Coronavirus Outbreak: What lessons can our battle with malaria teach us about tackling COVID-19?
COVID-19 presents a unique challenge to India’s policymakers and public health professionals. As they face difficult choices in the coming months, they can draw lessons from India’s recent success against malaria.
The novel coronavirus presents a unique challenge to India's policymakers and public health professionals. As they face difficult choices in the coming months, they can draw lessons from India's recent success against malaria. Three factors are key: Prioritise research and timely evidence; minimise disruption of health services and fight together as a nation.
COVID-19 has hit India hard. As of 11 May, India has more than 44,029 active cases and more than 2,200 deaths. Every case and every life lost is painful. Still, given India's population and the high infectiousness of COVID-19, experts believe that India has avoided the worst so far.
Much of the credit goes to the Indian people who have supported the clarion call by the Indian prime minister to fight COVID-19. The Opposition too has rallied behind the government.
We are, however, not out of the woods. Such crises require exceptional leadership and bold action informed by evidence. Lessons learnt during the ongoing battle against malaria can be valuable as we confront COVID-19.
Understand the virus
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 further reveal how COVID-19 is spreading and its impact on different populations.
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, therefore be at the centre of India's response and we must marshal all our public and private sector resources to support them.
Stay alert to new research and evidence
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 to identify new and more effective treatments in time and launch a more effective response.
Efforts are underway globally to develop vaccines and treatments to tackle COVID-19. While possible candidate vaccines are being developed, currently there are no vaccines effective against COVID-19. Similarly, there is currently no conclusive evidence to support specific drug treatment against COVID-19.
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 solidarity trial. Apart from the antimalarial drugs chloroquine and hydroxychloroquine, the solidarity trial includes Ebola and HIV treatments.
Continue fighting all diseases, not just COVID-19
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. When you let your guard down against malaria, it can bounce back.
Let us be ready for what is coming. 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 antimalaria drug is used to treat not just malaria but also rheumatoid arthritis and lupus. Ensuring sufficient availability will minimise disruptions to treatment of the aforementioned diseases and also reduce the risk from substandard and counterfeit alternatives.
Together, we can turn the corner
Taking a cue, 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. The government cannot do it alone. Parliamentarians, academics and researchers, civil society and the private sector, international organisations, 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.
KJ Alphons is Member of Parliament, Rajya Sabha.
Shahid Jameel is CEO, Wellcome Trust/Department of Biotechnology India Alliance.
Vaibhav Gupta is director, Country Acceleration, Asia Pacific Leaders Malaria Alliance
Rajiv Tandon is advisor, Asia Pacific Leaders Malaria Alliance and director, Health, RTI International India
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