Assess India's progress towards malaria elimination by 2030 and the bottlenecks.

India's National Framework for Malaria Elimination (2016–2030) targets zero indigenous cases, and the country's exit from WHO's High Burden to High Impact (HBHI) group in 2024 marks genuine progress [1]. Yet the distance between reported and estimated burden shows that control success has not yet become elimination readiness.

Evidence of progress

• Case and death decline: reported cases fell from 11,69,261 (2015) to 2,27,564 (2023) and deaths from 384 to 83 — roughly an 80% fall [1].
• Geographical shrinkage: of 10 high-burden (Category 3) States/UTs in 2015, only Mizoram and Tripura remained in 2023; 24 States/UTs now report an API below 1 per 1000 [1].
• Zero-transmission pockets: Ladakh, Lakshadweep and Puducherry record zero indigenous cases and are eligible for subnational verification [1].
• Systems strengthening: the National Strategic Plan (2023–27) embeds "test, treat, track" case management with real-time reporting through the Integrated Health Information Platform (IHIP), alongside IRS and LLIN-based integrated vector management [1]; the 2025 World Malaria Day campaign reinforced community mobilisation [2].

Persistent bottlenecks

• Surveillance gap: WHO's estimated burden for India remains far above reported cases, since estimates correct for reporting completeness and low health-service use [3]. Elimination requires detecting every case, so cases treated in the unregulated private sector remain invisible to IHIP [1].
• Incomplete radical cure: P. vivax relapse needs a 14-day primaquine course, but 8-aminoquinolines cause acute haemolytic anaemia in G6PD-deficient patients, so WHO advises testing before treatment [4]. G6PD rapid tests are rarely available where malaria RDTs already reach [5], and unsupervised long courses are abandoned once fever subsides.
• Residual foci: forested, tribal and border districts of the North-East and central India sustain transmission [1].

India has moved decisively from high burden to low burden; the harder task is closing the last mile. Co-locating G6PD rapid tests with malaria RDTs, enforcing private-sector notification, and sustaining vector control in residual foci would convert this decline into verified elimination, advancing SDG 3.3.