High Burden to High Impact (HBHI) Approaches - Country Perspective for Adoption and Adaptation in India

Abstract

In India, a National Framework for Malaria Elimination (NFME) has been developed and launched on 11 February 2016 align with the Global Technical Strategy (GTS) for malaria elimination 2016-2030. Malaria elimination will be carried out in a phased manner. In accordance with the NFME, National Strategy Plan for malaria elimination 2017-2022 has been developed by National Vector Borne Disease (NVBDCP), MoH & FW, Govt. of India in collaboration with WHO Country Office India and launched in July 2017. The country has made significant improvement in the malaria situation in recent years. Reported malaria cases were reduced by 49 % and deaths by 50% in 2018 compared to 2017. However, India and ten countries in Africa contribute approximately 70% of the world’s malaria cases and deaths. These countries adopted the “High Burden to High Impact (HBHI) approach”. HBHI has four response elements: (i) Political will to reduce malaria deaths; (ii) Strategic information to drive impact, (iii) Better guidance, policies and strategies, and (iv) A coordinated national malaria response. India has adopted this approach in May 2019 to further accelerate and sustain the progress in the states with high malaria burden. Initially, HBHI approaches are being adopted by NVBDCP with the support of WHO in four high burden states namely Jharkhand, Chhattisgarh, West Bengal and Madhya Pradesh. During the first phase, an in-depth situation analysis on malaria in these states have been conducted using the tools provided by WHO. Key features of adaptation of HBHI approaches in India and detail analysis of one state Madhya Pradesh are presented in the article.