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Table of Contents
REVIEW ARTICLE
Year : 2019  |  Volume : 56  |  Issue : 1  |  Page : 1-3

MERA India: Malaria Elimination Research Alliance India


1 Indian Council of Medical Research, New Delhi, India
2 ICMR–National Institute of Malaria Research, New Delhi, India
3 ICMR–Vector Control Research Centre, Puducherry, India
4 ICMR–Regional Medical Research Centre, Port Blair, India
5 ICMR–National Institute for Research in Tribal Health, Jabalpur, India
6 ICMR–Regional Medical Research Centre, Bhubaneswar, India
7 ICMR–Regional Medical Research Centre, Dibrugarh, India
8 National Vector Borne Disease Control Programme, Delhi, India

Date of Submission13-Mar-2019
Date of Web Publication7-May-2019

Correspondence Address:
Dr Manju Rahi
Scientist ‘E’, Indian Council of Medical Research, Ansari Nagar, New Delhi–110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-9062.257766

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  Abstract 


Keywords: Epidemiology; malaria-free India; malaria elimination; MERA India


How to cite this article:
Rahi M, Anvikar AR, Singh O P, Jambulingam P, Vijayachari P, Das A, Pati S, Narain K, Gangakhedkar R R, Dhingra N, Bhargava B. MERA India: Malaria Elimination Research Alliance India. J Vector Borne Dis 2019;56:1-3

How to cite this URL:
Rahi M, Anvikar AR, Singh O P, Jambulingam P, Vijayachari P, Das A, Pati S, Narain K, Gangakhedkar R R, Dhingra N, Bhargava B. MERA India: Malaria Elimination Research Alliance India. J Vector Borne Dis [serial online] 2019 [cited 2019 Jun 18];56:1-3. Available from: http://www.jvbd.org/text.asp?2019/56/1/1/257766




  Introduction Top


Over the past two decades, India has made impressive progress in malaria control. Recent trends show that the malaria burden has declined by 59% (2.03 million cases in 2000 to 0.84 million in 2017) and malaria deaths by 89% (932 deaths in 2000 to 103 in 2017). This success has provided a strong foundation for the commitment by the highest levels of leadership of the Government of India, to eliminate malaria from India by 2030. The National Vector Borne Disease Control Programme (NVBDCP) of India has developed a comprehensive framework to achieve the overarching vision of “Malaria-free India by 2030”. The NVBDCP’s National Strategic Plan clearly recognizes the critical role of research to support and guide malaria elimination efforts.

The foreseen challenges: Despite the impressive progress to date, elimination efforts face number of challenges. There remain critical operational gaps in services access, particularly for the vulnerable populations living in the high transmission areas as well as in the services provided by the private sectors. The quality and effectiveness of vector and environmental control measures need to be improved and scaled up. Moreover, the efficacy of existing tools is being undermined with the emergence and spread of drug and insecticide resistance. New improved tools and approaches are needed for disease surveillance, diagnosis, treatment, vector control, etc. to improve the health management system.

Why an alliance for research?: India has a longstanding tradition in malaria research through many organizations. However, there is very little cross-communication, harmonization and shared-learnings amongst the research communities. This often results in unnecessary duplication of efforts and at times leads to contradictory results due to inappropriate approaches. Moreover, the findings of scattered and isolated research, which may have programmatic importance, are not communicated effectively to the national programme, thus losing any translational value. Further, promising new tools based on preliminary findings are often lost in the laboratories due to inadequate support to develop them completely. In certain cases, due to a lack of expertise and/or infrastructure, the internal and external validity of the data generated may not be scientifically valid. Moreover, while each research organization is necessary based on its own mission, it is not sufficient to generate the required evidence to accelerate progress towards the national goal of malaria elimination. In addition, a key reason for research, often failing to influence policy and practice, is the insufficient engagement of policy-makers and implementers in prioritizing and defining the research agenda.

Genesis of MERA India: The prevalent situation highlights the need for a common platform and shared-research agenda and resources through establishment of the Malaria Elimination Research Alliance (MERA) India. MERA India erects on earlier in-country discussions as well as the Malaria Eradication Research Agenda (malERA) initiative and the Malaria Eradication Scientific Alliance (MESA). MERA India does not intend to duplicate international efforts rather complement this on a national scale while contributing to the broader global agenda.

What will MERA India achieve?: The purpose of MERA India is to identify, articulate, prioritize and respond to the research needs of the country to eliminate malaria from India by 2030. In particular, MERA should facilitate trans-institutional coordination and collaboration around a shared-research agenda which responds not only to programmatic challenges, and addresses gaps in available tools, but also proactively contribute to targeted research. MERA aims to harness and reinforce research in coordinated and combinatorial ways in order to achieve tangible impact on malaria elimination as well as provides a framework to the research community through establishment of a common platform for a trans-institutional alliance.

Who are the stakeholders of MERA India?: It will be established under the aegis of the Indian Council of Medical Research, Ministry of Health & Family Welfare, Govt. of India which would be a unified catalytic platform for the Department of Health Research, Department of Health and Directorate General of Health Services. While the major stakeholders of the alliance will be the Union and State Health Ministries and NVBDCP, National Institute of Malaria Research (NIMR), World Health Organization (WHO), Medicines for Malaria Venture (MMV), and medical colleges; several Multi-National Companies (MNCs) will also be made partners. This would provide the framework for various stakeholders to collectively deliberate inclusive, innovative and sustainable research, and stimulate, disseminate, build, reinforce learning and knowledge base towards measurable results and desired returns on investments.

What will MERA India do?: Prioritize research to address gaps and challenges

  • Identify dynamic research priorities in line with the national strategies for malaria elimination.
  • Support research targeted to ensuring quality diagnosis, case management, vector control and generation of new evidence and tools.
  • Plan supplementary and complementary research through consultation with the NVBDCP and stakeholders.


Orchestrate research with stakeholder engagement

  • Promote stakeholder engagement throughout the entire process of research.
  • Create an enabling environment for sharing of resources, infrastructure, capacities and expertise.


Promote and facilitate planning and conduct of prioritized research

  • Promote strong trans-institutional coordination in planning, conducting the prioritized research.
  • Provide support in identifying and pooling of resources.
  • Facilitate capacity building and strengthening for cutting-edge research.
  • Identify research organizations where additional partnership is required and invite partners to support research projects.


Translate and disseminate research into impact

  • Generate high quality research-based evidence for malaria elimination.
  • Disseminate research outputs in real-time at appropriate forums and through publications.
  • Accelerate growth of the malaria elimination knowledge base.
  • Advocate scaling up the findings of the research tuned to programme needs.


Proposed activities

By 2020: Tier-1 (short-term; 0–2 yr).

  • Map and create listserv of stakeholders as members and sharing of Terms of References (ToRs).
  • Compile past and current research pertaining to malaria in India, identify gaps/duplication in current efforts, and subsequently, conduct meta-analysis to create robust evidence.
  • Prioritize research topics for short-, medium-and long-term gain with stakeholders.
  • Conduct needs assessment of capacity needs, identify and expand existing capacity building efforts, and provide additional capacity building support.
  • Initiate and coordinate planning and execution of supplementary and complementary research—Few priority mission-mode projects.
  • Initiate multilogues by organizing stakeholder consultations, sharing of evidence from research and creation of policy briefs based on research findings, as needed and appropriate.


By 2022: Tier-2 (medium-term; 3–4 yr)

  • Review research priorities especially focusing on areas that could pose threat to sustaining malaria elimination.
  • Review MERA India—ToRs and revise, as needed and appropriate.
  • Continue planning and coordination for the identified research priorities.
  • Continue identification, facilitation for sufficient and sustained resources.
  • Continue sharing of evidence.


By 2030: Tier-3 (long-term; 5–10 yr)

  • Review research priorities especially focusing on country-wide malaria elimination.
  • Continue planning and coordination for those research priorities.
  • Deliver evidence-based research outcomes from basic and applied research conducted in support of the achieving elimination and preventing/mitigating the possibilities of re-introduction of malaria cases.
  • Support NVBDCP in seeking malaria elimination certification.


Proposed structures

A Leadership Group (LG), a Technical Advisory Group (TAG), Strategy-specific/Thematic Working Group (TWG) and a Secretariat are proposed. The composition and ToRs would remain dynamic and may be adjusted/ modified over the years, as needed.

Leadership Group: A high-level LG would be constituted to provide the overall advice and direction to MERA India. The LG would lead sustained political commitment and garnering financial support.

Technical Advisory Group: A TAG would be constituted to provide technical guidance and prioritize research topics. The TAG would also oversee establishment of MERA India and periodically review its activities vis-à-vis action plans. The TAG would also inform the LG periodically about the progress, achievements and challenges, if any and assist the LG in decision-making. It would facilitate the development and support of trans-institutional efforts under MERA India and ensure research is tuned to address programme gaps and challenges.

Thematic Working Groups: Specific TWGs would be constituted based on the strategic areas and draw upon a diverse set of competencies and knowledge. The TWGs would assist the TAG on various technical aspects.

  • Epidemiology (including surveillance and monitoring & evaluation).
  • Parasite biology
  • Therapeutics & diagnostics
  • Vector biology
  • Social sciences and communication
  • Health economics


The Thematic Working Groups would comprise:

  • All Institutes and Universities working on malaria
  • National and International Thematic Experts
  • Private sectors and NGOs
  • Professional bodies (like Indian Medical Association and Indian Association of Paediatrics).


Secretariat: A MERA India Secretariat is proposed to be established to support the establishment of MERA India, and constitution of the LG, TAG, TWG as well as to coordinate day-to-day activities. The Secretariat would also manage the MERA India portal. Presently, it is proposed to establish the Secretariat at the nodal research organization for malaria, i.e. ICMR–NIMR, New Delhi with its Director, as the focal point.






 

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