P.K. Srivastava and Anju Viswan K.
Malaria, Lymphatic Filariasis (LF) and Visceral leishmaniasis (VL) are the three vector-borne diseases targeted for elimination in India in pursuit to achieve the SDG goal. There have been significant achievements in reducing 89% of malaria cases in India. Population living at risk for LF has been reduced as only 134 out of 328 districts are undergoing the preventive chemotherapy of mass drug administration (MDA) and in rest, MDA has been stopped. VL cases have also been reduced to 1276 cases in 2021 as opposed to 8000 in 2015. The regular assessment and feasible course correction in strategic approaches viz., diagnostics and treatment with incentivization to grass root workers have led to globally recognised achievements. Considering the last mile challenge, emphasis has been to focus on intensified implementation of programme activities with enthusiastic and committed implementers prioritizing integrated or a mix of integrated and vertical approaches. It is important as the process of validation and certification of having achieved elimination are time consuming. Validation for malaria elimination requires evidence for no indigenous case, subnational validation, ensuring prevention of reintroduction (PoR) policy, claim for national certification and then wait for response of WHO. Similarly for LF, validation requires evidence of successful completion of three transmission assessment surveys (TAS) at the interval of 2 years between each TAS. In addition, establishment of Morbidity Management and Disability Prevention (MMDP) clinics in all endemic units and implementation of vector control need to be reflected in the dossier for certification of elimination. In case of VL, the preconditions of epidemiological surveillance, adequate access to diagnosis and treatment need to be fulfilled followed by sustenance phase of cases below 1 per 10 000 population for at least three consecutive years. Validation process starts when such reports are submitted to WHO and the international validation team (IVT) reviews them. The probability of achieving elimination thus depends on evidence of zero indigenous malaria cases, clearance of TAS by all LF endemic districts and sustenance of VL cases below 1 per 10000 population in all endemic blocks for 3 years. All such processes, guidelines and risk factors in achieving elimination therefore need to be repeatedly disseminated which should be user-friendly and feasible so that target is achieved by the year 2027 and remaining period of 3 years is used for validation.
P.K. Srivastava and Anju Viswan K., 2023. Probability of Elimination of Targeted Vector-Borne Diseases by 2030: Indian Perspective. Journal of Medical Arthropodology & Public Health 3(1): 81–91.