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India makes strides towards becoming a Malaria-free nation: Country excluded from WHO’s High Burden to High Impact group as cases plummet by 97%

The number of annual Malaria cases in India declined from 7.5 crore at the time of independence to 20 lacs by 2023, the number of Malaria-related deaths fell from 8 lacs to 83

India has achieved a significant milestone in its fight against malaria, with cases plummeting by over 97% since independence. Annual cases have decreased from approximately 75 million in 1947 to around 2 million by 2023, and malaria-related deaths have dropped from 800,000 to just 83 in the same period, as per a press release by the Union Ministry of Health and Family Welfare.

The World Health Organization’s (WHO) World Malaria Report 2024 highlights India’s substantial progress, including the country’s exit from the WHO’s High Burden to High Impact (HBHI) group in 2024. This achievement underscores India’s effective public health interventions and its commitment to achieving malaria-free status by 2030.

A notable aspect of this progress is the reduction in malaria cases and deaths between 2015 and 2023. Cases have declined from 11,69,261 in 2015 to 2,27,564 in 2023, while deaths have decreased from 384 to 83 during the same period. Additionally, intensified surveillance efforts have led to a significant rise in the Annual Blood Examination Rate (ABER), increasing from 9.58 in 2015 to 11.62 in 2023, ensuring early detection and timely intervention.

From 2015 to 2023, numerous states have transitioned from the higher-burden category to the significantly lower or zero-burden category. In 2015, 10 States and Union Territories were classified as high burden (Category 3), of these, in 2023 only two states (Mizoram & Tripura) remain in Category 3, whereas 4 states Odisha, Chhattisgarh, Jharkhand, and Meghalaya, have reduced the case-load and moved to Category 2.

The other 4 States, namely, Andaman & Nicobar Islands, Madhya Pradesh, Arunachal Pradesh, and Dadra and Nagar Haveli have significantly reduced the caseload and moved to Category 1 in 2023. In 2015 only 15 states were in Category 1, whereas in 2023, 24 states and UTs are in Category 1, reporting an API of less than 1 case per 1000 population.

As of 2023, Ladakh, Lakshadweep and Puducherry are in Category 0, i.e. zero indigenous Malaria cases. These areas are now eligible for subnational verification of malaria elimination. Additionally, in 2023, 122 districts across various states reported zero malaria cases, which demonstrates the efficacy of targeted interventions.

The Modi government’s comprehensive strategy includes the National Framework for Malaria Elimination (NFME) launched in 2016, aiming for zero indigenous malaria cases by 2027. Building on this, the National Strategic Plan for Malaria Elimination (2023-2027) emphasizes enhanced surveillance, prompt case management through a “testing, treating, and tracking” approach, and real-time data tracking via the Integrated Health Information Platform (IHIP).

Integrated Vector Management (IVM) has been central to India’s malaria control efforts. Measures such as Indoor Residual Spraying (IRS) and the distribution of Long-Lasting Insecticidal Nets (LLINs) have significantly reduced mosquito populations, disrupting the transmission cycle. Targeted management of the invasive Anopheles stephensi mosquito has further strengthened urban malaria control initiatives.

The government has also focused on strengthening surveillance and diagnostic capacities. The establishment of National Reference Laboratories (NRLs) at the National Centre of Vector Borne Diseases Control (NCVBDC) has ensured high-quality diagnostic services, while localized action plans for high-endemic districts have enabled tailored interventions. District-specific strategies, particularly for tribal and forested areas, have been instrumental in addressing the unique challenges of these regions.

Community integration has played a vital role in India’s malaria elimination journey. The inclusion of malaria prevention and treatment services in Ayushman Bharat health packages has ensured that even the most vulnerable populations have access to essential healthcare. Community Health Officers and Ayushman Arogya Mandirs have been pivotal in delivering these services at the grassroots level.

India’s commitment to capacity building and research has also been a cornerstone of its success. In 2024 alone, over 850 health professionals were trained through National Refresher Trainings, equipping them with the skills needed for effective malaria control. Research initiatives, including studies on insecticide resistance and therapeutic efficacy, have provided critical data to refine intervention strategies.

Collaborations and funding mechanisms have significantly contributed to India’s progress. The Intensified Malaria Elimination Project-3 (IMEP-3) targets 159 districts across 12 states, focusing on vulnerable populations. Resources are allocated for the LLIN distribution, entomological studies, and surveillance systems, enhancing the impact and sustenance of Malaria elimination activities.

Looking ahead, India remains steadfast in its goal to eliminate Malaria by 2030, the ministry’s press release said. The government is committed to achieving zero Indigenous cases by 2027 and ensuring prevention of Malaria re-establishment. By combining strategic frameworks, robust interventions, and community engagement, India is setting a global benchmark in malaria elimination and reaffirming its commitment to public health excellence.

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