India scores by battling HIV/AIDS but falls short fighting TB and malaria

The global burden and mortality from HIV/AIDS, TB and malaria across the world, and in the developing countries in particular, have dropped significantly since 2000, a report published today (July 24) in The Lancet points out.

According to the report, the HIV epidemic appears “smaller than previously estimated,” while in the case of malaria, the global burden is far higher than the WHO estimates.

On a finer scale, the reductions have been significant in the case of the global incidence of HIV, and child mortality from malaria in sub-Saharan Africa during the period 2000-2013. While globally HIV incidence dropped by one-third from its peak, child mortality from malaria in sub-Saharan Africa declined by 31.5 per cent.

The main reason for these reductions is the increased focus on the three diseases across the world brought about by the Millennium Declaration in 2000 through the formulation of Millennium Development Goal 6 (MDG 6). If MDG 4 aimed at reducing child mortality and MDG 5 targeted maternal mortality reduction, the formulation of MDG 6 focussed on stopping the spread of the three diseases by 2015.

In 2013, HIV incidence stood at 1.8 million compared with 2.8 million in 1997 when the incidence had peaked. Similarly, mortality from HIV/AIDS in 2013 was 1.3 million compared with 1.7 million in 2005, which was the year when the epidemic was at its peak.

Of the three diseases, India has had the most success battling HIV/AIDS. Since 2000, the annual rate of reduction in new cases was more than four times that of the worldwide rate — a decrease of 16.3 per cent per year compared with the global drop of 3.9 per cent.

In 2013, nearly 79,000 Indian died of HIV/AIDS and the number of new HIV infections was about 31,000.

Tuberculosis

Globally, concerted efforts to stem the HIV/AIDS epidemic have benefited TB control during the period 2000-2013. Globally, in 2013, there were 7.5 million new TB cases, and the disease caused 1.4 million deaths. The mortality figure in 2000 was 1.6 million.

Despite TB prevalence rates reducing since 2000, the number of people living with TB worldwide increased from around 8.5 million in 1990 to about 12 million in 2013.

In South Asia, where half of global TB deaths take place, mortality rate reduction per year was 4.2 per cent. In East Asia, death rates fell annually by 7.5 per cent.

But the TB scenario in India is grim. While globally the prevalence of TB in people who are not infected with HIV was 160.2 for 100,000, it was 275.3 per 100,000 people in India. Mortality figure last year in India in those who are HIV negative was more than 545,500.

“In India, success at reducing the prevalence of TB has fallen behind global progress, despite significant gains against HIV/AIDS,” a release states.

But the authors of the study have warned that with increased longevity, higher number of TB cases and deaths would occur globally.

Malaria

In the case of malaria, the epidemic peaked in the early 2000s — with 232 million cases in 2003 and 1.2 million deaths in 2004. Last year, 164.9 million malaria cases and 854,568 deaths due to malaria were reported from across the world. The Lancet study reveals that malaria is killing more people than previously estimated.

Though sub-Saharan Africa has higher malaria burden, about 50 per cent of global deaths from malaria last year were in just three countries — India, Nigeria and Democratic Republic of Congo. The mortality rate in India was 11 deaths per 100,000. Countries neighbouring India had death rates between 1 and 2 per 100,000.

India has halved the number of malaria deaths per 100,000 during the period 1990-2013. But malaria still remains a “tremendous health burden for Indians.” About 61 million cases were reported last year and it killed more than 116,000 people. The other three countries where over five million new cases are seen every year are Nigeria (30 million), Democratic Republic of Congo (six million) and Mozambique (six million).

Published in The Hindu on July 22, 2014

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