India’s Steady March Towards Malaria Elimination

Context

National Milestone – India has achieved a substantial decline in malaria burden over the last decade and is steadily advancing towards its commitment of eliminating malaria by 2030, despite persisting epidemiological and operational challenges.

India’s National Elimination Roadmap

Long-Term Vision – Achieve zero indigenous malaria cases nationwide by 2030 under India’s elimination architecture.

Short-Term Benchmark – Achieve nationwide interruption of transmission, including high-incidence regions, by 2027.

Disease Burden Snapshot –

In 2023, all but Tripura and Mizoram recorded API below 1.
Between 2022–2024, 160 districts in 23 States/UTs reported zero indigenous malaria cases.

Public Health Interventions Behind the Gains

System Strengthening – Expansion of surveillance networks and laboratory services.

Focused Action – Intensified operations in high-transmission districts.

Therapeutic Safeguards – Tracking antimalarial and insecticide resistance patterns.

Case Management – Ensuring completion of radical cure for Plasmodium vivax infections.

How Countries Are Declared Malaria-Free

WHO Validation Standards –

Absence of local transmission for three consecutive years.
Proven capacity to detect and contain imported cases.

Operational Requirements – Mandatory reporting, rapid diagnosis, and entomological surveillance.

Global Progress –

47 countries/territories certified malaria-free.
Recent additions: Georgia, Suriname, Egypt, Cabo Verde.

Findings from World Malaria Report 2025

Status Reclassification – India removed from WHO’s High Burden to High Impact list (2024).

Trend Analysis – Around 80% decline in malaria cases since 2015.

Regional Context – India contributes over 70% of malaria cases in the WHO South-East Asia Region.

Strategic Alignment – Consistent with WHO Global Technical Strategy milestones.

State-Level Evidence: Tamil Nadu Experience

Epidemiological Trend – Sharp fall from 2015 to 2025.

District Zoning –

Prevention-of-reintroduction zones: 33 districts
Elimination-stage zones: 5 districts

Key Interventions – Expanded testing, mosquito breeding control, migrant screening.

Policy and Planning Instruments

National Framework for Malaria Elimination (2016–2030) – Sets phased elimination targets.

National Strategic Plan (2023–2027) – Prioritises surveillance-led elimination, universal diagnosis, and vector control.

Persistent Bottlenecks

Human Mobility – Inter-State and cross-border movement.

Urban Vulnerabilities – Construction sites, stored water, dense housing.

Ecological Complexity – Dominance of Plasmodium vivax.

Emerging Resistance – Reduced sensitivity to frontline drugs.

Future Priorities

Granular Data Systems – High-quality real-time data.

Private Sector Integration – Mandatory reporting by private providers.

Citizen Participation – Household-level vector source reduction.

Source : The Hindu