Urban Malaria Threat: How Anopheles Stephensi Challenges India’s 2030 Malaria Goal

Urban Malaria Latest News

• India’s Malaria Elimination Technical Report, 2025 has flagged urban malaria driven by the invasive mosquito Anopheles stephensi as a growing national concern.
• It could threaten India’s target of eliminating malaria by 2030, with an interim goal of zero indigenous cases by 2027, aligned with World Health Organisation strategy.

Urban Malaria A New Challenge

• The spread of Anopheles stephensi in cities such as Delhi marks a shift from traditional rural malaria transmission.
• The species thrives in urban environments, breeding in artificial containers like overhead tanks, tyres, and construction sites.
• It efficiently transmits Plasmodium falciparum and P. vivax, complicating malaria control efforts.

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Why Anopheles Stephensi Is a Serious Threat

• Recognised globally as an invasive vector.
• Adapted to high population density, informal settlements, and fragmented urban healthcare systems.
• Requires city-specific vector control and surveillance strategies, unlike conventional rural-focused approaches.

Persistent High-Burden Pockets

• India has entered the pre-elimination phase, but malaria is now concentrated in specific pockets rather than widespread.
• High-burden districts persist in Odisha, Tripura, and Mizoram.
• Cross-border transmission from Myanmar and Bangladesh continues to affect northeastern border districts.

Key Drivers of Continued Transmission

• Asymptomatic infections, making detection difficult.
• Difficult terrain and remote tribal and forest areas.
• Population mobility and migration.
• Occupational exposure and uneven access to health services.

India’s Progress So Far

• Malaria cases reduced from 11.7 lakh (2015) to ~2.27 lakh (2024).
• Deaths declined by 78% over the same period.
• Active surveillance intensified in tribal, forest, border, and migrant-population settings.

Health System Gaps Identified

• Inconsistent reporting by the private sector.
• Limited entomological capacity.
• Drug and insecticide resistance.
• Operational gaps in remote tribal regions.
• Occasional shortages of diagnostics and treatment supplies.

Priority Actions and Research Areas

• Strengthen surveillance systems and vector monitoring.
• Improve supply-chain reliability for diagnostics and medicines.
• Focus operational research on:
  • Asymptomatic malaria infections
  • Ecology and control of Anopheles stephensi
  • Drug and insecticide resistance
  • Optimisation of P. vivax treatment regimens

Strategic Frameworks Guiding Elimination

• India’s success rests on a clear policy roadmap:
  • National Framework for Malaria Elimination (NFME), 2016: Target of zero indigenous cases by 2027.
  • National Strategic Plan for Malaria Elimination (2023–2027): Focus on enhanced surveillance, “test–treat–track” strategy, and real-time monitoring through the Integrated Health Information Platform (IHIP).

Vector Control and Urban Malaria Management

• Integrated Vector Management (IVM) has been central, including:
  • Indoor Residual Spraying (IRS)
  • Long-Lasting Insecticidal Nets (LLINs)
  • Special attention has been given to controlling the invasive Anopheles stephensi mosquito, strengthening urban malaria control.

Strengthening Diagnostics, Health Systems, and Communities

• Establishment of National Reference Laboratories under the National Centre of Vector Borne Diseases Control (NCVBDC).
• District-specific action plans for tribal, forested, and high-endemic areas.
• Integration of malaria services into Ayushman Bharat, with Community Health Officers and Ayushman Arogya Mandirs delivering care at the grassroots level.

Capacity Building, Research, and Partnerships

• Over 850 health professionals trained in 2024 through national refresher programmes.
• Research on insecticide resistance and drug efficacy guiding evidence-based interventions.
• Intensified Malaria Elimination Project–3 (IMEP-3) covering 159 districts in 12 states, focusing on vulnerable populations, Long-Lasting Insecticidal Nets (LLINs) distribution, entomological studies, and surveillance.

The Road Ahead 2030 Malaria-Free India

• India remains committed to achieving zero indigenous malaria cases by 2027 and elimination by 2030, with safeguards against re-establishment. 
• By combining strong policy frameworks, scientific interventions, community participation, and sustained funding, India is emerging as a global benchmark in malaria elimination.

Source: TH | PIB