MALARIA CONTROL STRATEGIESE

1. Early Case Detection and Complete Treatment (EDCT)

All fever cases are tested for malaria, and every confirmed case receives complete radical treatment to break transmission. Diagnosis is done through microscopy or RDTs, and treatment follows the national drug policy—chloroquine for sensitive cases and alternative regimens for resistant areas. Drug Distribution Centres (DDCs) and Fever Treatment Depots (FTDs) ensure easy community access to full-course treatment, with emphasis on adherence and cure.

2. Vector Control:

Vector Control includes chemical measures such as Indoor Residual Spraying (IRS) with approved insecticides, use of chemical larvicides in potable water, aerosol space sprays during the day, and Malathion fogging during outbreaks; biological control through deployment of larvivorous fish (e.g., Gambusia) and use of biocides in suitable habitats; and personal protective measures such as repellents, screened housing, insecticide-treated bed nets/LLINs, and wearing protective clothing to minimize mosquito contact.

3. Community Participation:

 Community participation focuses on actively engaging people in identifying and eliminating Anopheles breeding sites, promoting local ownership of malaria prevention, and encouraging sustainable behaviours. Communities are mobilized through awareness drives, supported by NGO-led initiatives that strengthen programme strategies and outreach. Collaboration with industry bodies such as CII, ASSOCHAM and FICCI further enhances resource mobilization, advocacy and cross-sector involvement, ensuring wider participation and shared responsibility in malaria control efforts.

4. Environmental Management and Source Reduction:

Long-term malaria control requires management of vector breeding sources through environmental and engineering methods, including:

• Filling, leveling, or draining water collections that support mosquito breeding.
• Ensuring proper covering of stored water.
• Channelization of water bodies to prevent stagnation and larval proliferation.

5. Monitoring and Evaluation:

A robust monitoring and evaluation system tracks the implementation of malaria elimination activities, measures progress against targets, and identifies gaps for timely course correction. Programme managers at all levels continuously analyse data for decision-making, supported by strong quality-control systems, capacity building, and dynamic data repositories. DVBDCO/DMO reviews key indicators weekly and monthly, provides feedback to CHCs, PHCs and private facilities, and works with the District Surveillance Unit to interpret and present data through dashboards for easy performance assessment. IHIP serves as the primary platform for real-time reporting of cases, vector control measures, outbreaks and surveillance activities. Regular monthly, quarterly, mid-term and annual reviews guide resource allocation and programme adjustments, while national and state teams ensure oversight through field validation, surveys and updated M&E tools. Monitoring of output, outcome and impact indicators enables continuous assessment of epidemiological trends, intervention effectiveness and progress towards malaria elimination.

Strategic Approaches as per National Strategic Plan-2023-27:

1. Transforming malaria surveillance as a core intervention for malaria elimination:

Under the National Strategic Plan 2023–27, malaria surveillance is defined as a case-based, real-time system that detects every infection, tracks its source, and triggers immediate action to stop onward transmission. Surveillance is applied across all settings—endemic, low-transmission, pre-elimination, and elimination districts—with increasing intensity and precision as transmission declines. Core surveillance actions follow the 1–3–7 timeline: notification of each case within 1 day, completion of case investigation within 3 days, and implementation of appropriate foci response measures within 7 days; classification of every case and focus; active and reactive case detection in and around reported cases; geo-tagging and GIS-based mapping of cases and foci; and complete reporting from public and private health sectors. ABER remains the key metric for ACD and PCD, with a minimum target of 10% in Category 2 and 3 areas. Also, surveillance must additionally maintain MBER of 1.5% in Category 3 and 1% in Category 2, while Category 1 should sustain ABER of 5-7% and Category 0 should sustain ABER of 1-3%.

2. Ensuring universal access to malaria diagnosis and treatment by enhancing and optimizing case management - “testing, treating and tracking”: Universal access to malaria diagnosis and treatment is ensured through timely parasitological confirmation of every suspected case using quality-assured RDTs or microscopy, with strengthened services across all levels including hard-to-reach areas. The strategy prioritizes sensitive and specific diagnostics, continuous capacity building, robust supply chains, and strong quality-assurance systems. All confirmed cases receive prompt, guideline-based treatment with strict follow-up to ensure EDCT, while public, private and informal providers are engaged for reporting and adherence. Drug efficacy, safety, relapse, and treatment failures are routinely monitored through Therapeutic Efficacy Studies, pharmacovigilance, and operational research to maintain effective case management nationwide.

3. Ensuring universal access to malaria prevention by enhancing and optimizing vector control Under NSP 2023–27, universal access to malaria prevention is ensured by strengthening entomological surveillance and implementing evidence-based integrated vector management. The strategy focuses on continuous monitoring of vector species, densities, breeding habitats and insecticide resistance; timely foci investigation; and targeted use of IRS, LLINs, larval source management and emergency vector control. Capacity building of entomology cadres, robust data reporting, collaboration with research institutions, and adherence to national guidelines support effective, area-specific vector control to interrupt transmission and sustain malaria-free status.

4. Accelerating efforts towards elimination and attainment of malaria free status: Under NSP 2023–27, acceleration towards zero indigenous malaria combines focused leadership with six programmatic levers — planning & implementation, multisectoral coordination, human resources, advocacy & SBCC, procurement & supply-chain, and finance — to deliver rapid, targeted action nationwide. State and district PIPs translate national priorities into local micro-plans; near-real-time case reporting through IHIP-Malaria enables prompt decision-making and foci response; and regular program reviews ensure adaptive course-corrections.

Capacity building is delivered through a cascade training model covering all cadres (ASHAs, CHOs, clinicians, entomologists, lab staff and private providers) with annual refreshers, while multisectoral task forces and community engagement drive ownership and service access for vulnerable groups. Procurement, LMIS and financial management systems are strengthened to ensure uninterrupted supplies and transparent use of resources.

Sustained financing, routine monitoring, operational research (TES, IRM, pharmacovigilance) and clear accountability mechanisms underpin the effort — ensuring interventions are evidence-driven, cost-efficient and scalable to achieve and sustain a malaria-free India.

5. Promoting research and supporting the generation of strategic information for malaria elimination and prevention of re-establishment of malaria transmission: The 5th strategy emphasises Research and Development as a continuous pillar for accelerating malaria elimination, focusing on generating evidence to refine policies and guide interventions at national, state and district levels. Priority areas include regular TES, quality assurance of diagnostics, vector biology and insecticide resistance studies, GIS-based mapping, and operational research on surveillance, case management, vector control and community engagement. Special emphasis is placed on Plasmodium vivax elimination, treatment-seeking behaviour in remote and tribal areas, private-sector engagement, and gender-related vulnerabilities. Research institutions such as ICMR, NCDC, medical colleges and universities will lead these studies in collaboration with NCVBDC. With the roll-out of IHIP-Malaria, the program will leverage real-time data for forecasting, modelling and climate-linked risk assessments. Additional operational research—such as costing studies, migration surveillance, KAP assessments chemoprevention in high-transmission settings—will support evidence-based, locally tailored interventions and help prevent re-establishment of transmission.