The latest World Malaria Report 2025 reveals a stark reality: India continues to be the epicenter of malaria transmission in the World Health Organization's South-East Asia Region. The nation accounted for a staggering 73.3% of all estimated cases and nearly 89% of malaria deaths in the region during 2024.
A Region of Contrasts: Steep Decline vs. Heavy Burden
This dominance persists even as the broader region celebrates one of the world's most dramatic reductions in malaria incidence. Since 2015, the region has seen a 65.7% fall in cases, with official reports logging 4.79 lakh cases and 99 deaths in 2024. However, WHO estimates paint a more concerning picture, indicating a true burden of approximately 2.7 million cases and 3,900 deaths, with India contributing the majority of these infections and fatalities.
Despite bearing the heaviest load, India's national trajectory offers significant hope. The country remains firmly on course to achieve the 2025 Global Technical Strategy goal of a 75% drop in incidence, having already surpassed a 70% reduction mark by 2024. Most districts report consistent declines, though significant hurdles remain.
Persistent Challenges and Key Vulnerabilities
The fight is far from over. Localized outbreaks in forested areas and cross-border transmission from Nepal continue to disrupt progress. The report highlights that children under five years old remain particularly vulnerable, accounting for 8.7% of cases and 18% of deaths. Furthermore, the Plasmodium vivax parasite, known for its ability to relapse and its resistance to eradication, was responsible for nearly two-thirds of all infections.
Experts point to systemic issues in healthcare delivery. Dr. Sunil Rana of Asian Hospital explains that malaria persists because timely healthcare often fails to reach tribal and forest communities. "Longer mosquito-breeding seasons due to climate shifts, delayed care-seeking, weak surveillance systems, and unchecked migration through border zones keep these outbreaks alive," he stated.
The Path Forward: Interventions and a Major Milestone
The reported gains are credited to aggressive, scaled-up interventions across the region. These include large-scale drives to distribute insecticide-treated nets in India, Myanmar, and Nepal. There has been a 143% growth in the use of rapid diagnostic tests since 2015, coupled with achieving 100% treatment coverage for confirmed cases.
On the treatment front, while low-level genetic deletions (pfhrp2/3) were detected in India—which can affect some rapid tests—the crucial finding is that treatment failure for key Artemisinin-based Combination Therapies (ACTs) stayed below 5%, confirming the continued efficacy of first-line drugs.
A landmark achievement highlighted in the report is India's exit from the WHO's 'High Burden to High Impact' group in 2024. This marks a critical shift in status, from a global high-burden nation to one where several states are nearing elimination—a transformation few countries have managed at such a scale. Neighbors Bhutan, Sri Lanka, and Timor-Leste have already been certified malaria-free.
The WHO report concludes with a global warning. Progress remains fragile and is threatened by emerging drug resistance, climate change-fueled outbreaks, and a concerning decline in international funding for malaria control programs worldwide.
