India has recently launched the National Framework for Malaria Elimination in India 2016-2030 as well as the National Strategic Plan for malaria elimination in India. Although malaria continues to be one of the major vector borne diseases prevalent in the country, its incidence is gradually decreasing. There is heterogeneity and variability in the risk of malaria transmission between and within the states of the country as many ecotypes/paradigms of malaria have been recognized. The high burden populations are ethnic tribes living in the forested pockets of the states like Orissa, Jharkhand, Madhya Pradesh, Chhattisgarh and the North Eastern states which contribute bulk of morbidity and mortality due to malaria in the country. Drug resistance, insecticide resistance, lack of knowledge of actual disease burden and new paradigms of malaria pose challenges for malaria control and elimination in the country.
India has responded well to these challenges and there had been introduction of malaria RDTs, artemisinin based combination therapy, long lasting insecticide nets and other novel vector control measures. When the country heads towards elimination, more and more research inputs are needed to address the issues like surveillance in hard-to-reach areas, disease burden asymptomatic parasitaemias, P. vivax relapses, G6PD testing, new species, changing vector behavior, managing severe malaria etc.