Dealing with Malaria, Prescribing medicines under generic names. Is it practical?, Current Affairs 29th April, 2017DEVENDRA VISHWAKARMA
Dealing with Malaria
Malaria is one of the most threatening epidemics of the world with high incidence in the developing world. The efforts to develop a medicine for the same have been all out and repeated trials have been conducted. Eradication of Malaria has been part of Millennium development goals too.
Malaria elimination is the interruption of local transmission (reduction to zero incidence of indigenous cases) of a specified malaria parasite species in a defined geographic area; continued measures are required to prevent re-establishment of transmission.
Malaria eradication is defined as the permanent reduction to zero of the worldwide incidence of malaria infection caused by all species of human malaria parasites. Once eradication has been achieved, intervention measures are no longer needed.
Path to malaria elimination
Countries are situated at different points along the road to elimination. The rate of progress will depend on the strength of the national health system, the level of investment in malaria control and a number of other factors, including biological determinants; the environment; and the social, demographic, political and economic realities of a particular country.
Beginning next year, the World Health Organisation will begin pilot tests of the injectable malaria vaccine RTS,S (or Mosquirix) on 750,000 children aged 5-17 months in Ghana, Kenya and Malawi.
- Any decision on wider use will be taken based on the results of the pilot tests in the three countries.
- If the vaccine does indeed prove to be ready for large-scale use, it will be a milestone in the fight against malaria.
- Although the number of cases globally and in the African region came down by 21% between 2010 and 2015, in 2015 itself the number of deaths worldwide on account of the disease was as high as 429,000.
- According to WHO estimates, Africa accounted for 92% of these deaths, and 90% of the 212 million new cases that year.
- The vaccine, given in four doses, protects against Plasmodium falciparum, which is the most prevalent malaria parasite in Africa.
- The three countries have been chosen as they have settings with moderate-to-high transmission of malaria and already have in place malaria control programmes such as the use of bed-nets, rapid diagnostic tests and combination therapy. Each country is to decide where precisely to run the pilots.
- Given the low protection efficacy of the vaccine even in tightly controlled clinical settings, the pilot tests will be useful in evaluating the likelihood of replicating the immunisation schedule in the context of routine health-care settings.
- Also, the extent to which the vaccine reduces the all-cause mortality has to be evaluated as this was not “adequately addressed” during the trial.
- There is, specifically, a need to ascertain if excess cases of meningitis and cerebral malaria seen during the trials are causally related to the vaccination.
- Unlike other vaccines, the less-than-optimum protection offered by this vaccine would mean that existing malaria intervention measures will have to be used in conjunction to reduce the incidence of the disease.
A disease like malaria if successfully eliminated can have long term benefits for African countries and also India. It is important that we closely monitor the studies and work in synergy to ensure best possible outcomes can be replicated. Health outcomes have spillover benefits in multiple sectors of the economy and society.
Connecting the dots:
- Analyse the impact of epidemics on the health profile of the country. Elaborate on the need to increase health expenditure keeping global norms in mind.
Prescribing medicines under generic names. Is it practical?
The Prime Minister’s recent announcement on making it mandatory for doctors to prescribe only the generic name, and not brand name of a drug, has generated a heated conversation in the media and in the pharma industry.