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Inaugural Address by Secretary (East) at the Kick-off Workshop on ASEAN-India Flagship Programme on Science & Technology for Combating Malaria: A Public Health Challenge NIMR, New Delhi, (May 11, 2015)

May 11, 2015

Dr. Neena Valecha, Director, National Institute of Malaria Research

Dr. Sadhana Relia, Scientist & Head of International, Multilateral & Regional Cooperation Division, Department of Science & Technology

Dr. R. C. Dhiman, Scientist ‘G’, National Malaria Research Institute

Distinguished experts and participants from ASEAN Member States and India

Ladies & Gentlemen

It is a great privilege for me to address the Opening Session of the kick-off Workshop on the ASEAN-India Flagship Programme on Science & Technology for Combating Malaria, a well-known public health challenge in our countries.

I would like to begin by complimenting NIMR for taking the initiative to organize this important Workshop, and also welcome experts from seven ASEAN Member States, viz. Cambodia, Indonesia, Philippines, Thailand, Singapore, Malaysia and Myanmar, who have travelled to India to participate in it. The Workshop provides us an opportunity to exchange views on the nature and dimension of the problem in our respective countries, the best practices we have adopted with varying degrees of success, the challenges we face today for the complete elimination of malaria, and the kind of collaborations we can forge to address this trans-national pandemic.

From the black-death that struck Europe in the 14th century to the Spanish influenza of early 20th century to the recent series of pandemics, be it malaria, SARS, Avian Flu, Swine Flu or Ebola, human society, over the centuries, has been constantly fighting a battle with infectious diseases. Across decades, these diseases have emerged, greatly affected human population, mutated and sometimes been controlled. Several obvious factors have enhanced the impact of infectious diseases, including malaria, on human population.

The rapid pace of globalization, combined with matching growth in trans-continental travel facilities, has meant more and more people are today travelling across borders for business, employment, studies, health treatment or tourism. The World Tourism Organisation statistics suggest that over 1 billion tourists travelled to foreign countries in 2013, which is expected to reach 1.6 billion by 2020. Such massive travel facilitates movement of infectious disease vectors and their consequences are therefore equally global.

An attendant phenomenon of rapid globalization is accelerating urban growth, especially in poorer countries. Today, roughly half of the world's population lives in cities, a figure that is expected to grow to 70% by 2050. Increasing density of population, weak health systems, poor urban infrastructure, inadequate sanitation have all contributed to spread of infectious diseases.

Misuse of antibiotics is helping generate more resistant and powerful disease strains. In fact, drug resistance has become a serious public health problem leading to increasing mortality rates and rising healthcare costs. Just in the case of malaria, it is estimated that around 300 million or more drug resistant malaria cases surface every year.

Global warming and rising temperatures also have implications for the spread of infectious diseases as disease vectors proliferate, exposing new regions and peoples to malaria, sleeping sickness, dengue fever, yellow fever and other insect-borne illnesses.

Infectious diseases, including malaria, are thus a major public health issue for both developed and developing countries. The difference is that for developing countries, the human cost is immediate and severe in terms of infant mortality, maternal mortality, and diminished economic productivity. But as infectious diseases move to the developed countries, there will be an increasing threat, particularly from the drug resistant varieties.

As experts dealing with the malaria pandemic, you would appreciate the fact that in spite of significant advances in medicinal research and development, and improved access to medicine, malaria continues to pose a serious threat to human life and cripples human productivity, across the globe.

WHO figures suggest that globally, an estimated 3.2 billion people in 97 countries and territories are at risk of being infected with malaria and developing disease, and an additional 1.2 billion are at high risk. According to the latest estimates, 198 million cases of malaria occurred globally in 2013 and the disease led to 584,000 deaths.

In India, in 2014, we had 1.07 million cases of malaria and 535 people died because of this disease. About 10% of malaria cases were reported from urban areas, with maximum number of cases being from Chennai, Vishakhapatnam, Vododara, Kolkata, Navi Mumbai, Vijaywada, etc.

I understand that the Southeast Asian region accounts for around 15% of malaria cases and 3% of deaths due to this disease worldwide, second only to Africa. Of the 10 ASEAN Member States, all the countries, except Brunei and Singapore have high malaria endemicity. Those most vulnerable include the tribal communities, migrant populations, and those working in development projects such as hydro-power dams, roads, irrigation projects, mining, and other plantations.

Eliminating this global pandemic has been a goal since 2007. In India, through a series of proactive measures, we have been relatively successful in containing the disease. These measures include early case detection and prompt treatment, vector control, community participation, environmental management and source reduction methods, and an effective monitoring and evaluation infrastructure on the ground.

Our experts would be sharing with the meeting more details about our malaria control strategy and programmes. I would, however, like to stress on a few governmental initiatives that have helped us fight malaria and other infectious diseases with a very high degree of success.

First, the Government has consciously strived to create a nation-wide network of research institutes. The National Institute of Malaria Research, the host of this workshop, was created in 1977 with the primary task to find short-term as well as long-term solutions to the problem of malaria through basic, applied and operational field research. The institute plays a key role in man power resource development through trainings/workshops and transfer of technology. NIMR has today a network of well-developed laboratories in New Delhi carrying out research on all aspects of malaria along with 10 field laboratories in malarious areas, which serve as testing ground for new technologies and help in the transfer of technologies.

Second, the Government has set up a separate Pharmaceutical Department within the Ministry of Health & Family Welfare for promoting drug research, boosting public-private partnership models, facilitating education in drug research, development of infrastructure, manpower and skills for the pharmaceutical sector. To promote R&D, the Government, along with the private sector, is planning to invest US$ 1-2 billion a year to make India one of the top five global pharmaceutical innovation hubs by 2020. This will be facilitated through deliberate actions on multiple fronts, which include infrastructure development, financial incentives to incubate innovation and shaping a favourable regulatory environment. The idea is to find cost-effective cure for diseases endemic in India with a target of discovering in India one out of 5-10 drugs discovered worldwide by 2020.

Third, while ensuring protection of the business interests of pharmaceutical companies, the Government has consistently advocated patent pooling to promote manufacture of cheaper generics, and making use of orphan drugs. Indian pharmaceutical industry today has a 14% share of the USD 57 billion worth generic market and we have close to 100 manufacturing facilities approved by the US FDA and the UK Medicines and Healthcare Regulatory Authority. As a result, we have ensured that medicines are cheap and affordable.

Fourthly, the Government has also approved a major health insurance scheme for workers of the unorganized sector which include families below the poverty line for coverage within a period of five years.

Finally, the Government has launched a slew or programmes under the National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM) to ensure strengthening of health infrastructure through public-private partnerships, to ensure that both the rural and urban poor have access to medicines.

The new Government led by Prime Minister Modi has also launched the ‘Swachh Bharat Abhiyan’ or ‘Clean India Campaign’ to improve rural and urban sanitation, which will undoubtedly have a positive fallout in controlling malaria.

I understand that all ASEAN Member States, both through proactive efforts of respective national governments and with the support of the World Health Organization (WHO) and other external partners, have succeeded in containing malaria to a large extent. At the same time, I am also told that all ASEAN countries, except Thailand, have limited capacity for research and the latest methodologies for prevention, management, control and elimination of malaria.

This ASEAN-India Workshop on Malaria is, therefore, in my view, both timely and mutually beneficial. I am sure the deliberations at the workshop over the next 5 days will enrich our collective knowledge and understanding of this trans-national health challenge, and experts from both sides will be able to identify and develop some concrete future collaboration projects that would bring mutual benefit in addressing this serious public health challenge.

I wish the workshop all success and thank you for your attention.