National Malaria Eradication Programme flops, fever continues to rage
In 1977, 55 people shivered their way to death; the figure last year was 161. Last fortnight, Health Ministry officials gloomily surveyed the reports sent in from the states in response to a question in the Lok Sabha; one of them admitted: "Malaria accounts for over 40 percent of the nation's health budget but there is no appreciable decline in its incidence."
That is an understatement. According to unofficial estimates over 20 lakh cases of the fever were reported from the government-run hospitals and dispensaries in the last six months alone.
It is true that the total number of cases has declined to 26 lakh from over 30 lakh in 1979 but it is also true that in 1965 there were only one lakh malaria cases in India. And the declining graph is flattening out: in 1978, malaria cases registered a 26 per cent fall while in 1981 their number fell by just 7.92 per cent over the previous year.
This is a far cry from the heydays of the NMEP when the spray programme initiated in 1953 brought the incidence of malaria from an astronomical 7.5 crore cases in that year to just one lakh 12 years later.
The NMEP wiped out the epidemics in states such as Orissa, Assam, Uttar Pradesh and Bihar where the number soared to 15 crore and more. Hygienic conditions, better health care, and the plentiful use of DDT spray brought happier times: no malaria deaths were reported between 1965 and 1973 and only three people died of the fever in 1974.
Vested Interests: When the World Health Organisation discovered that DDT use increased the chlorine content in the human blood, and when it became clear that the mosquitoes had developed resistance to traditional insecticides, the use of DDT in the NMEP was banned.
Instead, the Government put its money on Malathion, a powerful insecticide which is non-poisonous and evaporates soon after it is sprayed - it comes mixed in wettable dust powder. The Government issued licences to 10 companies with a total investment of Rs 22 crore for the production of 10,000 tonnes of the new insecticide. This, however, was still below the annual requirement of 18,000 tonnes.
However, it soon became clear that even this inadequate amount was not going to be available. The reason was the vested interests in the form of businessmen who had been making over Rs 40 crore annually by supplying DDT and another pre-Malathion insecticide, to the municipal corporations and the health departments in the various states.
The businessmen saw no reason why DDT should not keep its sway in the market and with their hold on the concerned bureaucracy developed over the years managed to stall the distribution of Malathion and continued to vend DDT through the back door this time.
Due to the ban on DDT and the squeeze on Malathion supplies engineered by a hostile bureaucracy, malaria cases more than doubled from 31 lakh in 1974 to 64 lakh in 1976. The Opposition cried foul in state assemblies over NMEP malpractices and the Union Government was grilled for its failure on the crucial front when 99 people fell victim to the scourge in 1975. In 1977, the programme was restructured away from its centralised set-up and state governments were entrusted with purchases of insecticides.
This made things worse. With the loosening of central control the DDT suppliers grew in courage. As Malathion is manufactured only by 10 big firms, which are averse to hanky-panky in supplies and transactions, the DDT suppliers, usually the relatives of politicians, are in clover.
In Punjab, for example, the son of a former chief minister has been made a major supplier of DDT to the health department. In Bihar, only 100 tonnes of the state's annual Malathion requirement of 500 tonnes has arrived. State government officials deny that they are buying DDT and not Malathion-mixed wettable dust powder, but they refuse to disclose their suppliers.
Complaints: The Malathion manufacturers cannot but look on in dismay. In a recent memorandum to the Health Ministry they asserted that their units are operating at less than 40 per cent of capacity because of the lack of demand - they produced only 2,600 tonnes in 1981-82 as against an installed capacity of 10,600 tonnes.
Says R.K. Gupta, chairman of Punjab United Pesticides, a public sector concern: "Because of the vested interests, various states are purchasing DDT and other non-suitable pesticides instead of Malathion.
Besides, the total expenses on pesticides and insecticides are much more than would have been incurred if Malathion had been bought." In fact, seven of the 10 Malathion producers are on the verge of closure and only Hindustan Insecticides, a Central Government undertaking, Cynamide India Ltd and IFFCO are pulling on manfully.
Ineffective materials and corruption apart, the NMEP as a whole is barely creaking along. Regular assessment of the situation in the country's 72 malaria zones is a myth. Blood smears required to be collected in the 115 towns under the urban malaria programme are taken erratically. Only one out of 10 villages has the required chloroquinine tablets, usually kept by the panchayat pradhan or the schoolteacher.
Even in the urban areas, there is an acute shortage of anti-malarial drugs and laboratories for the examination of blood smears. A Delhi Municipal Corporation official says: "We get only three paise per head. We can't even send a labourer to every street to spray insecticide, let alone provide medicines and plan in advance." The fever continues to rage.