Annual malaria cases at 2 mn in 2023, down 97% since 1947: Health ministry

India's journey toward a malaria-free future is a story of remarkable transformation and progress. At the time of independence in 1947, malaria was one of the most pressing public health challenges, with an estimated 7.5 crore cases annually and 800,000 deaths. Over the decades, relentless efforts have drastically reduced these numbers by over 97%, with cases declining to just 20 lakhs and deaths plummeting to just 83 by 2023, according to an official release by Ministry of Health and Family Welfare.

The latest World Malaria Report 2024, released by the World Health Organization (WHO), celebrates India's significant progress. India's achievements include a significant reduction in malaria cases and malaria-related deaths between 2017 and 2023. This success is further highlighted by India's exit from the WHO's High Burden to High Impact (HBHI) group in 2024, signifying a turning point in its fight against malaria. These achievements reflect the nation's robust public health interventions and its vision to achieve malaria-free status by 2030, the press release stated.

India's epidemiological progress is particularly evident in the movement of states to lower disease burden categories. 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 such as Odisha, Chhattisgarh, Jharkhand, and Meghalaya, have reduced the case-load and moved to Category 2. Also, 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 (progressed from high/medium-burden categories to 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.

Both, Malaria cases and deaths have dropped by around 80% from 2015-2023, with cases going down from 11,69,261 in 2015 to 2,27,564 in 2023, while deaths falling from 384 to just 83. This dramatic decline reflects the relentless efforts to combat the disease. Simultaneously, intensified surveillance efforts have led to a significant rise in the Annual Blood Examination Rate (ABER), increasing from 9.58 (2015) to 11.62 (2023). This strengthened surveillance has ensured early detection, timely intervention, and more effective treatment, the release stated.

The foundation of India's success lies in its comprehensive and multi-pronged strategy. The National Framework for Malaria Elimination (NFME), launched in 2016, provided a clear roadmap for achieving zero indigenous malaria cases by 2027. Building on this framework, the National Strategic Plan for Malaria Elimination (2023-2027) introduced enhanced surveillance, prompt case management through a "testing, treating, and tracking" approach, and the development of real-time data tracking through the Integrated Health Information Platform (IHIP).

Integrated Vector Management (IVM) has been at the core of India's malaria control efforts. Strategies such as Indoor Residual Spraying (IRS) and the distribution of Long-Lasting Insecticidal Nets (LLINs) have significantly curtailed mosquito populations and disrupted the transmission cycle. The targeted management of the invasive Anopheles stephensi mosquito has further bolstered urban malaria control efforts.

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, the press release added.

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 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 government is committed to achieving zero Indigenous cases by 2027 and ensuring prevention of Malaria re-establishment.