Latest news with #SHOBHASHUKLA
Scoop
03-08-2025
- Health
- Scoop
Prevention Revolution And Policy Harmonisation Are Critical To End AIDS
SHOBHA SHUKLA – CNS Despite having science-based tools for HIV combination prevention, there were 1.3 million people who A collage of people with text AI-generated content may be newly diagnosed with HIV in 2023 - and also in 2024 - hardly any decline between the two years. Despite having science-backed lifesaving antiretroviral therapy to help every person living with HIV healthy and well (and virally suppressed - which also ensures there is zero risk of HIV transmission because treatment works as prevention), 630,000 people died of AIDS-related illnesses in 2023 - and also in 2024 - hardly any decline between the two years. We clearly need a prevention revolution to drastically bring down new HIV infections as well as a lot more needs to be done to reduce AIDS-related deaths. 'Business as usual' is clearly not an option. In sub-Saharan Africa, one in four (~25%) of new HIV infections occur among key populations, but in Asia Pacific region, four in five (79%) of new HIV infections occur among key populations (such as men who have sex with men, sex workers, transgender people, persons who inject drugs, among others). In 2024 alone, there were an estimated 800,000 new HIV infections in sub-Saharan Africa, and women and girls accounted for 63% of them. Adolescent girls and young women aged 15-24 are more than twice as likely to acquire HIV as their male peers. These numbers remind us that HIV remains a public health crisis. But HIV is not just a medical or health issue—it is deeply intertwined with social, economic, and legal factors. To truly end HIV as a public health threat, we must look beyond the virus itself and address the broader context in which it thrives," said Letlhogonolo Mokgoroane, Legal Representative and Head of Strategic Litigation and Research, OurEquity, South Africa; member of Johannesburg Society of Advocates. "Sexual and reproductive health, rights and justice (SRHRJ) is about more than access to contraception or maternal care. It is about the right of every individual to make informed decisions about their bodies, free from violence, coercion, or discrimination. When people - especially women and girls - are denied these rights, they become more vulnerable to HIV and other health risks. For example, only 40% of young women in sub-Saharan Africa have comprehensive knowledge about HIV prevention. In some countries, less than 50% of women have access to modern contraception. Gender-based violence remains alarmingly prevalent: in South Africa, a woman is killed every three hours, and one in three women has experienced intimate partner violence," said Letlhognolo. Letlhogonolo was speaking in SHE & Rights (Sexual Health with Equity & Rights) session co-hosted by Global Center for Health Diplomacy and Inclusion (CeHDI), International Conference on Family Planning (ICFP 2025), Family Planning News Network (FPNN), International Planned Parenthood Federation (IPPF), Asian-Pacific Resource and Research Centre for Women (ARROW), Women's Global Network for Reproductive Rights (WGNRR), Asia Pacific Media Alliance for Health and Development (APCAT Media) and CNS. Survivors of violence are at a 50% higher risk of acquiring HIV "Criminalisation of same-sex relationships and sex work drives key populations underground, away from essential health services. In 31 African countries, same-sex relationships are still criminalised, making it difficult for LGBTQIA+ individuals to access HIV prevention and care. Sex workers, who are 13 times more likely to be living with HIV than the general population, often face harassment and violence, further increasing their vulnerability. Justice is central to this conversation. Laws and policies that discriminate against people living with HIV, LGBTQIA+ individuals, sex workers, and other marginalised groups, not only violate human rights but also fuel the epidemic," said Letlhogonolo. "For example, in Nigeria, the Same Sex Marriage (Prohibition) Act has led to a 41% decrease in access to HIV services among men who have sex with men. Justice means ensuring that everyone—regardless of who they are or whom they love—can access the information, services, and support they need to live healthy, fulfilling lives," added Letlhogonolo. If HIV funding is not fully restored, new infections and AIDS deaths can increase alarmingly "Recent global funding cuts could send the world back to levels of HIV infections and AIDS-related deaths not seen since the early 2000s. Next 5-years projection show that new HIV infections and AIDS-related deaths globally can dangerously rise if the lost funding (both this year and in recent years) does not return. Many countries have reduced their investments and domestic funding is often inadequate to fully fund the AIDS response – which has been relying on external support," said Eamonn Murphy, UNAIDS Regional Director for Asia Pacific, and Central Asia and Eastern Europe. 'Nine countries in Asia and the Pacific region have rising new HIV infection rates. 9 countries in the region have too low coverage of lifesaving antiretroviral treatments. Moreover, the region has been hit with funding crisis – and – overall HIV prevention crisis too. Between 2010 to 2024, there were 9 countries in Asia Pacific which reported an increase in newly diagnosed people with HIV. Fiji has the world's fastest growing epidemic, new HIV infections increased by over 3091% in Fiji,' said Murphy. 'Along with Fiji, other countries in Asia Pacific where there was an upswing in the number of people newly diagnosed with HIV between 2010-2024 are: 562% rise in Philippines; 187% rise in Afghanistan; 84% rise in Papua New Guinea; 67% rise in Bhutan; 48% rise in Sri Lanka; 42% rise in Timor-Leste; 33% rise in Bangladesh; and 16% rise in Lao PDR. Between 2010-2024, there were 9 countries in Asia Pacific which are also treating less than half of the people living with HIV, such as Afghanistan (11%), Pakistan (16%), Fiji (24%), Philippines (40%), Bangladesh (41%), Indonesia (41%), Mongolia (41%), PNG (46%), and Maldives (48%),' said Murphy of UNAIDS. Between 2010-2024, there were 9 countries in Asia Pacific which are also treating less than half of the people living with HIV, such as Afghanistan (11%), Pakistan (16%), Fiji (24%), Philippines (40%), Bangladesh (41%), Indonesia (41%), Mongolia (41%), PNG (46%), and Maldives (48%). 'Compared to the decline in the number of people newly diagnosed with HIV between 2010-2024 worldwide (40%), the decline in Asia Pacific is far behind (17%),' said Eamonn of UNAIDS. In Eastern and Southern Africa, new HIV infections declined by 57% during the same period. Pam Ntshekula calls for rights and safety of sex workers "Our mission is clear: sex workers deserve dignity, protection, and full recognition of their human rights. We are calling for the full decriminalisation of sex work because sex workers deserve to work in safe, free, and dignified spaces. Right now, criminalisation puts sex workers at risk - it makes them more vulnerable to violence, police abuse, stigma, and poor health access. Decriminalisation would mean sex workers can report crimes without fear, access healthcare without judgment, and work without hiding. It is not just a legal issue —it is about human rights, health, and safety. Every sex worker deserves to be protected, respected, and free to choose how they live and work," said Pam Ntshekula is a dedicated advocate for the rights and safety of sex workers and Lobbyist Officer, Sex Workers Education and Advocacy Taskforce (SWEAT), South Africa. "Many sex workers avoid clinics due to stigma and mistreatment. Full decriminalisation ensures safe, respectful access to SRHR services. Criminalisation limits condom use, outreach, and health education. Decriminalisation creates safer environments for prevention and care. Constant fear of arrest, violence, and shame harms mental wellness. SDG3 includes mental health - sex workers deserve safety and peace of mind," Pam added. "Sex workers face high levels of rape, assault, and abuse - often from police or clients. Decriminalisation allows them to report violence and access justice. Gender equality means protecting all genders and identities. My message is: There is no health without rights. There is no equality without decriminalisation. Decriminalising sex work is the single most powerful move to remove legal barriers to health access, justice, and human dignity. It also lets peer educators and health organisations do their work without fear," said Pam. "We also need to tackle poverty and unemployment by linking sex workers to job training, housing support, and social grants if they choose to exit. Empowerment means choices, not pressure." SDG goals and targets are not standalone but interconnected "Each of SDG goals and targets are interconnected. For example, studies show that countries with higher gender equality have lower rates of HIV infection among women. In Botswana, legal reforms to protect women's property rights have led to increased economic independence and better health outcomes. We cannot achieve health without justice. We cannot achieve justice without upholding rights. And we cannot uphold rights without addressing the root causes of inequality and exclusion," said Letlhogonolo. "It means we must break down silos. HIV programmes cannot operate in isolation from broader sexual and reproductive health services. Legal reforms must go hand in hand with public health initiatives. We must listen to and empower those most affected—young people, women, LGBTQIA+ communities, and people living with HIV—to lead the way," they added. "It means investing in education, not just about HIV, but about consent, healthy relationships, and bodily autonomy. In Uganda, the DREAMS initiative, which combines HIV prevention with education and economic empowerment for adolescent girls, has reduced new HIV infections among participants by 25%. Supporting community-based organisations is crucial: in Kenya, peer-led outreach among sex workers has doubled the uptake of HIV testing and treatment. It means holding governments accountable for their commitments to human rights and the SDGs," stressed Letlhogonolo. "In 2023, out of 54 African countries, only 16 African countries had fully funded their national HIV responses. We must advocate for increased domestic investment and international solidarity. And it means recognising that justice is not just a legal concept—it is a lived reality. When a young woman can access contraception without fear, when a gay man can seek HIV testing without shame, when a sex worker can report violence without risking arrest, we are moving closer to justice," rightly said Letlhogonolo. "Essential health services must include sexual and reproductive health services - including safe abortion and post-abortion care, menstrual health hygiene, and mental health services, with particular attention to women, adolescent girls, persons with disability, indigenous peoples, gender diverse communities, older people, young people, migrant workers, refugees, people living with HIV, sex workers, people who use drugs, among others. They must also include all health and social support services for survivors of sexual and gender-based violence," said Shobha Shukla, Lead Discussant for SDG-3 at the United Nations High Level Political Forum 2025 (HLPF 2025) in New York. "We have to ensure that health responses are people-centred, gender transformative and rights-based for all, without any condition or exclusion." She rightly called upon the government leaders who had assembled at the UN: "With less than 5 and a half years left to deliver on SDG3, we appeal to governments to step up their actions on gender equality and right to health - where no one is left behind." Shobha Shukla – CNS (Citizen News Service) (Shobha Shukla is a feminist, health and development justice advocate, and an award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service). She was also the Lead Discussant for SDG-3 at United Nations High Level Political Forum (HLPF 2025). She is a former senior Physics faculty of prestigious Loreto Convent College; current President of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media); Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024); and coordinator of SHE & Rights (Sexual Health with Equity & Rights). Follow her on Twitter/X @shobha1shukla or read her writings here
Scoop
29-07-2025
- Health
- Scoop
Person-Centred Care Is The Gateway To Health For All
SHOBHA SHUKLA, BOBBY RAMAKANT – CNS The irony of current times is that despite the writing on the wall "health is a fundamental human right," the ground reality cannot be farther from the truth. Over 70% people die of non-communicable diseases (NCDs) - a significant number of them are preventable. An infectious disease like TB, which is preventable and curable, continues to be the deadliest infectious disease worldwide - especially in the Global South. When HIV combination prevention should be a reality, along with treatment as prevention, over 630,000 people died of AIDS-related illnesses in 2024 - and 1.3 million were newly diagnosed with HIV in 2024 (hardly any change when compared with 2023 data). If every life matters, then why is A for accountability, missing from global health? After funding cuts by the US earlier in 2025 and other nations, the situation has become grimmer. "Global health suffers from sudden funding cuts, compromised logistic supply and massive reduction of the number of healthcare givers. The current time necessitates to establish the principle of achieving much more with much less by rapid enhancement of the quality of the services and healthcare," said Dr Sugata Mukhopadhyay, a noted global health thought leader who has worked on improving person-centred healthcare with governments as well as other stakeholders in several countries of the Global South, notably India and Mozambique as well as Indonesia, Nepal and Thailand. He also consults for a range of organisations including Humana People to People India (HPPI), which has demonstrated groundbreaking results in reaching the unreached high-risk people with best of public TB services and social support. Let us first serve those who are farthest behind Mahatma Gandhi's talisman is perhaps the best guiding light to reform the public health and social justice system: "I will give you a talisman. Whenever you are in doubt, or when the self becomes too much with you, apply the following test- "Recall the face of the poorest and the weakest man [woman] whom you may have seen, and ask yourself if the step you contemplate is going to be of any use to him [her]. Will he [she] gain anything by it? Will it restore him [her] to a control over his [her] own life and destiny? In other words, will it lead to swaraj [freedom] for the hungry and spiritually starving millions? Then you will find your doubts and your self melt away," said Gandhi ji. Our health system must meet the needs of the poorest of the poor and weakest of the weak. And the same quality of service which goes to this person should be a benchmark for everyone else. Person-centred care helps us reach those currently unreached with equity and rights "Stronger engagement of the affected, infected and vulnerable community members in the decision-making process and promoting cost-effective interventions which have both scalability and impact, are critical priorities," said Dr Sugata. He was speaking in an affiliated event of the world's largest HIV science conference (13th International AIDS Society - IAS - Conference on HIV Science or IAS 2025), and right after 10th Asia Pacific AIDS and Co-infections Conference (APACC 2025) concluded in Japan. "Person-centred care is focused and organised around the health needs and expectations of people and communities - rather than just on the diseases. In a people-centred care, everyone is as important as anyone else. There is no hierarchy. Everyone - from patients to healthcare providers to families, social workers and community members - involved co-contribute to a coordinated effort in the delivery of healthcare and services," he said. "Person-centric healthcare aims to replace unidirectional clinical approach with a health system and community partnership approach where the people, families and communities are no more regarded merely as the beneficiaries of the healthcare services but are equally engaged in the crucial decision-making processes regarding policies, overall disease management and continuum of care," said Dr Sugata Mukhopadhyay. Patient-centred care versus person-centred care "We also use a terminology like 'patient-centred healthcare' which is focused on the individuals seeking healthcare as patients. However, person-centred healthcare should be much beyond the patient-centred care. Patients should not be reduced to or defined by their 'diseases' or 'illnesses' and 'conditions.' They are persons with individual preferences, needs and abilities who are full partners in their healthcare. They are people - not cases or merely a number - to count and analyse," rightly said Dr Sugata. Differentiated service delivery model "We also use a terminology like 'differentiated service delivery models' which are already in place in HIV programmes, and are also being initiated in TB. This model focusses on more customised treatment and care according to the specific health and non-health needs of the people as an integral part of client-centred approach to reflect the preferences, expectations and needs of the people while reducing unnecessary burden on the health system. The idea is not only to treat the health conditions but also help the clients to overcome their health-related dysfunction and disabilities that can enhance their cure and sustain good health thereafter," he added. Should not we utilise person-centred healthcare to equally address the emotional and economic stability of the affected and infected people? We must address stigma (as well as intersectional stigma), discrimination, violation of rights, gender equity, reduction of out-of-pocket expenditure, organise livelihood opportunities and social protection to maximise impact of the treatment outcomes in TB and HIV," said Dr Sugata Mukhopadhyay. "For example, the expected outcomes of a person-centred TB care is the successful completion of both curative and preventive treatment. Expected outcomes of a person-centred HIV care would be sustained viral suppression which can finally reduce new TB and HIV cases and premature mortality - and ensure that undetectable equals untrabnsmittable or #UequalsU is a reality for all with HIV." "It takes a village to raise a child" Dr Sugata commends the important and critical roles played by a number of stakeholders to reap benefits of person-centred care, such as those played by civil society and community-based partners, people who have survived TB and risen to champion the cause, people living with HIV, among others. "They are playing a critical role to achieve these goals. There should be sustained advocacy to mobilise the Ministry of Health of high-burden nations to adopt patient-friendly policies for integrated and holistic care and that should be a priority in the context of Global South." Dr Sugata's Triple Mantra 1. "Instead of merely increasing collaboration between TB and HIV interventions, can we think about a merged and unified TB-HIV elimination programme rather than separated TB and HIV control programmes, because that is what the people need: one programme, one strategy, one implementation at the same healthcare settings by the same service providers," said Dr Mukhopadhyay. "Incidentally, it is the same group of poor and vulnerable people of HIV programmes who are also in the need of TB care and vice versa. So when clients are the same, why not the programmes?" 2. "Enhance the treatment of contacts of TB and HIV index-cases," he added. Index-case is the first identified case in a group of related cases of a particular infectious disease like TB or HIV. "We have to understand that a TB patient or a person living with HIV is part of a group of potential-affected and -infected people whom we call 'close contacts.' The index cases of TB and HIV should be treated in tandem with all their possible contacts with the help of an appropriate curative and preventive treatment package and should be monitored together to ensure completion of the curative and preventive treatment. People should be empowered to demand screening and treatment of their partners as part of the person-centred care." 3. "More capacities for person-centred care for TB and HIV have to be built at the national (or sub-national) level. And there should be appropriate guidance and cross learning materials for strengthening person-centred care, both for providers and people (like operational manuals, lesson learnt documents, patient information materials, patient charters, stigma assessment tools, etc). Equally, we should encourage community members for self- and community-monitoring for the progresses of the health condition status of services and they should be also encouraged to utilise available digital applications for such monitoring," said Dr Mukhopadhyay. Governments must ensure that people come before profit when it comes to accelerating progress towards promises enshrined in the domestic goals as well as in the United Nations Sustainable Development Goals or SDGs. Person-centred care is a critical cog-in-the-wheel to deliver on SDG-3, SDG-5 as well as other SDGs. Shobha Shukla, Bobby Ramakant – CNS (Citizen News Service)
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 )
