Urban Malaria Threatens India’s 2030 Elimination Goal

The Malaria Elimination Technical Report 2025 highlights a rising threat from the invasive Anopheles stephensi, which thrives in urban environments and may derail India’s 2030 malaria elimination target.

• The Malaria Elimination Technical Report, 2025 was released by the Ministry of Health. 
• Primary Vector: The invasive Anopheles stephensi mosquito is identified as the key vector driving urban malaria transmission.

About Anopheles stephensi

• Vector of Malaria: Primary vector of urban malaria, transmitting Plasmodium falciparum and Plasmodium vivax.
  • Highly efficient in densely populated human settlements.
• Container Breeder: Efficiently breeds in artificial water containers (storage tanks, discarded tires, construction sites), bypassing traditional control methods focused on rural water bodies.
• Geographic Distribution: It is native to South Asia and the Middle East.
  • Recently invaded parts of Africa (Horn of Africa), raising concerns of urban malaria spread.
• Breeding Behaviour: Prefers clean or lightly polluted water. Eggs and larvae survive well in stored water, making control difficult.
• Public Health Concern: Threatens malaria elimination goals due to:
  • Rapid urbanisation
  • Water storage practices
  • Insecticide resistance in some regions
• WHO Classification: Listed by WHO as an invasive malaria vector of high public health importance.

India’s Target

• Zero Indigenous Cases: India aims to achieve zero locally transmitted malaria cases by 2027.
• Complete Elimination: : Eliminate malaria nationwide by 2030.

Current Progress

• Major Reduction: Cases have fallen dramatically from 11.7 lakh in 2015 to ~2.27 lakh in 2024. Deaths have reduced by 78%.
• Shift in Transmission: Malaria is no longer widespread but persists in limited, high-risk pockets influenced by local ecology and infrastructure.

Why Urban Malaria is Rising?

• Urban Challenges: Container breeding, high density, informal settlements, and fragmented healthcare in cities.
• High-Burden Regions: Districts in Odisha, Tripura, and Mizoram.
• Cross-Border Transmission: Continued spread from Myanmar and Bangladesh into northeastern border districts.
• Systemic Gaps: Inconsistent reporting from the private sector, shortages of tests/treatments, and operational difficulties in remote tribal areas.

National Strategy & Priorities

• The report outlines a multi-pronged approach to tackle these evolving challenges.
• Top Immediate Priorities:
  • Strengthen surveillance systems.
  • Enhance vector monitoring (especially for An. stephensi).
  • Improve supply chain reliability for diagnostics and medicines.
• Intensified Surveillance: Focus on tribal/forest areas, border regions, and migratory population settings.
• City-Specific Strategies: Recognizing that urban malaria requires tailored control plans for each metropolitan area.

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