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Content

• Malaria
• Important International Initiatives related to Malaria
• Kala Azar (Visceral Leishmaniasis, Black Fever, and Dumdum Fever)
• Filariasis
• Neurocysticercosis
• Tuberculosis
• Leprosy
• STREP A
• Meningitis (Both Viral and Bacterial Reasons)

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1) MALARIA

• Cause of Malaria: It is caused by plasmodium pathogens.
  • There are five human malaria parasites: Plasmodium falciparum (deadliest of the five) and Plasmodium vivax are the most common causes. The list also includes P. ovale, P. malarie, and P. knowlesi.
  • Mosquitoes inject sporozoite (Spore-like) stage of the parasite into the skin when they bite, and the sporozoites travel to the liver. The parasite multiply in liver, and then infect the red blood cells.
• Mosquito Vector:
  • The plasmodium is carried by female Anopheles Mosquito (e.g. A. gambiae, A. culicifacies, A. fluviatilis etc.)
• Note: Malaria is the largest parasitic killer in the world.
• Key Interventions to control Malaria:
  • Prompt and effective treatment with artemisinin-based combination therapies.
  • Reducing Mosquitoes and Mosquito bites (female Anopheles Mosquito (e.g. A. gambiae, A. culicifacies, A. fluviatilis etc.)

 

A) DEVELOPMENT OF DRUG RESISTANCE:

A study from Africa has found that P. falciparum has developed resistance to the primary drug used to treat the disease i.e. Artemisinin and Artemisinin based combination therapies.

• Resistance was earlier shown in Asia, but experts are more worried about the development of resistance in Africa as it has 90% of the world’s Malaria cases

 

B) 2023 WORLD MALARIA REPORT – PUBLISHED BY WHO (DEC 2023)

• India:
  • In 2022, India accounted for 66% of the cases in the WHO South-East Asia region. This region accounted for only 2% of the global cases.
  • Plasmodium vivax was responsible for almost 46% of all cases in the region.
• WHO Africa region accounts for around 95% of the cases.
• Crucial milestone of the WHO Global Technical Strategy for Malaria 2016-2030 have been missed in 2020.
• Key factors impacting fight against Malaria:
  • Covid-19 disruptions; Drug and Pesticide Resistance; Humanitarian Crisis; climate change response; delays in program implementation.

 

C) GLOBAL TECHNICAL STRATEGY FOR MALARIA 2016-2030: WHO

• Aimed at dramatically lowering the global malaria burden over the 15 year period.

 

D) VACCINATIONS

As of Dec 2023, RTS/AS01 and R21/Matrix-M vaccines are recommended by WHO to prevent malaria in Children. Malaria vaccines should be provided to children in a schedule of 4 doses from around 5 months of age. These malaria vaccines act against P. falciparum, the deadliest malaria parasite globally and the most prevalent in Africa.

RTS,S

• The WHO has recommended widespread use of the RTS,S/AS01 (RTS,S) malaria vaccine (Commercial name: Mosquirix) among Children in regions of moderate to high P. falciparum malaria transmission.
• RTS, S has been developed by PATH Malaria Vaccine Initiative (MVI) and GlaxoSmithKline (GSK) with support from Bill and Melinda Gates foundation.
  • It is a recombinant vaccine. It consists of the P.falciparum circumsporozoite protein (CSP) from the pre-erythrocytic stage (i.e. the CSP is secreted at the sporozoite stage of this plasmodium). The CSP antigen causes the production of antibodies capable of preventing the invasion of hepatocytes and additionally elicits a cellular response enabling the destruction of infected hepatocytes.
  • Note: Mosquito bites transfer the CSP and sporozites into the human bloodstream, and the CSP nudges the parasite towards the liver, where it enters liver cells, matures and proliferates. The release of mature merozites marks the onset of the symptoms of malaria.

R21 MALARIA VACCINE

• Why in news?
  • A malaria vaccine manufactured by the biotechnology company Serum Institute of Technology of India and University of Oxford have passed the next round of regulatory approval by the WHO (Dec 2023).
    • R21/Matrix-M meets the WHO standards for vaccine quality, safety, and efficacy.
• Details about the vaccine:
  • R21 is a modified form of a vaccine called RTS,S or Mosquirix.
  • Vaccine is highly effective and can reduce malaria cases by 75% over a year.
  • It is the second malaria shot approved by WHO, following the RTS,S/AS01 one, which was approved in July 2022.
  • R21 is designed to be both more potent and cheaper to produce than Mosquirix. .
    • Note1: R21 and Mosquirix both target the malaria parasite in the sporozoite phase of its life cycle – the phase in which it enters the human body from its mosquitoe host. The vaccines include a protein (Circumsporozoite Protein (CSP)) secreted by the parasite at that stage, in the hope of stimulating an antibody response against it. R21 includes a higher concentration of these proteins.
    • Note2: Each of the vaccine is administered with a chemical called an adjuvant, which boosts immune responses to the inoculation. But the Adjuvant used with R21 is easier to make than that used with Mosquirix, raising hopes that it cold be cheaper as well.
  • WHO’s Approval:
    • WHO has added the vaccine to the WHO’s list of prequalified vaccines.
    • This was also recommended for use for the prevention of malaria in Children by the global health agency on 2nd Oct 2023.
  • How is a vaccine added in the WHO list of pre-qualified vaccine?
    • If a vaccine has undergone through evaluation of relevant data, testing of samples and WHO inspection of relevant manufacturing sites – and the outcome is positive – it is included in the WHO list of Prequalified Vaccines.
    • Pre-qualification is also a pre-requisite for vaccine procurement by UNICEF and fuding support for development y Gavi, the Vaccine alliance.

 

E) MALARIA’S COMBACK IN USA

• USA has recorded its first homegrown malaria cases in decades. In the year 2023, 9 indigenous cases have been reported (7 in Florida, one in Texas, and one in Maryland)
• How?
  • Anopheles mosquitoescapableofcarryingmalaria arestillverymuchpresent intheUSAthey’ve just had very few opportunities to transmit the parasite because there are so few infected people to feed on.
    • Experts believe that a person infected with Malaria traveled to the USA from a malaria-endemicarea andwasbittenbya localAnophelesmosquito, whichpickeduptheparasite and then bit someone else, passing on the parasite.
  • Climate change is making environment more suitable for Malaria. Higher temperature also enhance the growth rate and transmissibility of the parasites responsible for malaria. Higher rainfall and sea level rise may also make the situation more suitable for malaria.

2) IMPORTANT INTERNATIONAL INITIATIVES RELATED TO MALARIA

 

A) E-2025 INITIATIVE

• Under this initiative WHO has identified 25 countries, including 3 from Africa, with the potential to eradicate malaria by 2025.
  • The WHO will provide specialized support and technical guidance to these countries under the initiative.
• The initiative is built on the foundation of the E-2020 initiative. The countries were identified by WHO across four key criterias:
  • The generation of government endorsed elimination plan
  • Meeting a defined threshold of Malaria case reductions in recent years
  • A designated government agency for Malaria elimination and the capacity to confirm100% of suspected malaria cases in a laboratory
  • Selected by the Malaria Elimination Oversight Committee
• Countries selected for the E-2025 initiative:

Automatically Nominated	Newly Added
1- Mexico 2- Costa Rica 3- Ecuador 4- Suriname 5- Belize 6- Cabo Verde 7- Saudi Arabia 8- Islamic Republic of Iran 9- Nepal 10- Bhutan 11- Republic of Korea 12- Malaysia 13- Comoros 14- Bostwana 15- Eswatini 16- South Africa 17- Timor-Leste	1- Panama 2- Vanuatu 3- Honduras 4- Thailand 5- Guatemala 6- Dominican Republic 7- Sao Tome And Principe 8- Democratic People's Republic of Korea

 

B) CHINA CERTIFIED MALARIA FREE AFTER 70 YEARS OF FLIGHT: WHO (JUNE 2021)

• In 1940s, China used to report 30 million cases annually. Now, it has gone for four consecutie years without an indigenous case.
• Requirement of WHO’s Malaria Free status: 3 Consecutive years of zero indigenous cases. The country must also present rigorous evidence and demonstrate the capacity to prevent transmission re-emergence.
• China has become the 40th territory to be certified malaria free. The other recent countries to get Malaria free status include – El Salvador (2021), Algeria and Argentina (2019), and Paraguay and Uzbekistan (2018).
  • China is also the first country in WHO’s Western Pacific region to be awarded a malaria-free certification in more than three decades. The only others with certified status are Australia (1981), Singapore (1982) and Brunei (1987).
• Key initiatives by China which has made this possible?
  • Discovery of Artemisinin in 1970s -> most effective anti-malarial drug.
  • Among the first countries to test the use of insecticide treated net to prevent Malaria and China distributed millions of nets.

 

C) MAJOR NATIONAL INITIATIVES

• National Framework for Malaria Elimination (2016-2030)
  • Released by MoH&FW and aims to make India Malaria free by 2030.

3) KALA AZAR (VISCERAL LEISHMANIASIS, BLACK FEVER, AND DUMDUM FEVER)

• As per WHO, there are three main forms of Leishmaniases of which Kala-azar is the most serious form.
• Basics of Kala Azar (Black Fever)
  • Parasite: Protozoan parasite called ‘leishmania donovani‘. (Genus: Leishmania)
  • Vector: female Sand fly.
    • The parasite is spread to humans by bites from infected female sand flies.
  • Second largest parasite killer in the world (after malaria)
  • It is one of the most neglected Tropical Diseases (NTD).
  • The parasite migrates to the internal organs such as liver, spleen (hence visceral), and bone marrow, and, if left untreated, will almost always result in the death of the host.
  • Other factors:
    • The disease affects some of the poorest people in the world and is linked to malnutrition, population displacement, poor housing, a weak immune system and a lack of financial resources.
    • It is also linked to environmental changes such as deforestation etc.
  • Symptoms: Irregular fever, weight loss, anaemia, and swelling of the spleen and liver.
  • Only infects humans (no other animal known to harbour the infection in Asia), and humans are considered the only reservoir of the parasite.
  • Treatment: Anti-leishmanial medicines are available for treatment. Vector control is another aspect.
• Cases of Visceral Leishmaniasis or Kala Azar in India (Jan 2023)
  • Kala Azar cases in India fell to 834 in 2022 from 44,533 in 2007 – a 98.7% decline: Union health Ministry.
  • After missing deadlines thrice, India is poised to achieve the elimination target for visceral leishmaniasis or Kala Azar this year with no block in the country reporting more than 1 case per 10,000 people. (Dec 2023)
    • India needs to sustain the momentum over the next 3 years in order to receive the WHO certification.
  • India contributes to 11.5% of total cases reported globally.
  • 89% of the cases were reported from eight countries – Brazil, Eritrea, Ethiopia, India, Kenya, Somalia, South Sudan and Sudan.
• In October 2023, Bangladesh became the first country in the world to be officially validated by the WHO for elimination of Kala Azar as a public health problem
• National Kala Azar Elimination Program (NKEP)
  • Though the initial 2015 deadline has been missed, the numbers have been brought down significantly.
  • Key steps taken:
    • India has also expanded vector control interventions:
      • Indoor residual spraying to control the population of sandflies.
    • Since sandflies have developed resistance to DDT, the NVBDCP introduced a synthetic pyrethroid for indoor residual spraying in 2015.
    • Reducing Crevices in ‘Kuccha’ walls to reduce breeding areas.
    • ASHA (Accredited Social Health Activist) network was tasked with ensuring that people with PKDL complete treatment.
  • Note:
    • Since 2003, National Vector Borne Disease Control Programme (NVBDCP) is in charge of coordinating with endemic states to eliminate disease.
      • NVBDCP now funds consultants at state and district level and Kala-Azar Technical Supervisors (KTS) at the State’s blocks (or clusters of village panchayats) to conduct surveillance.
• International efforts to control Kala Azar
  • An initiative was launched by WHO to eliminate VL as a public health problem from SE Asia region by 2020. The deadline has now been extended to 2023.

POST KALA-AZAR DERMAL LEISHMANIASIS (PKDL)

• It is a complication of Kala-Azar, in which the disease-causing protozoan invades the patient’s skin cells. These cases act as reservoirs of the pathogens.
• PKDL treatment is a bigger problem
  • Diagnostic is difficult
    • PKDL cannot be diagnosed by the trademark rapid diagnostic kits. So, a skin snip examination is required. But not all PHCs are equipped with such tools.
  • Longer dose and greater quantity of drugs
    • PKDL requires a longer dose and greater quantity of drugs then primary Kala Azar.
  • Why treating PKDL is important?
    • It is not life threatening but can act as a source for Kala Azar infection to others.

OTHER TWO FORM OF LEISHMANIASIS

CUTANEOUS LEISHMANIASIS (CL)

• It is the most common form of leishmaniasis.
• It is caused by15 different species of the protozoan parasite Leishmania, transmitted by infected female sandflies.
• They are not life threatening, but can cause skin lesions, mainly ulcers, on exposed parts of the body, leaving life-long scars and serious disability or stigma.
  • About 95% of CL cases occur in the Americas, the Mediterranean basin, the Middle East and Central Asia.

MUCOCUTANEOUS LEISHMANIASIS

It leads to partial or destruction of mucous membranes of the nose, mouth, and throat. More than 90% of the cases come from Bolivia, Brazil, Peru, and Ethiopia.

4) FILARIASIS

• Basics:
  • It is a parasitic disease caused by infection with roundworms of the Filarioidea type.
  • Lymphatic Filariasis impairs the lymphatic system and can lead to the abnormal enlargement of the body parts, causing pain, severe disability, and social stigma. It is also known as elephantiasis and is a Neglected Tropical Disease.
• Vectors: Mosquitoes are infected with micro-filariae (immature larvae) when biting an infected host. This larva matures in the mosquitoe and when the mosquitoes bite people, people are infected with mature parasite larvae. The larvae then migrate into lymphatic vessels where they develop into adult worms.
  • It may be transmitted by different types of mosquitoes including the Culex Mosquito.
• The disease is prevalent in more than 50 countries.

5) NEUROCYSTICERCOSIS

• Details
  • Neurocysticercosis (NCC) is caused when a human consumes meat from (or is indirectly in contact with) – a pig infected with tapeworm.
    • The eggs of tapeworms invade muscles of the human body to make cysts. Sometimes thesecysts get into human brains,triggeringepilepticseizures,headaches,difficultywith balance and excess fluid around the brain.
  • A study published in the Nature journal in 2021 reported higher prevalence (42.2%) of NCC among patients with active epilepsy in the tea gardens of Assam. These findings were in sync with the older findings that NCC was one of the leading causes of seizures in developing countries, particularly in areas without proper sanitation and where pig rearing was widespread.
  • Why pig rearing is common among Assam Tea Garden workers?
    • Supplementation of meagre income by tea garden workers.
    • Unhygienic condition in which pigs are raised.
    • Pork is a staple food in NE India. It accounts for 68.75% of pork consumed in India.
  • How the disease spreads?
    • The life cycle of a pork tapeworm (taenia solium) takes it from pigs to humans and vice-versa.
      • Tapeworm eggs are spread through food, water, or surfaces contaminated with faeces.
        • Humans swallow the eggs when they eat contaminated food or put contaminated fingers in their mouth.
        • Consumption of infected, undercooked pork which are infected with taenia metacestodes (the larval stage of tapeworm) that develop into adult tapeworm in their intestines (taeniasis).
        • Adult tapeworm are released in person’s stool. During open defecation, the eggs can get lodged in nails and end up in humans. Those hands can contaminate food that others ate. So, a person who has never eaten a pork may also get infected.

6) TUBERCULOSIS

• Introduction
  • TB is an infectious bacterial disease caused by bacillus Mycobacterium tuberculosis, which most commonly affects thelungs (pulmonaryTB) but can affect othersites as well (extra pulmonary TB)
• Symptoms:
  • Healthy people -> often no symptoms (immune system wall off the bacteria)
  • Symptoms of active TB of the lung include coughing (sometimes with sputum or blood), chest pains, weakness, weight loss, fever, night sweats etc.
• Diagnosis
  • Sputum Smear Microscopy – used since more than 100 years.
  • Rapid Molecular Test – developed recently – uses polymerase chain reaction (PCR)
  • Culture Methods – needs developed laboratory capacity.
• Treatment
  • The effective drug treatments were first developed in the 1940s.
    • The most effective first-line anti-TB drug, rifampicin, became available in the 1960s.
    • The currently recommended treatment for new cases of drug-susceptible TB is a six month regimen of four first line drugs:  rifampicin, isoniazid, ethambutol and pyrazinamide. Treatment success rates of 85% or more for new cases are regularly reported to WHO by its member states.
  • Additionally, social determinants of TB such as under-nutrition, overcrowding and poor ventilation in slums and clinical risk factors such as diabetes mellitus, smoking etc. should be addressed simultaneously.
  • Treatment for Multi drug resistant TB (MDR-TB), defined as resistance to isoniazid, rifampicin (the two most powerful anti TB drugs) is longer, and requires more expensive and more toxic drugs. For most patients with MDR-TB, the current regimens recommended by WHO last 20 months, and treatment success rates are much lower.
• Vaccine
  • Not yet (BCG is not effective in tropical countries)
• Steps Taken
  1. For Detection
     • National Policy of Mandatory Reporting of detected cases since 2012
     • Launch of Nikshay Platform – a nation wide web-based and case-based reporting system that facilitates reporting of detected cases by care providers in public and private hospitals.
  2. National Strategic Plan for Tuberculosis Elimination (2017-2025)
     • Goal
       • Achieving rapid decline in the burden of TB, morbidity and mortality while working towards elimination of TB by 2025
     • 100% case finding by 2020
     • Elimination of TB 2025 (< 1 per 1,00,000 population)

• • Updated MDR-TB Recommendations from WHO (Aug 2018)
    • Replace all injectable with oral regime for MDR-TB patients.
      • Injectables have been found to be less effective
    • Prioritize newer drugs like Bedaquiline in the fully oral regime.
      • Data has shown that newer drugs show greater success in treatment and lower mortality rate.
  • 24 March: World Tuberculosis Day
  • New Vaccines and Medicines
    1. New BCG based TB vaccine, VPM1002 has shown promise in animal and small-scale human trials. It is to be supplied by Pune based Serum Institute of India.
    2. Bedaquiline – a new drug for drug resistant TB – launched by Union Health Ministry on 24th March 2016 (Worth TB Day)

 

A) WHO’S GLOBAL TB REPORT

7) LEPROSY

• Introduction
  • Leprosy, also known as Hansen’s disease, is a chronic infectious disease caused by Mycobacterium leprae. It is one of the oldest diseases known to humans and despite advances in all spheres of medical science, continues to be a public health challenge in India.
  • The disease mainly affects the skin, the peripheral nerves, mucosal surfaces of the upper respiratory tract and the eyes. The deadening of hands and feet leaves patients prone to kinds of disabling injuries that have become stigmatizing symbol of leprosy.
  • Leprosy is known to occur at all ages. Leprosy is a leading cause of permanent physical disability.
  • It is included under the list of Neglected Tropical Diseases of WHO.
  • India, Indonesia and Brazil constitute around 81% of the cases with India contributing to more than 50% of the cases.
• Transmission
  • The exact mechanism of transmission of leprosy is not known.
  • Till recently, most widely held belief was that the disease was transmitted by contact between cases of leprosy and healthy persons.
  • More recently, possibility of transmission by respiratory route is gaining ground. There are other possibilities like transmission through insects which can’t be ruled out.
• Treatment
  • Leprosy is curable with combination of drugs known as multidrug therapy (MDT) (to prevent drug resistance)
  • Treatment, before nerve damage occurs, is the most effective way of preventing disability due to leprosy.
• Leprosy Situation in India
  • India currently accounts for 60% of the total new leprosy cases in the world. Though, technically, WHO declared India leprosy free in 2005(<1 case per 10,000 population), the disease is still widespread in the region where poverty and stigma have kept patients hidden and untreated.
    • Bihar, Jharkhand, Odisha, West Bengal, Madhya Pradesh, Chhattisgarh, Odisha and Maharashtra account for 76% of the new leprosy cases.
  • Further, another worrying trend is that Leprosy is impacting the marginalized population more. For e.g. an analysis by ORF indicates that Adivasis account for 18.8% of India’s new cases and this percentage has been increasing over the last decade.
• Steps taken by India towards eradicating Leprosy:

a. National Leprosy Eradication Program (NLEP), running since 1983 – a centrally sponsored health scheme of MoH&FW, GoI.

• • • • NLEP is aimed at eradicating the disease from the country. India was able to eliminate leprosy (bring the number of cases to less than 1 per 10,000 population) by 2005, but complete eradication has not taken place yet.

b. Sparsh Leprosy Awareness Campaign (SLAC) under NLEP was launched in 2017.

c. Personal Laws (Amendment) Act, 2019 is aimed at removing leprosy as a ground for divorce in India family laws.

• • • • The act amends five acts – The Divorce Act, 1869, the Dissolution of Muslim Marriage Act, 1939, the Special Marriage Act, 1954, the Hindu Marriage Act, 1955, and the Hindu Adoption and Maintenance Act, 1956 – on provisions related to marriage, divorce, and separation of Hindu and Muslim couples.

8) STREP A

• Why in news?
  • A rare invasive form of a usually mild and common bacterial infection has killed several children in the UK in recent weeks (Dec 2022)
• Details
  • Group A streptococcus bacteria, also known as Strep A, is highly contagious and is commonly carried by many of us in our nose and throats and on our skin without resulting in serious illness.
  • Though most cases are not life threatening, it can develop into an infection known as invasive Group A strep (iGAS), which can be fatal, with the risk greatest among children and elderly. iGAS is rare, but it can be life-threatening. It occurs when bacteria goes deeper into the body, infecting the lungs, muscles and bloodstream.
• Symptoms of Strep A:
  • Symptoms are often flu like and mainly include a sore throat sometimes called “strep throat”. It is a mild infection but can be very painful. It can also lead to illnesses such as tonsillitis, scarlet fever and cellulitis. Most people with strep A recover without any complication.
• iGAS: A more invasive iGAS infection can get into a person’s bloodstream and deep tissue, causing more severe illnesses such as blood infections, endocarditis (an infection of the heart’s inner lining), meningitis, urinary tract infection, and streptococcal toxic shock syndrome, which cause low blood pressure and injury to organs such as the kidneys, liver and lungs.
• How is Strep A transmitted?
  • Person to person contact through coughing, kissing, sneezing, and touching someone with an infection or a carrier.
  • Invasive streptococcal infections are more likely to be picked up by people with existing health conditions “that reduce immunity to infections.”
• Why are Children badly impacted?
  • Rates of iGAS is highest at extreme ages – in children and the elderly.
    • Children are more likely to be exposed at crowded places like schools. Further, children tend to have less developed immunity.
    • COVID-19 lockdown have also led to less exposure to these infections -> leading to less immunity in general population.
• Treatment: Yes (course of anti-biotics)
• Vaccines: No
• Why more cases in 2022 in UK?
  • A new variant of bacteria?
  • Natural fluctuation in disease patterns post the pandemic

9) MENINGITIS (BOTH VIRAL AND BACTERIAL REASONS)

• What is Meningitis?
  • It is inflammation of the meninges (three membranes that cover the brain and spinal cord). It occurs when fluid surrounding the meninges becomes infected.
• Causes: Viral and bacterial infections; Cancer; chemical irritation; fungi; and drug allergies. 
  • Bacterial Meningitis: It is an extremely serious illness. It can be caused by several bacterias including Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus) etc.
    • Meningococcal meningitis (caused by the Neisseria meningitidis bacteria), is associated with high fatality rate. It primarily affects small children (though can infect everyone) and can cause severe brain damage if left untreated. It holds the potential to cause large epidemics as it has the potential to transfer from person to person through respiratory droplets.
      • This is vaccine preventable.
    • Haemophilus influenzae type b (Hib) was a common cause of meningitis in babies and young children until the Hib vaccine became available for infants.
  • Viral Meningitis is more common but generally less serious than bacterial meningitis.
  • Fungal Meningitis is very rare. Generally, people with weak immune system are vulnerable to it.
  • Parasitic and Amoebic meningitis are also rare.
  • Noninfectious meningitis is caused by diseases like cancer or in case of injury due to accident, surgery or reactions to medications.
• Contagious?
  • Some viral and bacterial meningitis are contagious. They can be transmitted by coughing, sneezing, or close contact.
• Symptoms: In the beginning the viral and bacterial meningitis have similar symptoms. However, bacterial meningitis symptoms are usually more severe. These symptoms also vary depending on your age.
• Regions most affected: Meningitis epidemics have occurred in the last decade in all regions of the world. But it is most common in the ‘Meningitis Belt‘, which spans 26 countries across sub-Saharan Africa.
• Vaccines:
  • Several vaccines protect against meningitis, including meningococcal, Haemophilus Influenza type b and Pneumococcal vaccines.
• “The Global Roadmap to Defeat Meningitis by 2030” by WHO (Sep 2021)
  • It aims to eliminate the epidemic of bacterial meningitis – the deadliest form of the disease – and to reduce deaths by 70 percent and halve the number of cases.
  • Focus on urgently expanding access to existing tools like vaccines, spearheading new research to prevent, detect, and treat the various causes of the disease and improving the rehabilitation for the affected.