India reported almost 3 million fewer malaria cases in 2017, a 24% decrease over the previous year, while cases increased worldwide to 219 million from 217 million, after registering a steady decline since 2010, according to the World Malaria Report 2018.
India’s reduction, the sharpest within a year, now means the country accounts for 4% of the world’s total malaria cases, and is no longer among the world’s top three countries in terms of number of cases (around 8.7 million in 2017).
Around 70% of the world’s malaria cases are found in India and 10 countries in sub-Saharan Africa. “There were 3.5 million more malaria cases reported in these 10 African countries in 2017 compared to the previous year, while India showed progress in reducing its disease burden,” said the report.
In 2017, India launched its five-year National Strategic Plan for Malaria Elimination that shifted focus from malaria “control” to “elimination” and provided a road-map with targets to end malaria in 571 districts out of India’s 678 districts by 2022.
What seems to have worked for India is the scaling up a diagnostic testing, treatment and surveillance and ensuring an uninterrupted drug and diagnostics supply chain, training community workers to test all fever cases and provide medicines, and distributing medicated bed-nets for prevention, under its ‘test-treat-track’ in the endemic north-eastern states and Odisha.
“Odisha is a driver of India’s success against malaria, where innovations, such as improving health care worker skills, expanding access to diagnostics and treatment and strengthening data collection, has led to the state recording a path-breaking decline of over 80% in reported malaria cases and deaths,” said Dr Pedro Alonso, Global Malaria Programme Director, WHO.
In Odisha, the National Institute of Malaria Research and the Odisha government collaborated with Medicines for Malaria Venture for an operational research programme called the Comprehensive Case Management of Malaria, which provided universal access to malaria diagnosis and treatment, and improved the quality of services and surveillance, and distributed 11 million medicated bed-nets.
“The result is 85% decline in the average monthly malaria cases in the intervention areas, from 2013-15 when universal access to malaria services was reached, to post interventions in 2016-2017,” said Dr Neena Valecha, director, National Institute of Malaria Research, New Delhi.
“The plan moved away from the ‘one-size-fits-all’ approach to use interventions tailored to local epidemiology and endemicity,” she added.
Till September 2018, there has been further improvement in the state, with reported malaria cases falling from 323,800 in 2017 from January to September, to 55,365 in 2018 till September, and deaths dropped to single digits during the same period.
“The backbone of the programme are the community health workers, who need to be equipped and trained to provide quality services. Along with that, maintaining a supply chain of quality products, introducing innovative reporting methods and continued research for development of new tools will help the country reach its malaria-free target,” said Dr Valecha.
Since 2000, India has reduced malaria deaths by two-thirds and halved the number of malaria cases.
The other countries that showed results were the malaria-endemic countries of China and El Salvador, which reported no local transmission in 2017.