India has made a remarkable achievement in reducing malaria cases and deaths, which has significantly contributed to the overall decline in the World Health Organization (WHO) South-East Asia region.

The WHO World Malaria Report 2024 showed that in 2023, the South-East Asia region reported four million cases in eight malaria-endemic countries, accounting for 1.5% of the global malaria burden. India alone contributed half of the cases in the region, followed by Indonesia with about a third.

Notable improvements were seen in the region, particularly in India, where projected cases declined by 200 to 17.7 million by 2023, and malaria incidence declined by 93%, from 20 cases to 1.5 per 1,000 people at risk. Matters are done. Sri Lanka was certified malaria free in 2016.

Globally, in 2023, 29 of the 83 malaria-endemic countries were responsible for approximately 95% of global malaria cases and 96% of malaria deaths. Nigeria (25.9%), Democratic Republic of Congo (12.6%), Uganda (4.8%), Ethiopia (3.6%), and Mozambique (3.5%) account for more than half of malaria cases worldwide.

Similarly, four countries are responsible for more than half of malaria deaths globally: Nigeria (30.9%), Democratic Republic of Congo (11.3%), Niger (5.9%), and Tanzania (4.3%).

Trend of malaria cases and deaths in India

Between 2022 and 2023, malaria cases in India are projected to decline by 9.6%, while Bangladesh, Indonesia and Nepal also recorded declines. However, some countries, such as Myanmar, Thailand and the Democratic People’s Republic of Korea, saw sharp increases in cases, highlighting uneven progress across the region.

Despite India’s success, about 88% of malaria deaths in the region occurred in India, along with Indonesia. Nevertheless, India, Bangladesh and Thailand achieved a death rate reduction of more than 63%.

Efforts to reduce malaria

The credit for India’s progress goes to community health workers, especially women, who have been instrumental in reaching remote populations. Her culturally sensitive approach ensures that female patients overcome social barriers to accessing health care.

Insecticide-treated mosquito nets (ITNs) and indoor residual spraying (IRS) have been major tools in malaria prevention. In 2023, India distributed more than 1.1 million ITNs to reduce malaria cases.

WHO’s High Burden to High Impact (HBHI) initiative, launched in 2018, supports malaria control in India by 2024. By then, India had moved out of the HBHI group due to significant progress. Malaria cases fell 69% from 6.4 million in 2017 to two million in 2023, and deaths fell 68% during the same period.

future challenges

The invasive Anopheles stephensi mosquito, known to spread malaria in urban areas, remains a challenge, with cases reported in eight African countries. A WHO July 2024 report highlighted lessons learned from India, Iran and Sri Lanka in controlling the species.

WHO has also turned its attention to IRS by publishing an updated manual in February 2024 to tackle other vector-borne diseases such as dengue and Zika.

A major breakthrough in 2023 was WHO’s recommendation of a second malaria vaccine, R21/Matrix-M, to complement the RTS,S vaccine. Together, these vaccines are expected to provide adequate protection to children in high-risk areas, further boosting malaria prevention efforts.

India’s achievements reflect the importance of sustained efforts and innovation in the fight against malaria, serving as a model for other high burden countries.