Malaria
Malaria
Context
In early 2026, India continues to be recognized for its historic trajectory in malaria reduction. Between 2015 and 2023, the country achieved an 80.5% reduction in malaria cases and a 78.3% drop in deaths. A major milestone reported in late 2025 is that 160 districts across 23 States and UTs successfully maintained zero indigenous cases for three consecutive years (2022–2024), positioning them for official subnational verification.
About the News
- HBHI Exit (2024): A defining achievement was India officially exiting the WHO's "High Burden to High Impact" (HBHI) group in 2024, signaling its transition from a high-endemic country to an elimination-phase nation.
- Elimination vs. Eradication: Elimination: Interruption of local transmission (zero indigenous cases) in a specific area (e.g., India).
- Eradication: Permanent global reduction to zero cases (e.g., Smallpox).
- The Target: India aims for zero indigenous cases by 2027 and WHO malaria-free certification by 2030.
Key Trends and Statistics
|
Indicator |
2015 Status |
2023/24 Status |
Trend |
|
Confirmed Cases |
11.69 Lakh |
~2.27 Lakh |
80.5% Decrease |
|
Malaria Deaths |
385 |
83 |
78.3% Decrease |
|
ABER (Surveillance) |
9.58 |
11.62 |
Increasing (Better detection) |
- Species Shift: Plasmodium vivax now accounts for nearly 40% of cases. Unlike P. falciparum, it can remain dormant in the liver as "hypnozoites," causing relapses months later.
- Geographic Concentration: Over 85% of cases are now concentrated in high-burden states: Odisha, Chhattisgarh, Jharkhand, and West Bengal. As of 2026, only Tripura and Mizoram remain above the threshold of 1 case per 1000 population (API > 1).
Challenges to Elimination
Despite progress, several "stumbling blocks" threaten the 2030 goal:
- Asymptomatic & Relapsing Malaria: The dormant liver stages of P. vivax act as a hidden reservoir.
- Urban Malaria & Anopheles stephensi: This invasive, city-breeding mosquito thrives in man-made containers (overhead tanks, tires, construction sites). It is highly adapted to dense urban settlements like Delhi and Chennai.
- Drug & Insecticide Resistance: Emerging resistance to Artemisinin-based Combination Therapy (ACT) in the Northeast and resistance to synthetic pyrethroids in mosquitoes necessitates more expensive dual-insecticide nets.
- Migration: Movement of workers from endemic states (like Odisha) to low-transmission states (like Tamil Nadu) frequently triggers "imported" outbreaks.
Initiatives and Strategies
- National Strategic Plan (2023-2027): Operationalizes the "Test, Treat, Track" (3Ts) strategy to ensure every case is identified and followed.
- Integrated Vector Management (IVM): Combines Indoor Residual Spraying (IRS) with the distribution of Long-Lasting Insecticidal Nets (LLINs).
- MERA India: The Malaria Elimination Research Alliance (by ICMR) focuses on operational research like mapping insecticide resistance.
- Global Tools: Rollout of the RTS,S and R21 vaccines (the latter co-developed by the Serum Institute of India) has opened new doors for prevention, particularly for children.
Way Forward
- Mandatory Reporting: Strengthening private sector notification, where ~70% of the population seeks care.
- 1-3-7 Surveillance Rule: 1 day to notify a case, 3 days to investigate, and 7 days to complete focal vector control.
- Urban-Specific Control: Linking malaria prevention with the Swachh Bharat Mission and construction-site regulations to target Anopheles stephensi.
- Radical Cure Adherence: Ensuring patients complete the 14-day primaquine course required to kill dormant P. vivax liver stages.
Conclusion
India has transitioned from "High Burden" to a "Pre-elimination" phase. Success now hinges on sustaining zero-case status in 160 districts while aggressively tackling the remaining "forest-tribal" and "urban-invasive" hotspots. With accurate real-time data through the Integrated Health Information Platform (IHIP), a malaria-free India is within reach.