National Framework for Malaria Elimination

The National Framework for Malaria Elimination (NFME) 2016-2030 outlines India’s strategy for elimination of the disease by 2030. The framework has been developed with a vision to eliminate malaria from the country and contribute to improved health and quality of life and alleviation of poverty.

The NFME document clearly defines goals, objectives, strategies, targets and timelines and will serve as a roadmap for advocating and planning malaria elimination in the country in a phased manner. Necessary guidance is expressed for rolling out the strategies and related interventions in each State/UT as per respective epidemiological situation.

Goals

In line with the WHO Global Technical Strategy for Malaria 2016–2030 (GTS) and the Asia Pacific Leaders Malaria Alliance Malaria Elimination Roadmap, the goals of the National Framework for Malaria Elimination in India 2016–2030 are:

• Eliminate malaria (zero indigenous cases) throughout the entire country by 2030; and
• Maintain malaria–free status in areas where malaria transmission has been interrupted and prevent re-introduction of malaria.

Objectives

• Eliminate malaria from all low (Category 1) and moderate (Category 2) endemic states/UTs (26) by 2022
• Reduce incidence of malaria to less than 1 case per 1000 population in all States/UTs and the districts and malaria elimination in 31 states/UTs by 2024
• Interrupt indigenous transmission of malaria in all States/ UTs (Category 3) by 2027
• Prevent re-establishment of local transmission of malaria in areas where it has been eliminated and to maintain malaria-free status of the country by 2030.

Key strategic approaches defined

• Programme phasing considering the varying malaria endemicity in the country
• Classification of States/UTs based on API as primary criterion (Category 0: Prevention of re- introduction phase; Category 1: Elimination phase; Category 2: Pre-elimination phase; Category 3: Intensified control phase)
• District as the unit of planning and implementation
• Focus on high endemic areas
• Special strategy for P. vivax elimination.

Short term milestones

• By end of 2016, all states/UTs are expected to include malaria elimination in their broader health policies and planning framework
• By end of 2017, all states are expected to bring down API to less than 1 per thousand population
• By end of 2020, 15 states/UTs under category 1 (elimination phase) are expected to interrupt transmission of malaria and achieve zero indigenous cases and deaths due to malaria.

It is also envisaged that in states with relatively good capacity and health infrastructure, such as, Gujarat, Karnataka and Maharashtra, accelerated efforts may usher malaria elimination sooner - within two to three years.

National Strategic Plan (NSP) for Malaria Elimination (2017-2022)

Over the past 15 years, India has made considerable progress in reducing its malaria burden. It has a vision of a malaria-free country by 2027 and elimination by 2030. However, the country still faces daunting challenges as malaria epidemiology exhibits enormous heterogeneity and complexity. The disease is mainly concentrated in tribal and remote areas of the country.

The National Strategic Plan (NSP) for Malaria Elimination (2017-2022) has been developed based on the National Framework for Malaria Elimination (NFME) of the National Vector Borne Disease Control Programme (NVBDCP), Ministry of Health & Family Welfare (MoHFW), Government of India and World Health Organization (WHO) Global Technical Strategy for Malaria Elimination (2016-2030).

Goal

The goals of NSP strategy are phased elimination of malaria in India. National Framework for Malaria Elimination (NFME) in India has set 2030 as eliminating malaria and goals of NSP are in consonance with overall goals

• Eliminate malaria in Category 1 districts (API <1) by 2020 and Category 2  districts (API 1-2) by 2022,
• Reduce transmission in Category 3 districts to stabilize APIat <1 by 2022.

Specific objectives of NSP

• Achieve universal coverage of case detection and treatment services in endemic districts to ensure 100% parasitological diagnosis of all suspected malaria cases and complete treatment of all confirmed cases.
• Strengthen the surveillance system to detect, notify, investigate, classify and respond to all cases and foci in all districts to move towards malaria elimination.
• Achieve near universal coverage of population at risk of malaria with an appropriate vector control intervention.
• Achieve near universal coverage by appropriate BCC activities to improve knowledge, awareness and responsive behavior regarding effective preventive and curative interventions for malaria elimination.
• Provide effective programme management and coordination at all levels to deliver a combination of targeted interventions for malaria elimination.

Source : National Vector Borne Disease Control Programme