Report of the Consultative Committee of Experts to Determine Alternative Strategies under National Malaria Eradication Programme
The government of India’s Ministry of Health and Family Welfare set up the Consultative Committee of Experts to Determine Alternative Strategies under National Malaria Eradication Programme in July 1974. Dr. B. A. Rao was appointed as its chairperson; he was the first director of the National Malaria Eradication Programme (NMEP) which was launched in 1958.
The Committee was asked to assess the prevalence of malaria in India; suggest a strategy for an ‘anti-malaria’ operation between 1974 and 1979 keeping in mind the financial constraints for such a programme; and make recommendations for research on malaria.
The seven-part report includes a preface (Part I) and discusses malaria in India (Part II), current and proposed concepts on malaria eradication (Part III), alternative strategies for malaria control (Part IV), research requirements (Part V), training health personnel (Part VI) and a summary of the report (Part VII).
The Consultative Committee analysed the reports of the government of India’s In-Depth Evaluation Committees of 1970 and 1974, which discussed the NMEP’s implementation. The first In-Depth Evaluation Committee (1970) recommended that the NMEP should aim to eradicate malaria in India. The second In-Depth Evaluation Committee (1974) proposed to shift NMEP’s focus from eradication to ‘effective control’ of the disease.
The Consultative Committee concurs with the second In-Depth Evaluation Committee’s recommendation of aiming to contain malaria rather than its eradication. “The committee hopes that with better availability of funds and further advance in technology and method in management the objective of eradication will again become a feasible proposition,” the report says.
There is an urgent need to mobilise all resources – public and private – to combat malaria in India, the report notes.
The Committee recommends classifying regions based on the incidence of malaria. The government should deploy resources such as insecticides, medicines and medical personnel for the NMEP depending on the intensity of malaria in an area. The broad categories for this should be areas with under 0.5 cases per 1,000 people, areas with 0.5 to 2 cases per 1,000 people, areas with 2 to 10 cases per 1,000 people, and areas with more than 10 cases per 1,000 people.
There is no single drug which can completely cure all stages of malaria, notes the report. It is important to conduct research to find the most effective drugs or combination of drugs to cure the disease.
The Committee emphasises the need for training health personnel at all levels in malaria control practices, and to develop more malariologists by encouraging scientists and medical graduates to take up the discipline.
The report points out that the NMEP’s available resources are underutilised. The programme requires the cooperation and coordinated action of related health services, transport authorities, as well as agencies responsible for importing and supplying such resources as drugs and insecticides. It is especially necessary to encourage people to participate in activities conducted as part of the NMEP.
The report discusses the absence of basic health services in many parts of India, and states that primary health centres have not been adequately utilised for implementing the NMEP. Disease control programmes should be integrated with the basic health services to effectively utilise funds and personnel for healthcare.
Focus and Factoids by Sowmya Jain.
Consultative Committee of Experts to Determine Alternative Strategies under National Malaria Eradication Programme (Chairperson: Dr. B. A. Rao)
Ministry of Health and Family Welfare, Government of India
29 Aug, 1974