Declining Transmission of Malaria in India: Accelerating Towards Elimination

Abstract

India is ecologically vast and has close to a billion-population living at risk of malaria. Given the evidence-based present-day intervention tools and large-scale implementation , India has recorded declining trends in disease transmission from 2 million cases in 2001 to close to a million cases in 2017 and embarked upon malaria elimination in keeping with the Global Technical Strategy by 2030. India is malaria endemic, but transmission intensities varied across its landscape with just few States of the east, central and northeast contributing bulk (80%) of total positive cases. Plasmodium falciparum and P. vivax are the predominant infections of which there has been steady increase in proportions of the former for constituting >60% of total cases what was 50:50 in 2001, a phenomenon attributed to emerging drug resistance. With the rolling out of the available intervention tools, malaria elimination is foreseeable yet there are multiple challenges which must be addressed to overcome the constraints. We strongly advocate continued disease surveillance and monitoring, universal coverage and intensification of core-interventions for prevention and treatment prioritizing high-risk States, strengthening cross-border collaborations for information sharing and coordinated activities, and above all sustained allocation of resources, creating the enabling environment to end malaria transmission.