title: Malaria elimination in India and regional implications.
abstract: The malaria situation in India is complex as a result of diverse socio-environmental conditions. India contributes a substantial burden of malaria outside sub-Saharan Africa, with the third highest Plasmodium vivax prevalence in the world. Successful malaria control in India is likely to enhance malaria elimination efforts in the region. Despite modest gains, there are many challenges for malaria elimination in India, including: varied patterns of malaria transmission in different parts of the country demanding area-specific control measures; intense malaria transmission fuelled by favourable climatic and environment factors; varying degrees of insecticide resistance of vectors; antimalarial drug resistance; a weak surveillance system; and poor national coordination of state programmes. Prevention and protection against malaria are low as a result of a weak health-care system, as well as financial and socioeconomic constraints. Additionally, the open borders of India provide a potential route of entry for artesunate-resistant parasites from southeast Asia. This situation calls for urgent dialogue around tackling malaria across borders-between India's states and neighbouring countries-through sharing of information and coordinated control and preventive measures, if we are to achieve the aim of malaria elimination in the region.
authors.affiliation: Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, ACT, Australia; Phuentsholing General Hospital, Phuentsholing, Bhutan. Electronic address: dockinley@gmail.com.
authors.forename: Kinley
authors.initials: K
authors.lastname: Wangdi
authors.affiliation: School of Public Health & Social Work, Queensland University of Technology, Brisbane, QLD, Australia.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Gatton
authors.affiliation: Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, ACT, Australia.
authors.forename: Gerard C
authors.initials: GC
authors.lastname: Kelly
authors.affiliation: Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, ACT, Australia.
authors.forename: Cathy
authors.initials: C
authors.lastname: Banwell
authors.affiliation: National Institute of Malaria Research (ICMR), Guwahati, Assam, India.
authors.forename: Vas
authors.initials: V
authors.lastname: Dev
authors.affiliation: Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, ACT, Australia.
authors.forename: Archie C A
authors.initials: ACA
authors.lastname: Clements
mesh_terms: D000818:Animals; D000962:Antimalarials / Q000494:pharmacology; D002980:Climate; D003695:Delivery of Health Care; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D018432:Drug Resistance, Multiple; D006801:Humans; D007194:India / Q000453:epidemiology; D007391:International Cooperation; D008288:Malaria / Q000188:drug therapy / Q000453:epidemiology / Q000469:parasitology / Q000517:prevention & control*; D010966:Plasmodium vivax / Q000469:parasitology
chemical_list: D000962:Antimalarials