Malaria Cases P. falciparum Cases

Impact of Fishes on Malaria Population 38000 in 93 villages Malaria cases Malaria cases

Interventions Started in 1997 Impact of Bioenvironmental Interventions in 100 million population in Maharashtra Interventions Started in 1997 Total Malaria Cases P. falciparum Cases

Editorial   United against malaria “WHO’s Global Malaria Eradication Campaign achieved some notable successes but it also proved that, without a much more flexible and variable strategy combined with poverty reduction, self reliance and sound environmental management, the war against this disease could not be won.” Dr. Hiroshima Nakajima Director General of WHO World Health. 51st Year, No.3, May-June 1998

Dr. Halfdan Mahler, Former Director-General, World Health Organization who initiated the imaginative Small Pox Eradication Programme said “All countries benefit from the fruits of India’s TB research -all countries except India”

Health Catastrophe of 21stCentury- Future Impact of Malaria Malaria problem will prove a great hindrance to socio-economic development in the fields of health, education, land exploitation, mining, road construction, agriculture, tourism et al. leading to greater poverty and under-development

SHARPENED OLD TOOLS AND UTILIZATION OF NEW TOOLS AND STRATEGIES WILL PRODUCE MORE FOCUSED AND SUSTAINABLE MALARIA CONTROL

New Tools in Malaria Control MALARIA DIAGNOSIS Dipstick/pLDH tests TREATMENT Artemisinin & Drug Combination ENVIRONMENT Health Impact Assessment VECTOR CONTROL Situation specific based on stratification, An. Sibling species, Bioenvironmental Methods, Treated Bed Nets, Bacillus thuringiensis, Neem Based Repellents, Selective Spraying

REDUCE POPULATION AT THE RISK OF MALARIA POVERTY ALLEVIATION STRATEGIES WILL REDUCE POPULATION AT THE RISK OF MALARIA

BETTER QUALITY AND COVERAGE OF HEALTH SERVICES WILL ACHIEVE EFFECTIVE MANAGEMENT OF MALARIA

DEFORESTATION WILL DISLODGE HIGHLY EFFICIENT VECTORS OF MALARIA Example: Anopheles dirus

HEALTH IMPACT ASSESSMENT WILL BECOME MANDATORY AND THIS WILL REDUCE RECEPTIVITY TO MALARIA

ENHANCED COMMUNITY AWARENESS WILL HELP IN MALARIA PREVENTION AND EARLY CASE DETECTION AND PROMPT TREATMENT

NEW DIAGNOSTICS, DRUGS, DRUG COMBINATIONS WILL REDUCE MALARIA FROM EVEN THE MOST DIFFICULT TERRAINS

ACKNOWLEDGEMENTS Late Professor V. Ramalingaswami, FRS Professor M. G ACKNOWLEDGEMENTS Late Professor V.Ramalingaswami, FRS Professor M.G.K. Menon, FRS THE INDIAN COUNCIL OF MEDICAL RESEARCH THE NATIONAL ANTI MALARIA PROGRAMME HEALTH DEPARTMENTS OF THE STATE GOVERNMENTS SCIENTISTS AND TECHNICAL STAFF OF THE MALARIA RESEARCH CENTRE AND ITS FIELD STATIONS NATIONAL AND INTERNATIONAL COLLABORATING INSTITUTIONS