Netting the mosquito: India as a ‘gateway to eradication’ of malaria

Martin Edlund recalls meeting Cipla doyen Dr Yusuf Hamied and hearing his story on the “hari goli” or the “green pill”, an anti-malaria drug.

The medicine was developed in response to a challenge from Mahatma Gandhi to Dr Hamied’s father during World War II, narrates Edlund, founding member and Chief Executive Officer of Malaria No More (MNM). These were early steps that went a long way in making India a leading provider of anti-malarials to the world. But today, as generic drugs from India face criticism from some quarters, Edlund points out that anti-malarials shipped from here support global humanitarian programmes. In fact, he adds, in addition to providing global supplies, India also plays a critical role in the battle against drug resistance.

There are really stringent standards for purchasing antimalarial drugs internationally...and Indian drugs are meeting and passing those standards, says Edlund, who has been a journalist and political consultant. Generics are chemically similar versions of innovative drugs. And institutions like The Global Fund to fight AIDS, Tuberculosis and Malaria and the US President’s Malaria Initiative purchase such medicines for programmes across the world, he points out.

“There is no question that the drugs that are being purchased and used internationally are being stringently tested and are passing those tests,” he reiterates. On quality, “you need to remain ever vigilant”, he says, adding that it is important that patients have access to quality drugs.

Edlund see India as a “gateway to eradication”.

“India is always the proving ground for a community’s ambition to end disease. That’s true for small pox and that’s true for polio and now we think it will be true for malaria as well,” says Edlund.

History shows us that drug resistance develops in the Mekong delta on the Thai-Cambodia border and it spreads to India and because Indians are so global, he says. Resistance spreading here could permeate to other parts of the world.

Mosquito-borne diseases

A non-profit organisation, MNM is working with the Indian government to develop a strategy to fight mosquito-borne diseases. This would tackle not just malaria but dengue and chikungunya, transmitted similarly, says Edlund.

In Orissa, a high burden region, it is associated with a programme involving Government’s ASHA or community health workers who are equipped with rapid diagnostic kits to quickly test and facilitate treatment. This is important to ensure that medicines are given only to those who need it, he explains. Resistance to a drug develops when people are treated randomly or when those taking the drug do not complete its full course. Responding to çoncerns of possible malaria under-reporting, Edlund observes that data about people being treated in private hospitals may not be getting captured. If the Government mandated that the private sector report its malaria cases to them (as is with TB), that would be “powerful”.

As the world’s first malaria vaccine gets piloted in Malawi, Edlund says tackling malaria will require new tools, resources, innovations and strategies. In India, that could mean tailoring strategies “not just State by State but in some cases district by district to end the disease.

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