Malaria setback

As we mark World Malaria Day today, Pakistan has suffered a major setback in the battle against the deadly disease. According to WHO data, malaria cases rose 400 per cent to 1.6 million in 2022, following the catastrophic floods of last year. The mosquitoes that carry this disease lay their eggs in pools of stagnant water. A quick glance at our open sewers and the potholes and puddles that line our roads is enough to tell us why this disease is so prevalent in our country. We are as desirable a breeding ground as any mosquitoes could hope for and last year’s monsoon helped make us an even better launching pad for baby mosquitoes. A third of the country was underwater and, in many areas, the floodwater has yet to be drained and hundreds of thousands of refugees are still living in camps right next to the water, waiting for them to dry out. This cannot be anything but a recipe for disaster.

These events illustrate the inescapable link that exists between climate change and public health. As our country becomes increasingly vulnerable to climate-related disasters, we also become more prone to public health catastrophes. This problem could not have come at a worse time as far as malaria is concerned as Pakistan was making substantial progress against the disease until last year. Punjab was moving towards eradicating malaria as industrialization, better water management practices and healthy systems curbed the incidence of the disease. Even now, the Ministry of National Health Services (MNHS) is claiming that Punjab, Azad Jammu and Kashmir, the Islamabad Capital Territory and Gilgit-Baltistan will be malaria-free by 2022, that malaria incidence will go down by up to 70 per cent in Khyber Pakhtunkhwa, Balochistan and Sindh and the country as a whole will be malaria free by 2035.

This MNHS’s prognosis seems rather optimistic, to say the least. We have likely not seen the last of catastrophic flooding as irregular rainfall patterns become the norm. Last year’s monsoon also showed just how inadequate our water management and disaster-preparedness infrastructures really are. In addition, despite recent improvements in the healthcare-delivery network, particularly when it comes to malaria, the system is not yet capable of responding to a climate disaster of any great magnitude. The quadrupling of malaria cases after the most recent disaster proves this. The frequency of such events is only going to rise in the coming years and, given Pakistan’s economic situation, it would be unreasonable to expect major improvements in either healthcare, infrastructure or sanitation, all of which need to get better in order for us to be free of the disease. Although some progress has been made in developing a vaccine for malaria, experts are quick to point out that regular diagnosis and treatment remain the best way to counteract the disease as large-scale vaccination efforts are still not feasible. Even if this were not the case, Pakistan’s record when it comes to vaccination and delivery of crucial health services is not exactly enviable. There has been a polio vaccine for decades, and yet we are one of two countries where the virus is still endemic. Unless there is a major turnaround on the health, infrastructure and climate fronts in the coming years, the current malaria setback might become permanent.