11 January 2016

India may have a malaria problem on its hands

It is no secret that global health data has its problems. They matter particularly when trying to understand disease burden trends and how to respond. As Ankita Rao & Vivekananda Nemana find in India, the issue may lead to some major problems. Take malaria in India for example:
The Indian government has spent billions of dollars — about $500 million from 2000 to 2013 — in its fight against malaria, a mosquito-borne disease. International agencies such as the World Bank and the Global Fund to Fight AIDS, Tuberculosis and Malaria, a big funder of global public health efforts, have provided major support. The country’s revamped national malaria program is on par with the standard of global care. But its recordkeeping has few admirers. Last year the government recorded only 561 deaths due to malaria, while an independent estimate earlier in the decade shows that the real toll could be as high as 200,000 each year. The disease is especially prevalent among the poor and in India’s vast rural areas, where about two-thirds of the population lives but is served by just 20 percent of the country’s health care infrastructure.

The staggering gap between official data and reality means that thousands of people die without an accurate diagnosis, according to a study by the British medical journal The Lancet. And the government is able to tout the malaria program’s success without a clear picture of how many people are dying. Malaria costs the country nearly $2 billion each year, and the impact of lost earnings and treatment bills falls disproportionately on rural, poor families. An extensive investigation by Al Jazeera America unearthed routine manipulation of malaria data, crippling shortages of essential supplies, chronic understaffing of hospitals and enduring dysfunction in World Bank–funded projects, which led to the Indian government’s returning millions of dollars in aid.
I wonder how many fill-in-the-blank combinations there are for disease/health issue (TB, dengue, maternal morality, stunting) and country (Kenya, Vietnam, Brazil) that can fit into the above paragraphs. Recent reports from major health bodies now include a section talking about the importance of data. Is this an issue that deserves more attention?

I am starting to think the answer is "yes."