Anup Anvikar | End to malaria in sight: India edging close to the finish line

India has been making leaps in its efforts to end malaria by 2030, in line with global goals. The efforts towards elimination have continued despite the Covid-19 pandemic. India’s progress in eliminating malaria has been significant and it has been heartening to witness the strides the country has made in reducing its burden. Malaria has been a major public health concern in the country for decades, with high numbers of cases and deaths reported each year. By focusing on vector control, patient outreach and early diagnosis and treatment, India has been able to successfully flip the narrative in its fight against the disease.

Malaria is a global problem and India’s success in reducing the burden of this disease can inspire other countries to take action and implement similar strategies. This can contribute to the global effort to eliminate malaria and improve the health and well-being of people around the world.

Despite the Covid-19 pandemic, India was one of eleven nations under the World Health Organisation’s High Burden to High Impact (HBHI) initiatives to witness decreases in the number of cases during the pandemic. India has made remarkable progress in the control and elimination of malaria in recent years, with 84 per cent reduction in malaria cases from 2016 to 2022 (1.09 million to 0.17 million). The deaths also saw a 80 per cent decline from 331 (2016) to 64 (2022). India launched the National Framework for Malaria Elimination (2016-2030) in the year 2016, with goal to eliminate malaria by the year 2030. Hence, the reference year 2016 is used as a baseline.

While numbers of cases are significantly reduced, malaria remains a significant public health concern, particularly in concentrated regions within the country like forest areas. For example, in 2019, 6.6 per cent of the total Indian population which lives in the country’s forested areas contributed 21 per cent of cases. It is essential that there is continued investment in malaria control programmes and to scale up interventions in malaria endemic areas. There is need to strengthen healthcare system and improve access to healthcare in remote areas, where the burden of the disease is far greater.

Investing in malaria prevention is critical to safeguarding the future of communities and individuals. The economic impact of malaria, particularly in developing countries like India, is enormous. The disease reduces productivity and causes individuals to miss work and education, resulting in loss of income, decreased economic growth and illiteracy. The out-of-pocket expenditure of treating malaria can be a significant burden on households, pushing them further into poverty.

By eliminating malaria, the country would be protecting its citizens and improving their quality of life. For this prevention is the key, especially in reducing the costs of the disease to individuals and society. Identified interventions to prevent and control malaria include malaria case management, vector control using indoor residual spray, long-lasting insecticidal nets, which have proven to be effective.

Rapid diagnostic tests (RDTs) have revolutionised malaria case management. They can detect malaria within minutes, enabling timely treatment, and also prevent complications and also deaths. India used 20 million of them in 2020. In resource-poor healthcare settings, RDTs have proven to be a useful support tool to diagnose malaria in places where timely quality microscopy diagnosis is a challenge.

Evidence based policy changes have ensured the availability of safe and effective antimalarial medicines as well as vector control tools in the country. Operational research has come up with models for malaria elimination in different settings.

Political commitment to eliminating malaria has been on the upswing, with leaders at all levels of government ensuring the fight against the disease is prioritised on the national public health agenda. The National Centre for Vector-Borne Disease Control, under the Government of India’s health ministry, has been at the forefront of the movement to end malaria in India once and for all. Collaborative action by government agencies, development partners, research organisations and others in the domain will be critical to ending the disease in the country once and for all.

With the shadow of malaria slowly lifting from the country, it is time to commit for sustained efforts to end the disease in India. Every year, on April 25, we celebrate World Malaria Day. World Malaria Day 2023 marks a significant milestone in India’s fight against the disease. This year’s theme is “Time to Deliver Zero Malaria: Invest, Innovate and Implement”. On this day, it is important to renew our commitment to eliminate malaria in India and ensure that efforts to prevent and control this deadly disease continue to receive the attention and resources they deserve.

With continued investments and sustained efforts, we can achieve a malaria-free India in the near future. Investing in malaria elimination in India is critical to improving public health, reducing poverty, and promoting economic development. Malaria disproportionately affects vulnerable populations, including children and pregnant women, and its elimination would lead to significant improvements in overall health and well-being. Malaria is a preventable and treatable disease that disproportionately affects the most vulnerable populations. Eliminating malaria can improve the health and well-being of millions of people, reduce healthcare costs, and promote economic development.

With diverse champions coming together to ensure that no stone is left unturned for malaria elimination, we can educate and mobilise community members and opinion makers and ensure scientific progress is encompassed within governmental elimination programmes. By leveraging the current momentum in elimination of this disease, we could conceive of achieving a malaria-free India far sooner than we had ever imagined.