India has unveiled a plan to eliminate malaria by 2027, an ambitious target given that the country reports 89 per cent of malaria cases in South-east Asia. The malaria elimination deadline is three years ahead of the global deadline. The plan, unveiled Wednesday, broke down all the districts into four categories based on their annual parasite incidence (API).
Six states — Odisha (40%) Chhattisgarh (20%), Jharkhand (20%), Meghalaya, Arunachal Pradesh and Mizoram (5-7%) — report most of the malaria cases in India. These, along with tribal areas of Maharashtra and Madhya Pradesh, account for 90 per cent of India’s malaria burden. In the categories made by the government, category zero districts have the least incidence — no case has been reported in the last three years. Here the plan is to maintain vigilance so that the disease is not reintroduced. Seventy five districts come in this category.
In category one are 448 districts, all of them in what has been termed as the elimination phase where the API is less than 1 per 1,000. The elimination target is set for 2020. In category 2 are 46 districts with API of 1-2 where the elimination target is for 2022. In category 3 are 109 districts with API higher than 2. In these, the target is to bring the API down to less than one by 2022. The total budget for the plan is Rs 10,653 crore.
In an admission of the challenges, the plan document unveiled by health minister J P Nadda notes that a severe lack of manpower plagues the programme. Against 80,000 sanctioned posts in 1,50,000 sub-centres, there are just 40,000 people in place. Elimination strategies have been structured to meet specific requirements of these districts. The backbone of the plan comprises awareness, entomological surveillance in vulnerable areas, use of diagnostic kits to identify the malaria parasite and an outbreak warning system.