Thematic Feature: Cross-border malaria elimination along the India-Bhutan and India-Nepal borders

Bhutan, India, and Nepal have made significant strides towardsending malaria after decades of consistent efforts. Bhutan and Nepal reported zeroand 36 indigenous malaria cases respectively in 2022, and both are aiming toeliminate malaria entirely by 2025 – five years ahead of the global goal. Whilestill a malaria high-burden country, India has also made impressive gainsagainst malaria with a 60% case reduction within five years. To achieve the goalof malaria elimination by 2030, all countries are strengthening last-mile eliminationefforts, focused on hard-to-reach populations and vulnerable communities –including efforts around cross-border malaria.

The national malaria programmes in Bhutan, India, and Nepal havefaced several challenges and their experiences can provide insights into planningand implementing strategies to address cross-border malaria. APLMA haspublished a new Thematic Feature addressing these learnings oncross-border malaria.

International land borders present a unique challenge foranti-malaria programmes. These regions are usually remote and difficult to access,may see regular migration between countries, and may even have porous bordersin some places – all of which can hinder efforts to track, monitor, and treatmalaria. Preventing the re-establishment of malaria in some malaria-freedistricts bordering high-endemicity cross-border districts may also be achallenge.

Bhutan, India, and Nepal have stepped up efforts in recentyears to address the challenges of cross-border malaria. Bhutan ensured thatcross-border collaboration was specifically included in the national strategicplan as essential for achieving and sustaining malaria elimination. Both Bhutanand India have begun cross-border collaboration meetings for malaria withsupport from WHO and the Southeast Asia Regional Coordination Mechanism Forum. Indiaand Nepal have also streamlined cross-border communication for effective implementationin both countries.

From the experiences of these three countries, it is clearthat joint surveillance mechanisms, joint guidelines and action plans, andstrong regional coordination are essential to addressing cross-border malaria. Malariadoes not respect borders and thus it is essential for local communities, nationalmalaria programmes, and global stakeholders to work together in ensuring theend of this deadly disease.

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