National Framework for Malaria Elimination in India

Targets:
By 2027: Achieve zero indigenous malaria cases across all States and Union Territories.
By 2030: Prevent re-establishment of malaria in areas declared malaria-free and sustain elimination nationwide.

Key interventions for Category 3 States/UTs (Intensified control):
Category 3 areas (API ≥1/1000) require aggressive, integrated measures:

1. Universal access to diagnosis and treatment: Ensure availability of Rapid Diagnostic Tests and microscopy at peripheral facilities, prompt case management with effective antimalarials (ACT for Plasmodium falciparum, chloroquine where appropriate for P. vivax) and ensure complete radical cure with primaquine for P. vivax after G6PD screening when required.
2. Vector control through Integrated Vector Management: Mass distribution and promotion of Long Lasting Insecticidal Nets, targeted Indoor Residual Spraying, environmental management and larval source reduction, and use of larvicides in breeding hotspots.
3. Strengthened surveillance and response: Case-based surveillance, immediate reporting, active case detection, fever surveillance, focal screening, and prompt outbreak investigation with targeted interventions.
4. Community engagement and behavioural change: Mobilise communities for net use, early treatment seeking, environmental sanitation and involvement of local stakeholders.
5. Health system strengthening: Ensure logistics, supply chains, trained workforce, functional laboratories, and referral networks.

Parameters for epidemiological surveillance:
Monitor Annual Parasite Incidence (API) per 1,000 population annually; Annual Blood Examination Rate (ABER); Slide Positivity Rate (SPR); Slide Falciparum Rate (SFR); proportion of P. falciparum cases; treatment adherence and cure rates; drug efficacy monitoring and molecular surveillance for resistance; vector susceptibility to insecticides; malaria mortality; geographic mapping of cases and hotspots; coverage indicators for LLINs, IRS, and case management; timeliness of reporting and response.

These combined measures, sustained funding and multisectoral coordination are essential to achieve the 2027 and 2030 goals. Regular program evaluation, operational research, sustained financing, intersectoral collaboration, and cross-border coordination support implementation and long-term success. and community ownership efforts.