As cases drop, India’s malaria deadline appears attainable

India accounted for 79 percent of all malaria cases in Southeast Asia and over 83 percent of all malaria deaths in the region in 2021, according to World Health Organisation’s World Malaria Report 2022

Malaria has long been a significant public health challenge in India, affecting millions of people. Over 95 percent of its population resides in malaria-endemic areas, primarily in tribal habitats, foothills and inaccessible places. 

According to World Health Organisation’s World Malaria Report 2022, India accounted for 79 percent of all malaria cases in Southeast Asia and over 83 percent of all malaria deaths in the region in 2021. 

Data collected from National Center for Vector-Borne Diseases Control shows that more than 173,900 malaria cases were reported in 2022. States of West Bengal, Chhattisgarh, and Odisha together accounted for over 54 percent of these cases. These states also accounted for 30 per cent of the total malaria deaths in 2022.

However, India has seen a downward trend over the years, with malaria cases decreasing steadily from 429,928 in 2018 to 99,849 in 2022. Despite disruptions during the COVID-19 pandemic, the country managed to sustain the reduction in the cases from 338,494 in 2019 to 186,532 in 2022.

Whereas death cases decreased from 96 in 2018 to 64 in 2022. India also stood out as one of the five high-burden high-impact countries in the South-East Asia region to report a decline in malaria deaths in 2021.

Strategies for control and eradication

The eradication of malaria continues to be a primary focus for India. India implemented its inaugural National Framework for Malaria Elimination (NFME), 2016-2030 which focuses on achieving zero indigenous cases of malaria in the country by 2027 and achieving elimination by 2030.

Indian states have been adopting programme to support the national malaria elimination goal.  Odisha was once contributing 41 percent of the country’s annual malaria cases and 13 percent of deaths. In 2017, the ‘Durgama Anchalare Malaria Nirakaran’ (DAMaN) program was put into action in 22 districts to specifically target remote and inaccessible regions, while also implementing rigorous surveillance measures to ensure zero occurrence of malaria cases.

Under the DAMaN program, mass screening was done in inaccessible areas for screening of individuals irrespective of fever status using a special camp approach. As a result, Odisha witnessed a significant decline in malaria cases in the following years. From 444,843 cases reported in 2016, Odisha had 66,311 cases in 2018 – an 85 percent reduction, the highest drop in malaria cases across the country that year. This remarkable success of the program prompted the Odisha government to extend DAMaN till 2027.

In 2017, Malaria Elimination Demonstration Project (MEDP) was launched as another attempt to achieve the elimination goal. MEDP was a first-of-its-kind Public-Private-Partnership between the Indian Council of Medical Research (ICMR), Government of Madhya Pradesh (GoMP), and the Foundation for Disease Elimination and Control of India (FDEC-India). The goal of MEDP was to demonstrate the successful elimination of malaria from 1233 villages of the Mandla district of Madhya Pradesh and to use the lessons learnt for eliminating the disease from the rest of the country. 

MEDP employed time-tested approaches of information, education and communication, capacity building, rapid testing of infected individuals followed by prompt treatment. After inclusion of the project, significant change was seen in terms of malaria prevalence. Within the three most affected blocks of Mandla, there was a reduction of nearly 90 percent in malaria cases between September 2017 and March 2020. According to the Mandla-MEDP progress report 2018-2020, a total of 1.15 million population was tracked for malaria in Mandla, out of which 26 percent tested positive for malaria fever.

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