Mosquito Breeding Habitats in SSP in Gujarat

Year ,667 29, , , , , , , ,166,142 1,843, ,436, , ,898,140 1,055, ,310, , ,864, , ,319, , ,018, , ,266, , ,296,008 1,465, ,503, , ,019,065 1,404, , ,047, % NAMP population in BPL states at risk of malaria Relationship of Poverty with Malaria in the Indian States Below Poverty Line in Total malaria cases in India Total malaria cases in BPL states % Malaria cases in BPL states Total P. vivax cases in India % P. vivax cases in BPL states Total P. falci- parum cases in India % P.falci- parum cases i n BPL states

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

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 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. MALARIA IN PUNJAB

Rice Cultivation and Malaria in Punjab % Share of Cropped Area % %

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. DamDam Dam completed Dam impounded

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 in 93 villages Malaria cases

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

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

Year DDT sprayed in mt against 200 mt % Coverage Chloroquine Tablets in Lakhs Total malaria cases P. falciparum cases SITUATION ANALYSIS OF BETUL DISTRICT, MADHYA PRADESH

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 in 160 villages Malaria cases

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 in 93 villages Malaria cases

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. 51 st 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 21 st Century- 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

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.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