Malaria lessons valuable in coronavirus pandemic

Coronavirus has hit India hard. As of 27th April, India had more than 21,000 active cases and more than 900 deaths. Still, given India’s population and the high infectiousness of COVID-19, experts believe that India has avoided the worst so far. We are, however, not out of the woods yet. Lessons learnt during the ongoing battle against malaria can be valuable.

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The fight against malaria has shown us that research is a helpful ally in defeating microorganisms. 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 SARS-CoV-2, the coronavirus that 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 reveal how COVID-19 is spreading and its impact on different populations.

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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 be at the centre of India’s response and we must marshal all our public and private sector resources to support them.

The history of malaria control shows us that we must continuously monitor the efficacy of drugs. There have been instances when antimalarials have become less effective in treating the disease. Monitoring such resistance has helped us identify new and more effective treatments.

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

India is rightly pulling out all the stops to battle COVID-19. 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 death in West Africa during the Ebola crisis. We must not let that happen in India.

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 the treatment.

Let us be reminded that a ‘whole of society’ effort has made success against malaria possible in India. Most recently, a group of Parliamentarians have come together to advocate for malaria elimination in India. We need a similar effort to thwart COVID-19. Parliamentarians, academics and researchers, civil society and private sector, international organizations, and other key stakeholders, must 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.

(Alphons is MP, Rajya Sabha; Jameel is CEO, The Wellcome Trust/DBT Alliance; Gupta is Director, Country Acceleration, Asia Pacific Leaders Malaria Alliance (APLMA); Tandon is Adviser, APLMA)