National Project Implementation Plan - NVBDCP

The Enhanced Malaria Control Project (EMCP) was implemented with the
support of the World Bank during 1997 to 2005 with the objectives of
creating an enhanced and more effective malaria control program focusing
on the tribal areas with high disease burden and supporting the introduction
of mix of cost-effective and sustainable strategies. The Project was
implemented in 1045 Primary Health Centers (PHCs) in 100 districts of 8
states (Andhra Pradesh, Chhattisgarh, Gujarat, Jharkhand, Madhya Pradesh
Maharashtra, Rajasthan and Orissa) predominantly inhabited by tribal
population. In the EMCP areas, the number of cases have declined from
1.17 m in 1997 to 0.76 m in 2005 (44% decline) and deaths from 522 to
301 (42%). The Pf cases reduced from 0.71 m to 0.51 m (28%).
India adopted WHO- RBM strategy and was successful in bids during the
GFATM Round IV. Under GFATM, NVBDCP is supporting malaria control in
the states of Assam, Arunachal Pradesh, Meghalaya, Tripura, Nagaland,
Mizoram, Manipur, West Bengal, Jharkhand and Orissa.
1.3. Kala-azar Control in India
Kala-azar has been endemic in India for a long time and earliest outbreaks
date back to early nineteenth century. With the implementation of
successive National Malaria Control operations from 1953, the disease
declined to negligible proportions due to collateral benefit of IRS. However,
withdrawal of IRS from some erstwhile malaria endemic areas resulted into
a gradual build up of vector population that ultimately led to resurgence of
kala-azar in seventies initially in 4 districts of Bihar. Slowly the disease
started spreading to other areas in Eastern India.
Concerned with the increasing incidence of Kala-azar, the GOI launched a
centrally sponsored Kala-azar Control Program in the year 1990-91. The
initial success of the program resulting in a significant decline in Kala-azar
morbidity could not be sustained by the states. An expert committee
chaired by the Director General of Health Services reviewed the program in
2000 and recommended the feasibility of eliminating Kala-azar from India
and the NHP (2002) has endorsed this recommendation and set a goal for
eliminating Kala-azar by 2010.
1.4 Program Constraints
The NVBDCP is also affected by the generic constraints of public health
system in India such as large number of vacant staff positions, weak
program management capacities, delays in procurement, ineffective
distribution of supplies, weak financial management, and insufficient
supervision and monitoring. Further, non- engagement and lack of
oversight of private sector plays an important role in the diagnosis and
treatment of malaria and Kala-azar cases.
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