Malaria Elimination–Are We on the Right Track?
India has taken a significant stride in reducing malaria at a time when the global malaria situation is at the crossroads. India’s malaria elimination effort has gained momentum since the launch of India’s National Framework for Malaria Elimination in 2016 to eliminate malaria from the country by 2030 followed by National Strategic Plan in 2017. The key strategic approach that has enabled an intensified focus on high burden geographies is India’s stratified intervention plan embedded into a phased malaria elimination approach from areas with differential disease burden. The strategy focuses on applying vector control tools like Long Lasting Insecticidal Nets as well as Indoor Residual Spraying in high burden areas, strengthening the completeness of surveillance and early detection followed by complete treatment; and introducing case-based surveillance in the low endemic settings. To sustain the current gains and prevent the loss of momentum through the ongoing pandemic convolution, India needs to further strengthen surveillance, access to case management, and vector control. The focus area for surveillance strengthening should typically include the hard-to-reach geographies, severed from service-level access especially during monsoon. Boosting active surveillance in these geographies is the need of the hour. Besides, in >60% of India's ailments, communities seek treatment from the private sector. India needs a robust and inclusive reporting system to precisely map the malaria burden across public and private sectors. To optimize the use and maintenance of vector control tools like insecticidal nets, strengthening of community behavior change are essential. Parallelly, India needs to strengthen (i) vector surveillance through recruitment and activation of specialist entomologists; and (ii) upscale larval source management and implementation of urban byelaws to prevent urban outbreaks. The programmatic efforts can be synergized through data-driven decision and integrating climate-based forecasting for programmatic decisions. To achieve the improvisation, the program also needs to be sustainably resourced to meet the funding gaps. On balance, India has been making progress towards the appropriate direction in eliminating malaria but will need to boost its resources, workforce, and surveillance completeness in pursuit to achieve its goal of eliminating malaria within a decade.
Keywords: Malaria, National Strategic Plan, Malaria elimination, Vector control tools
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