Latest news with #HealthForAll
Scoop
23-06-2025
- Health
- Scoop
Design Health Services Around People, Not The Disease
"We need to design services around people, not the disease," rightly said Dr Nittaya Phanuphak. Unless point-of-care health technologies are deployed for those who are most-in-need in a person-centred and rights-based manner, we would fail to deliver on the promises enshrined in #HealthForAll and SDGs goals and targets. "Point-of-care health technologies sitting in centralised laboratories are as good as centralised, lab-dependent ones - both remain inaccessible to those in acute need," said Shobha Shukla. "But when point-of-care tools are taken and deployed as close as possible to the communities to serve them with equity and human dignity, real change happens." Shobha and Dr Nittaya were speaking at the 2nd Asia Pacific Conference on Point-of-Care Diagnostics for Infectious Diseases (POC 2025) and in lead up to the 13th International AIDS Society Conference on HIV Science (IAS 2025). Dr Nittaya Phanuphak is the Convener of POC 2025; Executive Director of Institute of HIV Research and Innovation (IHRI) and Governing Council member of International AIDS Society (IAS). Shobha leads CNS (Citizen News Service) and Chairs Global Antimicrobial Resistance Media Alliance (GAMA). Community-led models proved same day "test and treat" for HCV is feasible and effective In India's Manipur, Community Network for Empowerment (CoNE) and partners did a path-breaking study to prove that same day "test and treat" is possible, feasible and effective for hepatitis C virus (HCV). They could do so because for the confirmatory test, the sample did not have to go for centralised laboratories but could be tested on WHO recommended point-of-care, decentralised, battery-operated (with solar power recharging capabilities) and laboratory independent multi-disease molecular testing platform, Truenat. So, when confirmatory test Truenat could be deployed closer to the communities, it became possible to screen people, and offer molecular test on Truenat to those who needed a confirmatory test on-spot. Result came back within an hour after which treatment initiation could be followed upon. Giten Khwairakpam, one of the study co-authors who works with amfAR's TREATAsia programme, was speaking at POC 2025. Truenat is made in India by Molbio Diagnostics, is the largest used molecular test for TB in India (and also deployed in over 85 countries globally), and over 9000 machines are deployed by the government (for TB) across India. This study enrolled 643 people (during November 2021 to August 2022) out of which 503 were screened - all were males and had a history of injection drug use. Community people who formerly had a history of injection drug use conducted the screening. 155 people were found to have viraemia, out of which 98% (153) were initiated on treatment on the same day (remaining 2 people also were initiated on treatment soon after). All (100%) completed the treatment. All (100%) those who tested negative were offered vaccination for hepatitis B virus. It is a powerful example from the communities which should inform national and global policies for improving hepatitis responses on the ground - in person-centred manner. Philippines' Bantayan offers another strong example when point-of-care tools are deployed at point-of-need In multiple islets of Bantayan in the northernmost part of Cebu, Philippines, only around one-third of the estimated TB cases could be notified before the pandemic. But after the introduction of new TB screening and diagnostic tools, now almost all the TB (99%) is found in 2024. Dr Samantha Tinsay, government Municipal Health Officer, Bantayan, Cebu, Philippines and her team made a major difference in bridging the gap between TB services and people who were left behind on islets of Bantayan. She took point-of-care and battery operated AI-CAD enabled X-Rays and Truenat (point-of-care, battery-operated, laboratory independent and de-centralised molecular test) - both kept safely in a moulded plastic box - loaded on a pump boat - and went from islet to islet - screening people for TB and offering confirmatory Truenat molecular test on the spot. Within an hour or so, those found with active TB disease were linked to TB treatment care pathway. New TB case notifications, as well as treatment success rate, increased manifold. But the journey was not easy - also due to inclement weather and stormy seas. Dr Samantha's untiring efforts have resulted in a tremendous increase in TB case finding: the number of persons screened for presumptive TB went up from 187 (in 2019) to 2506 (in 2022), 2027 (in 2023), and 5679 people in 2024. 'TB treatment success rate has also increased to 97% in 2023,' she confirmed. Average TB treatment success rate in the Philippines was 78% in 2023 as per the WHO Global TB Report 2024. Imagine the difference it can make in the Philippines' response to end TB if such interventions can be scaled up and become a norm. Dr Darivianca Elliotte Laloo, who has earlier served at the Stop TB Partnership and International Union Against Tuberculosis and Lung Disease (The Union) and currently leads Molbio Diagnostics as General Manager, chaired this session at POC 2025. She said that Truenat, which was validated independently by the Indian Council of Medical Research of the Government of India in 2017, offers PCR molecular testing for over 40 diseases (including current strains of COVID-19). Being WHO recommended battery-operated, laboratory independent, decentralised and point-of-care molecular test for TB with solar power charging capacities, it is increasingly getting deployed in peripheral areas of several high-burden countries now. Largest rollout of Truenat in Africa took place in Nigeria last December. Nigeria is home to largest number of people with TB in Africa. We need to close the gap between people-in-need and point-of-care standard diagnostics by taking services closer to them or at their doorstep, said Dr Laloo. Colossal cost of misdiagnosis on communities Noted #endTB activist Blessina Kumar who leads Global Coalition of TB Advocates (GCTA) shared a powerful real-life testimony of Meera, who survived one of the most serious forms of drug-resistant TB (Extensively Drug-Resistant TB or XDR-TB). If someone had XDR-TB in 2012, there were tools back then too, to test for TB and drug-resistant TB within 100 minutes. And after drug-susceptibility testing (to ensure that TB bacteria is sensitive to medicines used in the therapy), an effective treatment could have helped Meera towards cure. But misdiagnosis caused havoc: She had to endure the rigours of going through TB treatment for six years (2012-2018). She also had to spend around INR 300,000 (~USD 4000) as well which is a grim reminder that delayed or wrong diagnosis often results for catastrophic costs for people in need. She also had to be stay away from her 4 months old son because of TB. TB stigma and discrimination also did not spare her: she was not allowed in the kitchen or living room, and had to use separate utensils and clothes. She not only battled depression but also attempted suicide twice. Experts say that soon after initiation of an effective TB treatment, a person becomes non-infectious. But TB stigma and discrimination still lurks. After 6 years, Meera finally got the right diagnosis and treatment, and could get cured. She advocates for person-centred TB care since then. In 2025, if anyone has XDR-TB or any other form of drug-resistant TB, it should take an hour or two for confirmatory TB test (upfront molecular test) and treatment hopefully will be over in next six-months using the latest WHO recommended regimen - and with full health and social care and support. Imagine the difference it can make if we deploy science-based standard healthcare tools to serve the people where they are in person-centred manner. Inequities and injustices firewall most-in-need people from accessing standard care "It is not lack of TB diagnostic, treatment and prevention tools that are causing human suffering and killing people but inequity and injustices that plague our world. For example, rich nations like Australia could bring down TB rates to elimination level 50 years ago with whatever tools they had. In USA, lab on wheels with X-Rays were going to remote areas to find more TB in 1950s," said Shobha Shukla. "I have myself seen TB pins of 1940s and 1950s that were worn by people in USA to declare that they had taken an X-Ray to screen for TB." But, in the Global South, even after 50-70 years - it is not so common as it should be - to see lab on wheels taking an (AI-CAD enabled) X-Ray and molecular test closer to the unreached people with standard TB services. WHO called upon all governments in 2018 to replace microscopy with 100% upfront molecular testing for TB by 2027. All world leaders agreed to do so too in their Political Declaration of United Nations General Assembly High-Level Meeting on TB 2023. Despite this, out of those who got diagnosed, more than half (52%) did not get upfront molecular test in 2023 – rather they got microscopy or were not bacteriologically confirmed at all. Most of them would be in the Global South, wonders Shobha. "Early and accurate diagnostics is the ONLY entry-gate towards TB treatment care pathway. It reduces catastrophic costs faced by the most vulnerable, reduces avoidable human suffering and risk of TB death and helps stop the spread of TB infection," she said. 100 days campaign in India heralds a foundational shift on how we find TB based on science and evidence India's TB Prevalence Survey 2019-2021 showed that almost half of TB patients were asymptomatic. The Indian govt-led 100 days campaign from 7 December 2024 to 24 March 2025 was launched in 347 most affected districts to screen everyone regardless of symptoms among high-risk populations, including homeless and migrants. After 24 March 2025, given the impact, it was expanded to all 806 districts nationwide. As per government's concept note of 100 days campaign, vans were to go closer to high-risk groups with Artificial Intelligence Computer-Aided Detection (AI-CAD) enabled portable X-rays, Truenat molecular test machines for sputum testing, and other tests as required. 129.7 million people were screened and over 285,000 asymptomatic people with active TB disease were found – all of whom would have been missed if AI-CAD enabled X-ray was not done. "Imagine the public health impact of stopping TB spread, reducing human suffering and putting an additional nearly 300,000 to path of healing perhaps," said Shobha. Walk-the-talk on multi-disease elimination approach "As WHO multi-disease elimination approach is being finalised, we need to recognise that we have a lot of under-utilised multi-disease tools which we use for TB only. Truenat offers molecular testing for over 40 diseases. Likewise, artificial intelligence we use for TB detection, such as DeepTek's Genki and QureAI, both screen people within seconds for a number of diseases (DeepTek's Genki screens for more: 26 pathologies)," said Shobha. "Let us be responsible and fully optimally utilise diagnostic infra we have at point-of-need and scale them up too. It helps with pandemic prevention, preparedness and response too." And with regards to TB, follow the science – screen everyone in high-risk settings in people-centred manner. Bobby Ramakant – CNS (Citizen News Service) (Bobby Ramakant is part of CNS (Citizen News Service) and a World Health Organization (WHO) Director General's WNTD Award 2008. He is also on the Board of Global AMR Media Alliance (GAMA) and Asia Pacific Media Alliance for Health and Development (APCAT Media). Follow him on X: @bobbyramakant)
Scoop
08-06-2025
- Health
- Scoop
Despite Being Preventable And Curable Cervical Cancer Remains 4th Biggest Cancer In Women
Prophylactic vaccination against human papilloma virus (HPV) – which is one of the most common sexually transmitted infections and which causes cervical cancer – and screening, and treatment of pre-cancer lesions are very cost-effective strategies … Cervical cancer (cancer of the cervix) is preventable and curable, only if it is detected early and managed effectively. Yet it is the 4th most common cancer among women worldwide, with the disease occurring in 660,000 women and claiming the lives of 350,000 women in 2022 worldwide, as per the World Health Organization (WHO). China, India, and Indonesia had the highest number of cervical cancer cases in 2022. Moreover 42% of cervical cancer cases and 39% of deaths associated with it worldwide, took place in China and India- 23% cases and 16% deaths in China, and 19% cases and 23% deaths in India. India reported over 123,000 new cases of cervical cancer and around 77,000 deaths – highest number of deaths worldwide in 2022. Cervical cancer disproportionately affects younger women, and as a result, 20% of children who lose their mother to cancer do so due to cervical cancer, says WHO. As cervical cancer is the only cancer that can be eliminated, the WHO Director General had called upon the governments in 2018 to eliminate it. All governments globally committed to do so by 2030 (by endorsing the global strategy to eliminate cervical cancer by 2030 at the World Health Assembly 2020). But despite some progress, the world is way off the mark from the elimination goal in 2025. Where cervical cancer burden is greatest, access to lifesaving services is most broken Cervical cancer reflects the global inequities between the Global North and the Global South: The highest rates of cervical cancer incidence and mortality are in low- and middle-income countries. In fact, 94% of the cervical cancer deaths in 2022 took place in these countries where access to health services is appalling. This reflects major health inequities which are driven by lack of access to vaccination, cervical cancer screening and treatment services. Prophylactic vaccination against human papilloma virus (HPV) – which is one of the most common sexually transmitted infections and which causes cervical cancer – and screening, and treatment of pre-cancer lesions are very cost-effective strategies to prevent cervical cancer. WHO's call to deliver on #HealthForAll dates to the 1970s, but even now gaping health inequities and injustices plague the health systems – especially in the Global South. Vaccines against HPV have existed since almost 20 years now. No surprise for guessing that both Cervarix (made by Glaxo) and Gardasil (made by Merck) were made in the rich nations – and their rollout in the Global South has been far from ideal. In 2022, India-based Serum Institute in collaboration with the Department of Biotechnology of the government of India developed India's first indigenously produced HPV vaccine called Cervavac. So, now there is a vaccine developed in the Global South too. But its rollout is far from ideal as of now. It is still not a part of India's public health programme, for instance. Same inequities block access to HPV screening in the Global South 'Almost all cervical cancers (~95%) are caused by persistent HPV infection. Women living with HIV are 6 times more likely to develop cervical cancer compared to the general population, and an estimated 5% of all cervical cancer cases are attributable to HIV,' said Dr Kuldeep Singh Sachdeva, former head of Indian government's national TB and HIV programmes. Dr Sachdeva was speaking at the National Dialogue and stakeholder meet organised by National Coalition of People living with HIV in India (NCPI Plus) bringing together over 100 community leaders from almost all states of India. Dr Sachdeva currently leads Molbio Diagnostics as President and Chief Medical Officer. He was speaking ahead of 10th Asia-Pacific AIDS & Co-Infections Conference (APACC 2025), Japan; 2nd Asia Pacific Conference on Point of Care Diagnostics for Infectious Diseases (POC 2025), Thailand; and 13th International AIDS Society Conference on HIV Science (IAS 2025), Rwanda. Cervical cancer screening efforts in most settings of the Global South have long been hampered by reliance on outdated methods like pap smears and visual inspection with acetic acid (VIA) test, both of which suffer from poor sensitivity, high subjectivity, and dependence on specialised infrastructure. Advanced molecular HPV tests developed by the Global North, while highly accurate than pap smear and VIA, remain inaccessible for most women living in peripheral, rural, and resource-limited settings, especially of the Global South. India's first point-of-care HPV test that can be deployed at point-of-need in the Global South In April 2025, India's first ever indigenously developed RT-PCR molecular test for HPV on Truenat (called HPV-HR Plus) got an independent multi-centric validation done by Government of India's Department of Biotechnology, Biotechnology Industry Research Assistance Council (BIRAC) and Grand Challenges India. Truenat HPV-HR Plus test is made by Molbio Diagnostics in India. This independent validation of Truenat HPV-HR Plus was conducted under the study 'Validating Indigenous Human Papilloma Virus (HPV) Tests for Cervical Cancer Screening in India.' The study involved leading Indian government's research institutes, including All India Institute of Medical Sciences (AIIMS) Delhi, ICMR National Institute for Cancer Prevention and Research (NICPR) Noida, and ICMR National Institute for Research in Reproductive and Child Health (NIRRCH) Mumbai, in collaboration with WHO's International Agency for Research on Cancer (IARC). There are over 200 genotypes of HPV but those that put the infected person at risk of developing cervical cancer are few. Truenat HPV-HR Plus molecular test enables detection for 8 HPV high-risk genotypes – which account for over 96% cervical cancer cases worldwide. These HPV high-risk genotypes include 16, 18, 31, 33, 35, 45, 52 and 58. Out of these, 16 and 18 high-risk genotypes dominate globally as 77% of invasive cervical cancer cases are associated with them. These high-risk genotypes can also cause cancer of the anus, penis, vagina, vulva, and oropharynx (throat). Raising cervical cancer awareness and health literacy among people with HIV As women living with HIV are 6 times more at risk of cervical cancer, communities and networks of people with HIV must come forward to find ways to integrate cervical cancer screening as well as for other cancers (such as breast cancer) programmatically and in people-centred manner, said Daxa Patel, co-founder of National Coalition of People living with HIV in India (NCPI Plus) and its former President. Agrees Pooja Mishra, Secretary of NCPI Plus that it is unacceptable when cervical cancer, which is preventable and curable – and the only cancer which can be eliminated – still kills 350,000 women worldwide. We also need to raise awareness, health and treatment literacy among the young people, said Mishra. That is why NCPI Plus took leadership in organising a national dialogue and stakeholder consultation on preventing cancers among people with HIV, especially women. Truenat HPV-HR Plus test is critical for closing the screening gap, particularly for asymptomatic women and women who are at higher risk for persistent HPV infection. By shifting HPV screening closer to the most-at-risk people and communities, this test ensures early detection, better triaging, and timely treatment – especially in historically underserved populations. Over 10,000 Truenat RT-PCR molecular test machines are already deployed globally in over 85 countries (mostly for TB), and mostly in the Global South nations in remote settings. Truenat is a battery operated (with solar power charging), laboratory independent, de-centralised and point-of-care test that provides highly accurate diagnosis for over 30 diseases (including TB, HPV, HCV, HBV, STIs, COVID-19, etc) within an hour – thus enabling same day test and treat, counselling and follow-up. Superiority of Truenat HPV-HR Plus test Older Pap smear test detects precancerous or cancerous cervical cancer cells whereas Truenat HPV-HR Plus test detects the presence of high-risk HPV DNA (8 genotypes). Pap smear is a cytological screening test and depends on the observing medical expert's skill and slide quality, whereas Truenat is a PCR-based nuclear acid amplification test with very high sensitivity and specificity. False negative reports are higher and false positive reports are also moderate when pap smear is used whereas both are low with Truenat HPV-HR Plus. The most recent validation of Truenat HPV-HR Plus showed 100% specificity and 100% sensitivity. Truenat HPV-HR is designed to work with cervical swab samples collected by a clinician (self-collection of samples is still under evaluation), and it gives highly accurate results in just 60 minutes. Whereas, a pap smear results may take 3-7 days as these are laboratory dependent. Easy to use and with high stability at room temperature, Truenat HPV-HR Plus requires minimal biosafety and is optimised for use at both the laboratory and near-patient settings. This test overcomes shortcomings of current diagnostic methods, including variable sensitivity and specificity, high costs, complex workflows, and dependence on advanced equipment, said Dr Sachdeva. Highlighting the importance of developing health technologies in the Global South, Rajesh S Gokhale, Secretary, Department of Biotechnology, Ministry of Science and Technology, Government of India said, 'Truenat HPV-HR Plus represents the kind of diagnostic innovation we need – dependable, scientifically rigorous, locally developed, and built to serve our public health system. It is a huge step forward in strengthening cervical cancer screening across India.' 'HPV infection is common. However, persistence of HPV infection could be deadly. Studies show that nearly half of persistent HPV infections do not resolve by 24 months. These silent carriers drive the progression to high-grade pre-cancerous lesions and cancer. That's why extended HPV genotype detection is crucial,' shared Dr Sachdeva. HPV also causes oropharyngeal cancers Oropharyngeal cancers related to HPV vary from 28% to 68% in the richer nations. Indian studies also show alarming numbers though, more research is needed for science-informed responses towards eliminating HPV related cancers in our population, said Dr Ishwar Gilada, President Emeritus of AIDS Society of India (ASI) and Governing Council member of International AIDS Society (IAS). 'While there is increasing evidence of HPV-associated oropharyngeal cancer in both men and women globally, there still remain gaps in gender-neutral HPV vaccination policies globally,' said Dr Sachdeva. Community leaders like Manoj Pardeshi, who is among the co-founders and inspiring lights of NCPI Plus, said that regardless of gender, all those eligible and at risk of HPV related cancers, must be vaccinated against HPV. Programme addressing cervical cancer elimination should expand to eliminate all HPV related cancers in people-centred ways, regardless of gender. HPV is transmitted through: – Sexual contact: Transmission mode is through vaginal, anal, or oral sex with an infected person. – Skin-to-skin contact: Transmitted through non-penetrative sexual activities involving skin-to-skin contact. The WHO Guidelines recommend HPV detection via molecular test after age of 30 (and every 5 years thereafter). Vaccination against HPV is highly recommended for younger people under the age of 15 or before the initiation of sexual activity. Do not leave equity behind 'Truenat HPV-HR Plus test is about equity in detection. By expanding beyond traditional targets, we reach the genotypes that matter more in our populations for cervical cancer elimination. This means earlier intervention, fewer missed cases, and better outcomes,' said Dr Sachdeva. Truenat HPV-HR Plus offers the best of both worlds – critical genotype coverage and real-world deploy-ability. What does it mean to eliminate cervical cancer by 2030? To eliminate cervical cancer, all countries must reach and maintain an incidence rate of below 4 per 100,000 women. Achieving that goal rests on three key pillars and their corresponding targets: vaccination: 90% of all eligible young people must be fully vaccinated with the HPV vaccine by the age of 15. screening: 70% of women should be screened using a high-performance test by the age of 35, and again by the age of 45; treatment: 90% of women with pre-cancer treated and 90% of women with invasive cancer managed. No other cancer but cervical cancer is fully preventable and curable if detected and managed early. Even one death from it is a death too many. Shobha Shukla – CNS (Citizen News Service) (Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate. She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media) and Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024). She also coordinates SHE & Rights initiative (Sexual health with equity & rights). Follow her on Twitter @shobha1shukla or read her writings here
Scoop
30-04-2025
- Health
- Scoop
Health Equity And Inclusion Remain Fundamental To #endMalaria
Press Release – Citizen News Service We cannot divorce equity and inclusion from malaria response. And we cannot dislocate #endMalaria goals from other SDGs for sustainable elimination of the disease worldwide where no one is left behind. SHOBHA SHUKLA – CNS Governments have promised to end malaria by 2030. With around five and a half years left to eliminate the vector-borne disease worldwide, it is alarming that progress is off the mark. More worrying is that whatever progress has happened towards ending malaria, can be reversed. Without adequate science-backed and strategic investments and actions, how will countries that have ended malaria, keep the burden below the elimination levels? Climate change worsens the crisis as disease patterns shift. Equitable access to life-saving malaria tools is key to reversing trends We cannot divorce equity and inclusion from malaria response. And we cannot dislocate #endMalaria goals from other SDGs for sustainable elimination of the disease worldwide 'where no one is left behind.' 'Even if it is hard and difficult, and even if it is not 'popular', we need to keep remaining inclusive and equitable in our approaches towards ending malaria. We need to uphold gender equity, social inclusiveness, disability rights and inclusion, because if we focus on health equity and inclusion, it is doing justice to #HealthForAll where no one is truly left behind,' said Professor (Dr) Maxine Whittaker, Dean at James Cook University, Australia and Advisor to CSO Platform ( She was speaking with CNS Managing Editor Shobha Shukla at the End Malaria Dialogues at World Health Summit Regional Meeting. Reinvigorated global efforts warranted to curb rising malaria threat According to World Health Organization (WHO) Global Malaria Report 2024, there were over 263 million people who suffered because of malaria and over 597,000 who died of it worldwide in 2023. These figures are so disturbing, appalling and unacceptable for a disease which is both preventable and curable. Not just this: the number of people with malaria disease in 2023 was more than those who had malaria in 2022 (11 million more got malaria in 2023 than those who got in 2022). Around 95% of malaria deaths occurred in Africa, where many at risk of malaria still lack access to the services they need to prevent, detect and treat the disease. In Asia and the Pacific region, in terms of number of people with malaria, India has the maximum cases but as a percentage of those with malaria in a population, Papua New Guinea has the highest prevalence. Malaria-free places must remain malaria-free As of November last year (2024), 44 countries and 1 territory had been certified malaria-free by WHO, and many more are steadily progressing towards the goal. Of the 83 malaria-endemic countries, 25 countries now report fewer than 10 cases of malaria a year, an increase from 4 countries in 2000. Since 2015, Africa has also achieved a 16% reduction in its malaria mortality rate. However, the 2023 mortality rate of 52.4 deaths per 100,000 population at risk is still more than double the target level of 23 deaths per 100,000 population set by the Global Technical Strategy for Malaria Elimination 2016-2030, and progress must be accelerated. Do not take the foot off the #endMalaria accelerator Places that have eliminated malaria, need to ensure there is no resurgence of malaria. Disease surveillance or prevention for example must go on in a robust and science-backed manner and should be fully funded. 'Once you take the foot off the accelerator, malaria resurgence occurs – that has been well documented. This is what we are very concerned about because all the gains we have made, not just in malaria but in maternal and child health and infant mortality, can wither away. Malaria was one of the major causes of that in some countries that are close to elimination,' says Whittaker. In December 2024, WHO Global Malaria Report 2024 communique said that 'WHO is also calling for investments in robust data systems that are capable of monitoring health inequalities, including through the collection and analysis of data disaggregated by sex, age and other social stratifiers. Equity, gender equality and human rights should be the cornerstones of antimalarial innovation, with people most impacted by the disease engaged in the design and evaluation of new tools and approaches.' #EndMalaria funding is less than HALF of what is required Whittaker underlines the importance of fully funding the fight against malaria. Funding for malaria control globally remains inadequate to reverse current trends, especially in malaria high-burden African countries. In 2023, total funding reached US$ 4 billion, falling far short of the year's funding target of US$ 8.3 billion set by the Global Technical Strategy. Insufficient funding has led to major gaps in coverage of insecticide-treated nets, medicines, and other life-saving tools, particularly for those most vulnerable to the disease. Prof Whittaker looks up to domestic philanthropies and corporate social responsibility of the private sector to bridge the funding gap. The funding cuts to WHO have only added to the problem. Beyond funding, malaria-endemic countries continue to grapple with fragile health systems, weak surveillance, and rising biological threats, such as drug and insecticide resistance. In many areas conflict, violence, natural disasters, climate change and population displacement are exacerbating already pervasive health inequities faced by people at higher risk of malaria, including pregnant women and girls, children aged under 5 years, Indigenous Peoples, migrants, persons with disabilities, and people in remote areas with limited healthcare access. The proverbial last kilometre Prof Maxine Whittaker has contributed significantly over the years in helping shape a community-centric response towards ending malaria in Greater Mekong Sub-Region. Along with Thailand, three other countries are close to #endMalaria goal, but the last kilometre can be longer or tougher than one can imagine. One concern she shares is what she heard from many others at World Health Summit regional meet. Community engagement is either not there or not enough in malaria response with dignity, rights, equity and justice. Some should NOT be more equal than others. Whittaker believes that 'Engaging people and communities helps us find best of ways to meet their needs.' She is hopeful and shares that there are plans to ensure that there is no reestablishment of malaria in Greater Mekong Sub-Region. Malaria response along the Thailand and Myanmar border is marred by the conflict brewing in Myanmar. Thailand was very close to being able to eliminate malaria, but malaria again got reestablished in some parts, shared Dr Whittaker. 'We need proper decentralisation, along with financial and resource devolution, to ensure that local problems get best of local solutions to end malaria. This requires an educated decentralised management and health workforce. If we look at experiences, we will see that some may think after getting close or achieving malaria elimination that 'there is no need to worry about' or 'there is no malaria problem anymore in backyard' and slacken not just programmes but also investment. We need to keep investing in #endMalaria programmes as well as be a lot smarter now!' says Whittaker. Climate change and malaria WHO reported that the 2022 floods in Pakistan were a massive setback for fight against malaria and a warning for the world of how climate change will impact disease response efforts. Pakistan experienced the worst flooding in its history in 2022. At its height, more than a third of the country was underwater and 33 million people were affected. 'Even before the waters receded, the mosquitoes came en masse, driving the worst malaria outbreak in the country since 1973,' said the WHO report. It had the biggest impacts on the poorest people. When the rains started to subside, there were huge collections of stagnant water everywhere which was a perfect breeding ground for malaria. As per the WHO, before the floods, there was gradual progress in malaria control in Pakistan. But after the floods this country saw at least a four-fold increase in the reported number of malaria cases. Professor Maxine said: 'With climate change, as places get warmer, parasites may not like that. Which means they may move to higher altitudes or cooler climates. This could be a problem then when they cause diseases and untimely deaths.' Malaria vaccine: is it helping? As of December 2024, 17 countries in Africa had introduced malaria vaccines through routine childhood immunisation. The continued scale-up of the vaccines in Africa is expected to save tens of thousands of young lives every year. Newly developed malaria vaccine may not suit near-elimination settings, says Whittaker. 'Malaria vaccine is doing reasonably well as a package of public health interventions to actually reduce morbidity and mortality and also help reduce some of the infant and child malaria cases. It was designed for a particular purpose, whether it is going to be of use in southern or southeast Asian region, or the Pacific, is not certain.' Professor Whittaker calls for a whole-of-society and whole-of-government approach to end malaria – with equity, inclusion and justice as key cog in the wheel. Shobha Shukla – CNS (Citizen News Service) (Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate. She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media) and Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024). She also coordinates SHE & Rights initiative (Sexual health with equity & rights). Follow her on Twitter @shobha1shukla or read her writings here )
Scoop
30-04-2025
- Health
- Scoop
Health Equity And Inclusion Remain Fundamental To #endMalaria
SHOBHA SHUKLA – CNS Governments have promised to end malaria by 2030. With around five and a half years left to eliminate the vector-borne disease worldwide, it is alarming that progress is off the mark. More worrying is that whatever progress has happened towards ending malaria, can be reversed. Without adequate science-backed and strategic investments and actions, how will countries that have ended malaria, keep the burden below the elimination levels? Climate change worsens the crisis as disease patterns shift. Equitable access to life-saving malaria tools is key to reversing trends We cannot divorce equity and inclusion from malaria response. And we cannot dislocate #endMalaria goals from other SDGs for sustainable elimination of the disease worldwide 'where no one is left behind.' 'Even if it is hard and difficult, and even if it is not 'popular', we need to keep remaining inclusive and equitable in our approaches towards ending malaria. We need to uphold gender equity, social inclusiveness, disability rights and inclusion, because if we focus on health equity and inclusion, it is doing justice to #HealthForAll where no one is truly left behind,' said Professor (Dr) Maxine Whittaker, Dean at James Cook University, Australia and Advisor to CSO Platform ( She was speaking with CNS Managing Editor Shobha Shukla at the End Malaria Dialogues at World Health Summit Regional Meeting. Reinvigorated global efforts warranted to curb rising malaria threat According to World Health Organization (WHO) Global Malaria Report 2024, there were over 263 million people who suffered because of malaria and over 597,000 who died of it worldwide in 2023. These figures are so disturbing, appalling and unacceptable for a disease which is both preventable and curable. Not just this: the number of people with malaria disease in 2023 was more than those who had malaria in 2022 (11 million more got malaria in 2023 than those who got in 2022). Around 95% of malaria deaths occurred in Africa, where many at risk of malaria still lack access to the services they need to prevent, detect and treat the disease. In Asia and the Pacific region, in terms of number of people with malaria, India has the maximum cases but as a percentage of those with malaria in a population, Papua New Guinea has the highest prevalence. Malaria-free places must remain malaria-free As of November last year (2024), 44 countries and 1 territory had been certified malaria-free by WHO, and many more are steadily progressing towards the goal. Of the 83 malaria-endemic countries, 25 countries now report fewer than 10 cases of malaria a year, an increase from 4 countries in 2000. Since 2015, Africa has also achieved a 16% reduction in its malaria mortality rate. However, the 2023 mortality rate of 52.4 deaths per 100,000 population at risk is still more than double the target level of 23 deaths per 100,000 population set by the Global Technical Strategy for Malaria Elimination 2016-2030, and progress must be accelerated. Do not take the foot off the #endMalaria accelerator Places that have eliminated malaria, need to ensure there is no resurgence of malaria. Disease surveillance or prevention for example must go on in a robust and science-backed manner and should be fully funded. 'Once you take the foot off the accelerator, malaria resurgence occurs – that has been well documented. This is what we are very concerned about because all the gains we have made, not just in malaria but in maternal and child health and infant mortality, can wither away. Malaria was one of the major causes of that in some countries that are close to elimination,' says Whittaker. In December 2024, WHO Global Malaria Report 2024 communique said that 'WHO is also calling for investments in robust data systems that are capable of monitoring health inequalities, including through the collection and analysis of data disaggregated by sex, age and other social stratifiers. Equity, gender equality and human rights should be the cornerstones of antimalarial innovation, with people most impacted by the disease engaged in the design and evaluation of new tools and approaches.' #EndMalaria funding is less than HALF of what is required Whittaker underlines the importance of fully funding the fight against malaria. Funding for malaria control globally remains inadequate to reverse current trends, especially in malaria high-burden African countries. In 2023, total funding reached US$ 4 billion, falling far short of the year's funding target of US$ 8.3 billion set by the Global Technical Strategy. Insufficient funding has led to major gaps in coverage of insecticide-treated nets, medicines, and other life-saving tools, particularly for those most vulnerable to the disease. Prof Whittaker looks up to domestic philanthropies and corporate social responsibility of the private sector to bridge the funding gap. The funding cuts to WHO have only added to the problem. Beyond funding, malaria-endemic countries continue to grapple with fragile health systems, weak surveillance, and rising biological threats, such as drug and insecticide resistance. In many areas conflict, violence, natural disasters, climate change and population displacement are exacerbating already pervasive health inequities faced by people at higher risk of malaria, including pregnant women and girls, children aged under 5 years, Indigenous Peoples, migrants, persons with disabilities, and people in remote areas with limited healthcare access. The proverbial last kilometre Prof Maxine Whittaker has contributed significantly over the years in helping shape a community-centric response towards ending malaria in Greater Mekong Sub-Region. Along with Thailand, three other countries are close to #endMalaria goal, but the last kilometre can be longer or tougher than one can imagine. One concern she shares is what she heard from many others at World Health Summit regional meet. Community engagement is either not there or not enough in malaria response with dignity, rights, equity and justice. Some should NOT be more equal than others. Whittaker believes that 'Engaging people and communities helps us find best of ways to meet their needs.' She is hopeful and shares that there are plans to ensure that there is no reestablishment of malaria in Greater Mekong Sub-Region. Malaria response along the Thailand and Myanmar border is marred by the conflict brewing in Myanmar. Thailand was very close to being able to eliminate malaria, but malaria again got reestablished in some parts, shared Dr Whittaker. 'We need proper decentralisation, along with financial and resource devolution, to ensure that local problems get best of local solutions to end malaria. This requires an educated decentralised management and health workforce. If we look at experiences, we will see that some may think after getting close or achieving malaria elimination that 'there is no need to worry about' or 'there is no malaria problem anymore in backyard' and slacken not just programmes but also investment. We need to keep investing in #endMalaria programmes as well as be a lot smarter now!' says Whittaker. Climate change and malaria WHO reported that the 2022 floods in Pakistan were a massive setback for fight against malaria and a warning for the world of how climate change will impact disease response efforts. Pakistan experienced the worst flooding in its history in 2022. At its height, more than a third of the country was underwater and 33 million people were affected. 'Even before the waters receded, the mosquitoes came en masse, driving the worst malaria outbreak in the country since 1973,' said the WHO report. It had the biggest impacts on the poorest people. When the rains started to subside, there were huge collections of stagnant water everywhere which was a perfect breeding ground for malaria. As per the WHO, before the floods, there was gradual progress in malaria control in Pakistan. But after the floods this country saw at least a four-fold increase in the reported number of malaria cases. Professor Maxine said: 'With climate change, as places get warmer, parasites may not like that. Which means they may move to higher altitudes or cooler climates. This could be a problem then when they cause diseases and untimely deaths.' Malaria vaccine: is it helping? As of December 2024, 17 countries in Africa had introduced malaria vaccines through routine childhood immunisation. The continued scale-up of the vaccines in Africa is expected to save tens of thousands of young lives every year. Newly developed malaria vaccine may not suit near-elimination settings, says Whittaker. "Malaria vaccine is doing reasonably well as a package of public health interventions to actually reduce morbidity and mortality and also help reduce some of the infant and child malaria cases. It was designed for a particular purpose, whether it is going to be of use in southern or southeast Asian region, or the Pacific, is not certain." Professor Whittaker calls for a whole-of-society and whole-of-government approach to end malaria - with equity, inclusion and justice as key cog in the wheel. Shobha Shukla – CNS (Citizen News Service) (Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate. She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media) and Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024). She also coordinates SHE & Rights initiative (Sexual health with equity & rights). Follow her on Twitter @shobha1shukla or read her writings here )
