Malaria: India's Soft Power can Save Africa

Published on 30th May 2011

India has an historical and cultural relationship with Africa, from the days of the old silk route and Africa is home to nearly 3 million people of Indian origin, mostly in east and southern Africa. In addition to economic ties, India could build on this soft presence by taking up issues such as health care and education, which could help transform the lives of hundreds of millions of people in Africa.

At the first Africa-India summit held in New Delhi in 2008, it was agreed that there would be increased co-operation in the area of malaria control. Minister Anand Sharma, highlighted the importance of working together in partnership and sharing experiences in several key areas, one of which was healthcare. More specifically, Mr Sharma noted that malaria was a “transnational challenge…that is not confined to one region.” Indeed, malaria is still a major public health concern in Africa, imposing enormous economic costs and a great deal of human misery.

Some donors, notably the US President’s Malaria Initiative, have supported some highly effective malaria control projects. African countries can build on this success by working with India, especially as the traditional donor countries are being forced to tighten their belts and reduce foreign aid budgets.

Malaria is both preventable and curable. While India faces a massive malaria problem, the greatest burden of the disease is carried by Africa, which accounts for the vast majority of the 800,000 malaria deaths recorded annually. Assistance from India in this area will be of significant humanitarian and strategic importance for both present and future relations.

Formal malaria control programmes were started under British colonial rule and continued after Indian Independence in 1946. One of the most remarkable periods in global malaria control began with the introduction of DDT around this time. This extraordinary insecticide eradicated malaria from southern Europe and the United States and proved to be the most effective weapon against the disease at the time.

To this day DDT remains an integral part of malaria control in Africa and India. In the Southern Africa region DDT is seen as a crucial component of the region’s malaria elimination plans. But African countries do not have an easy time using this life-saving insecticide. Pressure from environmental groups has limited its use and exporters fear that even the tiniest residues of DDT on their produce, detectable thanks only to advanced scientific testing equipment, will lead to its rejection from the EU. DDT is now only produced by an Indian public sector company, which is also exporting it to Africa. Over a dozen countries in Africa, including Angola, Botswana, Congo, Eritrea, Ethiopia, Gambia, Mozambique, Namibia, South Africa, Swaziland and Uganda, have informed the World Health Organistion (WHO), about their decision to have DDT as part of their arsenal against malaria.

In order to ensure sufficient supplies of DDT, the Southern African Development Community (SADC) recently announced plans for regional production of the insecticide. As malaria epidemics can arise rapidly, it is crucial to have sufficient supplies of public health insecticide easily and cheaply available. Any importation delay from India could cost lives and as the regulations governing the trade and use of DDT become more onerous, having product close at hand would be highly beneficial. India’s Ministry of Chemicals is therefore in a position to assist with the production and formulation of DDT in Africa.

However, DDT is not a panacea and India can also help with many other aspects of malaria control. Although we know how malaria is transmitted and how it can be cured, it is in fact a highly complex disease. Depending on the setting, mosquitoes breed, bite and behave differently and so understanding the local mosquito populations and what will be most effective in interrupting transmission is crucial. Regrettably most African countries lack trained malaria control professionals who can develop disease control strategies and then continuously monitor results and adapt the interventions accordingly. As India faces many of the same obstacles, increased collaboration and funding malaria control centres in Africa would benefit both countries.

Along with assisting in improved mosquito control, India can help Africa in improving access to safe, effective and affordable malaria medicines. India is a major producer of the new highly effective artemisinin-combination therapies (ACT), the first line treatment for malaria in most countries. Assisting African countries in improving access to these more expensive medicines and ensuring that they are used rationally and only ever to treat malaria would be an additional opportunity for Africa-India collaboration.

China, often seen as India’s rival in relations with Africa, has also chosen to use malaria in its courtship of Africa. Unfortunately, the Chinese government has often chosen to dump large volumes of free malaria treatments into African countries that are neither approved by the World Health Organization or indeed by the countries themselves. This is hardly a helpful or constructive way to tackle malaria or build sustainable partnerships. If India focuses on helping African countries access appropriate and approved technologies and build the health systems to implement them, they will be fostering relations that will benefit both regions for many years to come.

India’s initiative to help in Africa’s fight against malaria could be a very low cost way to improve the lives of some of the poorest people, while reinforcing the less intrusive soft presence of India in the African continent.

By Barun Mitra and Jasson Urbach

Barun Mitra is with Liberty Institute, an independent think tank in New Delhi, India. Jasson Urbach is a director of Africa Fighting Malaria, a health advocacy group based in South Africa.


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