Malaria Elimination Efforts in India

Why in News?

India has reduced malaria cases by nearly 80% between 2015 and 2023 and is on track to meet its 2030 elimination target, though challenges like migration, urban transmission, and drug resistance remain.

What was India’s malaria elimination journey?

• Target – India set an ambitious target to eliminate malaria (zero indigenous cases) by 2030 under National Framework for Malaria Elimination in India (2016-2030).
• Interim milestone – Interrupting indigenous transmission across the entire country, including all high-transmission States and Union Territories (UT), including high-burden regions by 2027.
• Current Status
  • In 2023, 34 States/UTs achieved an annual parasite incidence of less than one except in two States, Tripura (5.69) and Mizoram (14.23).
  • By the end of 2025, 160 districts in 23 States/UTs had reported zero indigenous cases between 2022 and 2024, marking steady progress toward India’s 2027 interim target.
• Key drivers of the progress – The Ministry of Health and Family Welfare (MOHFW) credits robust surveillance systems and sustained interventions (testing, treatment, vector control).
• Core measures include
  • Strengthen surveillance systems and diagnostic capacity.
  • Intensify control efforts in high-burden districts.
  • Monitor drug resistance and insecticide resistance.
  • Ensure compliance with 14-day radical treatment for Plasmodium vivax.

To know about Malaria disease, click here

How is prevalence of the disease measured?

• WHO Certification – According to the WHO, a country is granted a certification of malaria elimination when
  • The chain of local transmission of all human malaria parasites has been interrupted nationwide for at least three consecutive years, and
  • A fully functional surveillance and response system is in place to prevent re-establishment of indigenous transmission.
• This ensures imported cases don’t spark new outbreaks.
• Surveillance includes mandatory reporting, rapid diagnostics, and vector monitoring.
• Global Status – As of mid-2025, 47 countries or territories have been officially certified malaria-free by the WHO.
• Recently certified countries – Georgia (2025), Egypt (2024), Cabo Verde (2024), and Suriname (2025).
• Other examples include
  • Europe - Entire region certified malaria-free.
  • Asia-Pacific - Countries like Sri Lanka (2016) and China (2021).
  • Africa - Algeria (2019) and Morocco (2010).
  • Americas - Paraguay (2018) and El Salvador (2021).

How does the World Malaria Report 2025 assess India’s progress?

• India Exits WHO High Burden Group – India made significant progress in reducing malaria incidence and mortality in its high-endemic States, officially exiting the WHO “High Burden to High Impact” Group, in 2024.
• Case reduction – Malaria cases reduced by around 80% from 2015 to 2023 in the country.
• Regional share – In 2024, India accounted for 73.3% of the 2.7 million estimated malaria cases in the WHO South-East Asia Region.
• Over the past two decades, the region has achieved major reductions in malaria cases and deaths, according to WHO South-East Asia region.
• On track for WHO GTS target – India is on track to meet the WHO Global Technical Strategy (GTS) goal of cutting malaria cases by 75% by 2025, compared to 2015 levels, having already reduced them by over 70% in 2024.

What findings are shown in the Tamil Nadu case study?

• Steady decline – As per the State’s Directorate of Public Health and Preventive Medicine show a steady decline in malaria cases, from 5,587 in 2015 to 321 in 2025.
• District classification (since 2023) -
  • Category O (Prevention of re-establishment) - 33 of 38 districts with zero indigenous cases.
  • Category I (Elimination phase) - 5 districts, including Chennai, where API is less than 1 per 1,000 population at risk.
• Annual Parasite Incidence (API) – API is the number of confirmed new malaria cases registered in a specific year, expressed per 1,000 individuals under surveillance, for a given country, territory, or geographic area.
• Measures taken by TN
  • Detection & Diagnosis - Intensive malaria testing in government hospitals and primary health centres.
  • Larval Control - Regular measures to reduce mosquito breeding.
  • Migrant Worker Surveillance – Intensive surveillance is being taken up among workers coming from malaria-prone neighbouring States.

How is India working to eliminate malaria?

• 2 national plans - to guide and accelerate malaria elimination —

• National Framework for Malaria Elimination in India (2016-2030) – Outlines the vision, goals, and targets for a phased malaria elimination by 2030, and
• National Strategic Plan (NSP) for Malaria Elimination (2023-2027) – Builds upon earlier frameworks and focuses on -
  • Transforming malaria surveillance as a core intervention for malaria elimination,
  • Ensuring universal access to diagnosis, treatment by enhancing and optimising case management by “testing, treating and tracking” and
  • Ensuring universal access to prevention by enhancing and optimising vector control.

What are the challenges?

• Migration & Cross-Border Importation – Movement of people from malaria-endemic neighbouring States risks reintroducing malaria into low-transmission areas.
• Urban Transmission – Cities face unique risks due to rapid urbanisation, expanding infrastructure, and widespread apartment complexes where water storage can become breeding grounds.
• Hard-to-Reach Populations – The special focus is needed in urban, forest, tribal, project/border areas, and among migrant workers.
• Persistent transmission – The Plasmodium vivax transmission accounts for nearly two-thirds of regional cases, continues to complicate elimination efforts.
• Localised transmission – In India and Nepal, population movement and cross-border importation drive localised outbreaks, highlighting the need for targeted subnational and regional coordination.
• Antimalarial Drug Resistance – WHO reports partial resistance to artemisinin in eight African countries, with partner drugs also showing reduced effectiveness, raising concerns for future malaria treatments.

What lies ahead?

• Data Accuracy – Reliable and precise data is essential at this stage to guide malaria elimination efforts.
• Surveillance – Private practitioners must be included in strict public health surveillance, with mandatory reporting of even suspected malaria cases.
• Fighting Urban Malaria Together – Addressing Urban Malaria needs both government initiatives and household-level action, as clean stored water often becomes the source of mosquito breeding.

Reference

The Hindu | Can India eliminate malaria by 2030?