India has made substantial strides in its fight against malaria, demonstrating notable progress in public health interventions aimed at eliminating the disease. From over 75 million cases annually at the time of independence in 1947, malaria cases have reduced by over 97%, with only 2 million reported in 2023. Deaths related to malaria have also fallen dramatically, from 800,000 in 1947 to just 83 last year.
This progress is highlighted by India’s exit from the World Health Organization’s (WHO) High Burden to High Impact (HBHI) group in 2024, a significant milestone in the global fight against malaria. Additionally, in 2023, 122 districts across various states reported zero malaria cases, marking a remarkable achievement in disease control and prevention.
The decline in malaria cases and fatalities can be attributed to comprehensive strategies such as the National Framework for Malaria Elimination (NFME) and the National Strategic Plan for Malaria Elimination (2023–2027). These frameworks focus on enhanced surveillance, improved diagnostics, prompt treatment, and community engagement.
Integrated Vector Management (IVM) has been central to these efforts, employing measures such as Indoor Residual Spraying (IRS) and the distribution of Long-Lasting Insecticidal Nets (LLINs) to disrupt the transmission cycle. Specific efforts have also been directed at controlling the Anopheles stephensi mosquito, which is responsible for urban malaria.
Between 2015 and 2023, malaria cases dropped from 1.17 million to just over 227,000, while deaths reduced from 384 to 83. Surveillance has also improved significantly, with the Annual Blood Examination Rate (ABER) increasing from 9.58 in 2015 to 11.62 in 2023, ensuring early detection and timely treatment.
India’s progress is evident in the reduction of high-burden states. From 2015 to 2023, states such as Odisha, Chhattisgarh, Jharkhand, and Meghalaya moved to lower disease burden categories. Several states, including Andaman & Nicobar Islands, Madhya Pradesh, Arunachal Pradesh, and Dadra and Nagar Haveli, transitioned to Category 1, reporting fewer than one case per 1,000 population annually. Ladakh, Lakshadweep, and Puducherry have achieved Category 0 status, reporting zero indigenous malaria cases in 2023.
India’s fight against malaria has been bolstered by investments in diagnostic and surveillance infrastructure. National Reference Laboratories (NRLs) at the National Centre for Vector Borne Diseases Control (NCVBDC) ensure accurate diagnostics, while district-specific strategies address the unique challenges of tribal and forested regions.
Training and capacity building have been prioritised, with over 850 health professionals receiving refresher training in 2024. Research initiatives, including studies on insecticide resistance and treatment efficacy, continue to guide intervention strategies.
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Collaborations have played a vital role in sustaining progress. Projects such as the Intensified Malaria Elimination Project-3 (IMEP-3) target vulnerable populations in high-endemic districts, with resources allocated for LLIN distribution, entomological studies, and strengthened surveillance systems.
Community health initiatives, such as the integration of malaria services into Ayushman Bharat health packages, have ensured that vulnerable populations receive necessary care. Community Health Officers and Ayushman Arogya Mandirs have been instrumental in delivering these services at the grassroots level.
India aims to achieve zero indigenous malaria cases by 2027 and eliminate the disease entirely by 2030. With a focus on preventing re-establishment and sustaining progress, the country is setting an example in global malaria elimination efforts.
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