Description
Introduction
India, akin to countries globally, is committed to achieving universal health coverage by 2030, to realize the SDG 3.8. However, malaria persists as a significant public health concern in the country. India has implemented several initiatives since the 1950s, specifically targeted at malaria management, such as the National Malaria Control Programme in 1953, subsequently modified to the National Malaria Eradication Programme in 1958; the Urban Malaria Scheme from 1971-1972; the Modified Plan of Operation and the Plasmodium Falciparum Containment Programme in 1977; the ICMR’s dedicated Malaria Research Centre in 1977; the Malaria Action Programme in 1995; the Enhanced Malaria Control Project in 1997; the National Anti-Malaria Programme in 1998; the National Vector Borne Disease Control Programme in 2003; and the inaugural National Framework for Malaria Elimination (2016-2030) in 2016, in close alignment with the WHO’s Global Technical Strategy for Malaria (2016–2030). In addition to these specific measures, national and domestic public health policies and plans have also addressed malaria eradication strategies within the country. Even though the domestic malaria cases and mortality has steadily declined in the past decade, the country still accounts for about 66% of the malaria cases and about 44% of the reported malaria morbidity of the WHO South-East Asia Region. In addition, about 95% of the residents live in the malaria endemic zones of the country. To make matters worse, India allocates lowest per person funding at risk, despite being the largest contributor to the estimated cases of the region.
Objectives
The elimination of malaria is pivotal for achieving universal health coverage. This research examines the accomplishments and limitations of India’s malaria control laws and policies in order to identify the barriers towards realization of malaria elimination, and postulate legal and policy measures to address these identified barriers with the aim of furthering progress towards universal health coverage in the country.
Methodology
This research undertakes a comprehensive evaluation of India's malaria control programmes, plans, policies, and strategies, to assess the progress towards the national mission of malaria elimination by 2030, and recommends requisite legal and policy interventions.
Results and Discussions
The National Framework for Malaria Elimination (2016-2030) has contributed to an overall decline in the reported cases. The framework is largely in accordance with the international standards and best practices. However, several geographic and socio-economic factors hinder India’s malaria control efforts. Targeted legal and policy reforms are required for funding, vector control, local-level malaria control programmes, case management, diagnostics, surveillance, collaboration, response timelines, capacity building, and community and private sector participation. The engagement of diverse stakeholders in advocacy and awareness initiatives will significantly enhance the overall effectiveness of the legal and policy interventions.
Conclusions
The research recognizes the complexities of India's malaria control interventions and underscores the need for a comprehensive legal and policy framework addressing multi-faceted aspects of surveillance, monitoring and evaluation, inter-sectoral collaboration, regulation, funding, research, and community engagement.
Keywords
Malaria, universal health coverage, India
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