This week Delhi reported its first death from chikungunya this year. Contrast this with news from Sri Lanka that it is now malaria-free. A feat it has pulled off through an “unorthodox strategy”, as the WHO calls it. It involved mobile clinics in high-transmission areas to reduce the “parasite reservoir”, and sustained surveillance and community engagement. India too needs a layered strategy, beyond fogging the neighbourhood, to tackle mosquito-related diseases such as malaria, dengue and chikungunya. Building construction sites, and road and agriculture projects need to be planned keeping public health consequences in mind. Real estate projects should be heavily penalised if they leave unmanned pools of standing water.
The old-world mosquito net (treated with repellent) is another effective protector. It certainly was part of Sri Lanka’s armour. There’s work being done on mosquito repellent paint, for instance. And it may help to rope in companies dealing in household sprays and mosquito repellents to sponsor nets in high-transmission regions. The ground reality in India is a lot more complex but sometimes the simplest interventions can be most effective.
The Government needs to ensure effective diagnosis and treatment of people with malaria so that they do not stop taking their medicine halfway through the treatment, causing drug resistance. It also needs to instil confidence in people to get themselves treated at local primary healthcare centres or local doctors. Otherwise, everyone lands up at a large hospital. That’s when we see tragic consequences as Delhi did last year, when a couple committed suicide after their child died of dengue, reportedly for want of a hospital bed.
Deputy Editor