Elimination of Malaria in India
Kartavya Desk Staff
Source: TH
Subject: Health
Context: India is in the news for its remarkable public health achievement of reducing malaria cases and deaths by over 80% between 2015 and 2023.
• Furthermore, the Ministry of Health and Family Welfare (MOHFW) recently reported that 160 districts across 23 States and UTs maintained zero indigenous cases for three consecutive years (2022–2024).
About Elimination of Malaria in India:
What it is?
• Malaria elimination is defined as the interruption of local transmission (reduction to zero incidence of indigenous cases) of all human malaria parasites in a defined geographical area.
• It differs from eradication, which refers to the permanent reduction to zero of the worldwide incidence of an infection.
Key Trends in Malaria in India:
• Drastic Case Reduction: Confirmed malaria cases plummeted from 11.69 lakh in 2015 to approximately 2.27 lakh in 2023, an 80.5% drop.
• Plummeting Mortality: Malaria-related deaths fell by 78.3% during the same period, reaching a historic low of 83 deaths in 2023.
• Surveillance Growth: The Annual Blood Examination Rate (ABER) increased from 9.58 in 2015 to 11.62 in 2023, indicating that India is testing more people despite falling case numbers.
• Species Shift: Plasmodium vivax now accounts for nearly 40% of cases, posing a unique challenge due to its ability to remain dormant in the liver and cause relapses.
• Geographic Concentration: As of 2025, over 85% of cases are concentrated in just a few high-burden states, primarily Odisha, Chhattisgarh, Jharkhand, and West Bengal.
Initiatives Taken to Eliminate Malaria
In India:
• National Framework for Malaria Elimination (2016-2030): A roadmap categorizing states into four categories based on transmission intensity to provide tailored interventions.
• National Strategic Plan (2023-2027): Focuses on the “Test, Treat, Track” (3Ts) strategy and achieving zero indigenous cases by 2027.
• Integrated Vector Management (IVM): Massive distribution of Long-Lasting Insecticidal Nets (LLINs) and Indoor Residual Spraying (IRS) in high-risk tribal and forest areas.
• MERA India: The Malaria Elimination Research Alliance, launched by ICMR to foster operational research and innovation.
Globally:
• WHO Global Technical Strategy (GTS): A global framework aiming for a 90% reduction in malaria incidence and mortality by 2030.
• E-2025 Initiative: A WHO-led effort supporting a group of countries (including those in the Mekong region) that have the potential to eliminate malaria by 2025.
• Malaria Vaccines: The rollout of the RTS,S and R21 vaccines in African countries has marked a new era in global prevention.
Challenges to Elimination of Malaria are:
• Asymptomatic & Relapsing Malaria (P. vivax): Dormant liver stages of P. vivax cause relapses without new mosquito bites.
E.g. In states like Odisha, the persistence of P. vivax hotspots despite high net coverage makes interruption of transmission difficult.
• Antimalarial Drug Resistance: Resistance to artemisinin-based combination therapies (ACT) threatens the treat pillar.
E.g. Emerging signs of partial resistance in West Bengal and Northeast border areas could render standard treatments less effective.
• Migration and Cross-Border Importation: Movement of people from endemic to malaria-free zones triggers new outbreaks.
E.g. Tamil Nadu, which is near elimination, frequently reports imported cases among migrant workers arriving from higher-burden states like Odisha.
• Urban Malaria Paradigms: Rapid urbanization creates unique breeding sites like construction tanks and overhead wells.
E.g. Large metropolitan cities like Chennai struggle with Anopheles stephensi, an urban vector that breeds in man-made clean water containers.
• Insecticide Resistance: Mosquitoes are increasingly evolving to survive the chemicals used in bed nets and sprays.
E.g. Surveys in Chhattisgarh and Jharkhand have shown mosquito populations developing resistance to synthetic pyrethroids, requiring a shift to more expensive dual-insecticide nets.
Way Ahead:
• Mandatory Reporting: Ensure all private practitioners and hospitals mandatorily report every suspected and confirmed case.
• Strengthening Surveillance: Transform surveillance into a core intervention, focusing on case-based investigations in “Category 1” and “Category 0” districts.
• Inter-sectoral Convergence: Collaborate with urban planning, education, and rural development ministries to manage environmental factors.
• Community Engagement: Use Behavior Change Communication (BCC) to involve households in larval control, especially in urban settings.
• Innovation & Research: Scale up the use of new dual-insecticide bed nets and foster research through the Malaria Elimination Research Alliance (MERA) India.
Conclusion:
India is on a steady path toward its 2030 elimination goal, having already achieved a massive 80% reduction in cases and exiting the WHO’s high-burden list. Success now hinges on sustaining zero-case status in 160 districts while aggressively tackling the remaining hotspots in tribal and urban areas. With continued political commitment and accurate real-time data, a malaria-free India is a tangible reality for the next decade.
Q. The need for a global action against Dengue has never been more imminent with India being a focal point. Comment. (200 Words)