E-Paper
From control to elimination: India’s fight against mosquito-borne diseases
This article is authored by CK Mishra, former Union health secretary, Government of India.
In the past, India's response to mosquito-borne diseases often came after an outbreak had arrived. For millions of Indians the risk never arrived on a schedule. It stretched from the first summer heat through the monsoon and the weeks after it: children missed school with malaria, sole-earners lost wages to dengue, relatives developed hathi-paon after years of discomfort. While insecticide nets protected the poor and fogging machines moved through the lanes fever wards filled simultaneously, and by the time the response caught up, the disease had already done its damage.
A decade ago, the ministry of health and family welfare launched the National Framework for Malaria Elimination and set the targets we still cite today: zero indigenous cases by 2027, elimination by 2030. At the time, this timeline felt aspirational, built on hope. What changed things over a decade was not a single tool or action, but the discipline of micro-planning, mapping transmission block by block, and implementing vector control measures across every endemic district. It was the same discipline which helped India close the gaps in the immunisation programme and, later, in the fight against kala-azar.
Behind that discipline and progress sat a bigger shift in the government’s approach from curative to preventive health. Alongside it came something closer to a real One Health approach, treating human health, animal health and the environment as one connected problem instead of three separate issues. The Parliament Standing Committee on Health's recent report on vector-borne diseases builds on this same thinking. Released earlier this month, the report has pertinent implementation-level recommendations. At a time when dengue outbreaks are becoming more frequent, and climate-linked changes and urbanisation are altering how these diseases spread, the report signals the need for a more proactive and coordinated public health strategy. The task ahead is an encouraging one: build on existing momentum and strengthen the systems that stop outbreaks before they start.
India’s mosquito-borne disease burden is still significant, and the challenge keeps shifting. These illnesses hit the poorest communities hardest, where treatment comes late and lost wages hurt more. Conventional mosquito control can no longer keep pace, and these diseases continue to affect millions.
The National Academy of Medical Sciences (NAMS) Task Force on Vector Borne Diseases and Parliament’s Standing Committee on Health both recommend a stronger “Integrated Vector Management” approach where preventive strategies are widened to include better diagnostics, surveillance and reporting systems, alongside vaccination.
This approach is both realistic and achievable. India exited WHO’s High Burden to High Impact group for malaria in 2024, and the government has set a target of zero indigenous malaria cases by 2027 and full national elimination by 2030. Yet, it is essential to confront the breadth of the challenge head-on: India was reported to account for an estimated 73.3% of the 2.7 million malaria cases across the WHO South-East Asia region in 2024. The effort now needs to sharpen, not ease off.
Dengue tells a similar story, moving in the right direction but not fast enough. India still accounts for roughly a third of the world's dengue burden, with an estimated 300,000 cases a year. Dengue kills far fewer people than malaria, but it fills hospital wards, puts pressure on the health system, costs working days and leaves long recoveries behind it. It is a disease measured less in deaths than in disruption.
The answer lies in broadening India's conception of prevention beyond spraying and surveillance. At present, the Universal Immunisation Programme includes vaccination against Japanese encephalitis in endemic areas, demonstrating the value of immunisation as a public health tool against vector-borne diseases. As new vaccines for diseases such as dengue and malaria advance globally, they offer another layer of protection for populations at risk. But the lessons from decades of vector control are clear: a vaccine sitting outside surveillance, community engagement and sustained mosquito control will not hold on its own. However, paired with these interventions, it gives India a fighting chance it hasn’t had before.
To defeat mosquito-borne diseases we must move beyond vector management toward a more ambitious vision of disease management and prevention. The recent approval of a dengue vaccine marks an important milestone in the country's response to mosquito-borne diseases, adding a promising preventive tool to an already expanding public health response. Paired with the National Centre for Vector Borne Diseases Control's (NCVBDC) ongoing efforts in surveillance, early diagnosis and case management, the vaccine can reduce severe illness and save lives even where transmission continues.
Today, we stand closer than ever to a year in which no season extracts a heavy toll on lives and livelihoods. Our progress against malaria proves what sustained investment and systems-led thinking can do. What we need now is a coordinated national strategy, backed by commitment at the highest level, that treats prevention as the default and not the fallback. Our gains must reach the last mile, the households that have carried this the longest. On World Mosquito Day, there is much to applaud in India's evolving response to mosquito-borne diseases, but it is also a timely reminder that the greatest gains still lie ahead of us.
(The views expressed are personal)
This article is authored by CK Mishra, former Union health secretary, Government of India.
