India’s sharp decline in malaria cases over the past decade represents one of the most significant public health achievements in recent times. With a growing number of districts reporting zero indigenous cases, the country has entered a critical transition phase—from reducing disease burden to sustaining elimination and preventing resurgence.
India’s malaria elimination roadmap
In 2016, India adopted the National Framework for Malaria Elimination (2016–2030), committing to eliminate malaria nationwide by 2030. An interim target was set for 2027 to interrupt indigenous transmission across all States and Union Territories, including high-transmission areas. By the end of 2025, the Ministry of Health and Family Welfare reported that 160 districts across 23 States and UTs had recorded zero indigenous malaria cases continuously between 2022 and 2024. This milestone reflects the cumulative impact of long-term investments in surveillance, diagnosis, treatment, and vector control.
How malaria prevalence is measured
Malaria prevalence and transmission intensity are assessed using standard epidemiological indicators. The most commonly used measure in India is the Annual Parasite Incidence (API), which represents the number of confirmed malaria cases per 1,000 population at risk in a year. Districts with an API below one are considered to be in the elimination phase, while districts reporting zero indigenous cases for successive years enter the prevention of re-establishment phase. These metrics guide programmatic decisions and resource allocation.
Global certification norms and India’s status
According to the , a country is certified malaria-free only when the chain of local transmission of all human malaria parasites has been interrupted nationwide for at least three consecutive years, supported by a fully functional surveillance and response system. As of mid-2025, 47 countries and territories have received this certification. India has not yet reached this stage, but the World Malaria Report 2025 notes that it exited the WHO’s “High Burden to High Impact” group in 2024 and achieved an overall reduction of nearly 80% in malaria cases between 2015 and 2023.
Subnational progress and the Tamil Nadu experience
Tamil Nadu offers a clear illustration of how sustained interventions can translate into near-elimination. Malaria cases in the State declined from 5,587 in 2015 to 321 in 2025. Since 2023, 33 out of 38 districts have reported zero indigenous cases and moved into the prevention of re-establishment category. The remaining districts, including Chennai, are still in the elimination phase but maintain an API of less than one. Intensive surveillance, larval control, and focused monitoring of migrant populations have played a central role in these outcomes.
Strategies driving the decline
India’s malaria elimination efforts are guided by two national instruments: the National Framework for Malaria Elimination (2016–2030) and the National Strategic Plan for Malaria Elimination (2023–2027). Key strategies include transforming surveillance into a core intervention, ensuring universal access to diagnosis and treatment through the “test, treat, track” approach, and strengthening vector control. Special emphasis is placed on urban areas, tribal and forest regions, border districts, and migrant populations where transmission dynamics are more complex.
Persistent challenges and emerging risks
Despite significant progress, several challenges remain. Migration from malaria-endemic regions poses a continuous risk of reintroduction in low-transmission areas. Urban malaria presents unique difficulties due to rapid urbanisation, water storage practices, and construction activity. Additionally, Plasmodium vivax—which accounts for a large share of malaria cases in South Asia—complicates elimination efforts because of its tendency to relapse and the need for prolonged treatment. The World Malaria Report 2025 also highlights the growing threat of antimalarial drug resistance, including partial resistance to artemisinin derivatives in multiple regions globally.
What lies ahead for elimination
As India approaches the goal of zero indigenous malaria cases, the focus shifts from reducing incidence to sustaining elimination. Accurate data reporting, compulsory notification by private healthcare providers, and strong community participation—especially in urban settings—become critical. Strengthening surveillance systems, maintaining diagnostic capacity, and ensuring rapid response to imported cases will determine whether India can meet its 2027 interim milestone and the 2030 elimination target.
What to note for Prelims?
- Annual Parasite Incidence (API) and its role in malaria elimination phases.
- WHO criteria for malaria-free certification.
- Targets under the National Framework for Malaria Elimination (2016–2030).
- India’s exit from the WHO “High Burden to High Impact” group.
What to note for Mains?
- Importance of surveillance and health systems strengthening in disease elimination.
- Urban malaria and migration as challenges to sustaining elimination.
- Role of Plasmodium vivax and drug resistance in complicating malaria control.
- Need for Centre–State coordination and community-level participation.
