Why in news?

India’s Malaria Elimination Technical Report, 2025 has flagged urban malaria driven by the invasive mosquito Anopheles stephensi as a growing national concern.

It could threaten India’s target of eliminating malaria by 2030, with an interim goal of zero indigenous cases by 2027, aligned with World Health Organisation strategy.

What’s in Today’s Article?

• Urban Malaria: A New Challenge
• Why Anopheles stephensi Is a Serious Threat?
• Persistent High-Burden Pockets
• India’s Progress So Far
• Strategic Frameworks Guiding Elimination
• The Road Ahead: 2030 Malaria-Free India

Urban Malaria: A New Challenge

• The spread of Anopheles stephensi in cities such as Delhi marks a shift from traditional rural malaria transmission.
• The species thrives in urban environments, breeding in artificial containers like overhead tanks, tyres, and construction sites.
• It efficiently transmits Plasmodium falciparum and P. vivax, complicating malaria control efforts.

Why Anopheles stephensi Is a Serious Threat?

• Recognised globally as an invasive vector.
• Adapted to high population density, informal settlements, and fragmented urban healthcare systems.
• Requires city-specific vector control and surveillance strategies, unlike conventional rural-focused approaches.

Persistent High-Burden Pockets

• India has entered the pre-elimination phase, but malaria is now concentrated in specific pockets rather than widespread.
• High-burden districts persist in Odisha, Tripura, and Mizoram.
• Cross-border transmission from Myanmar and Bangladesh continues to affect northeastern border districts.
• Key Drivers of Continued Transmission
  • Asymptomatic infections, making detection difficult.
  • Difficult terrain and remote tribal and forest areas.
  • Population mobility and migration.
  • Occupational exposure and uneven access to health services.

India’s Progress So Far

• Malaria cases reduced from 11.7 lakh (2015) to ~2.27 lakh (2024).
• Deaths declined by 78% over the same period.
• Active surveillance intensified in tribal, forest, border, and migrant-population settings.
• Health System Gaps Identified
  • Inconsistent reporting by the private sector.
  • Limited entomological capacity.
  • Drug and insecticide resistance.
  • Operational gaps in remote tribal regions.
  • Occasional shortages of diagnostics and treatment supplies.
• Priority Actions and Research Areas
  • Strengthen surveillance systems and vector monitoring.
  • Improve supply-chain reliability for diagnostics and medicines.
  • Focus operational research on:
    • Asymptomatic malaria infections
    • Ecology and control of Anopheles stephensi
    • Drug and insecticide resistance
    • Optimisation of P. vivax treatment regimens

Strategic Frameworks Guiding Elimination

• India’s success rests on a clear policy roadmap:
  • National Framework for Malaria Elimination (NFME), 2016: Target of zero indigenous cases by 2027.
  • National Strategic Plan for Malaria Elimination (2023–2027): Focus on enhanced surveillance, “test–treat–track” strategy, and real-time monitoring through the Integrated Health Information Platform (IHIP).
• Vector Control and Urban Malaria Management
  • Integrated Vector Management (IVM) has been central, including:
    • Indoor Residual Spraying (IRS)
    • Long-Lasting Insecticidal Nets (LLINs)
    • Special attention has been given to controlling the invasive Anopheles stephensi mosquito, strengthening urban malaria control.
• Strengthening Diagnostics, Health Systems, and Communities
• Establishment of National Reference Laboratories under the National Centre of Vector Borne Diseases Control (NCVBDC).
• District-specific action plans for tribal, forested, and high-endemic areas.
• Integration of malaria services into Ayushman Bharat, with Community Health Officers and Ayushman Arogya Mandirs delivering care at the grassroots level.
• Capacity Building, Research, and Partnerships
  • Over 850 health professionals trained in 2024 through national refresher programmes.
  • Research on insecticide resistance and drug efficacy guiding evidence-based interventions.
  • Intensified Malaria Elimination Project–3 (IMEP-3) covering 159 districts in 12 states, focusing on vulnerable populations, Long-Lasting Insecticidal Nets (LLINs) distribution, entomological studies, and surveillance.

The Road Ahead: 2030 Malaria-Free India

• India remains committed to achieving zero indigenous malaria cases by 2027 and elimination by 2030, with safeguards against re-establishment.
• By combining strong policy frameworks, scientific interventions, community participation, and sustained funding, India is emerging as a global benchmark in malaria elimination.