DIRECTORATE GENERAL OF HEALTH SERVICES

National Vector Borne Disease Control Programme

History of Malaria Control in India

• In 1947, at India’s independence 22% population of country was estimated to suffer from marking with 75 million cases and 0.8 million deaths due to Malaria annually. To combat devastating effects of Malaria, the National Malaria Control Programme (NMCP) was launched in 1953 built around three key activities - insecticidal residual spray (IRS) with DDT; monitoring and surveillance of cases; and treatment of patients.  Malaria related morbidity and mortality in India rapidly brought down within a few years. Encouraged by the programme’s success.It was converted to National Malaria Eradication Programme (NMEP) in 1958. But in 1976, there was a massive resurgence of malaria with 6.46 million cases reported attributed to poor health infrastructure and sub-optimal monitoring and logistics in many parts of the country. In addition, P.falciparum resistance to chloroquine and vector resistance to insecticides were also reported. As a consequence, the modified plan of operations (MPO) was launched in 1977 with a three-pronged strategy: early diagnosis and prompt treatment, vector control and IEC/BCC with community participation. The malaria incidence showed a decline again and in 1984 the cases were reduced to about 2 million with 247 deaths. In order to combat malaria in high transmission areas of the country, an Enhanced Malaria Control Project (EMCP) was launched with additional support from the World Bank in 1997 and Intensified Malaria Control Project (IMCP) launched with support of The Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM) in 2005. The malaria control programme and other Vector Borne Diseases namely Kala-azar, Dengue, Lymphatic Filariasis, Japanese Encephalitis and Chikungunya were integrated into the National Vector Borne Disease Control Programme (NVBDCP) in 2002. New tools for malaria prevention and control were introduced under NVBDCP i.e., monovalent RDTs for P. falciparum detection in 2005; ACT in 2006; LLINs in 2009; antigen detecting bi-valent RDTs for detection of both P. falciparum and P. vivax in 2013; and newer insecticides and larvicides in 2014- 15.

Roles & Functions

• Directorate of National Vector Borne Disease Control Programme (NVBDCP) is the central nodal agency for prevention and control of six vector borne diseases (VBDs) i.e. Malaria, Dengue, Lymphatic Filariasis, Kala-azar, Japanese Encephalitis and Chikungunya in India. It is part of the Technical Division of the Directorate General of Health Services, Government of India, equipped with Technical Experts in the field of Public Health, Entomology, Toxicology and parasitological aspects of Vector Borne Diseases. The Directorate is responsible for framing technical guidelines & policies as to guide the states for implementation of the above mentioned six diseases Programme strategies& is also responsible for budgeting and planning the logistics pertaining to GOI supply. Monitoring is done through regular reports and returns of MIS. The Directorate carries out evaluation of Programme implementation activities from time to time. The resource gap is also assessed as to provide an equitable support based on the magnitude of the problem and the available resources.
• The 17 Regional Offices for Health and Family Welfare (ROH & FW), MOH&FW, GOI located at different state headquarters, manned by technical persons to coordinate and monitor all national health and family welfare Programmes by close liaison and field visits and for providing technical advice to the concerned states. Under National Vector Borne Disease Control Programme these offices are entrusted with the responsibility of conducting the entomological studies in collaboration with zonal entomological setup of the state, drug resistance studies, cross checking of blood slides for quality control, capacity building of the states, etc.
• Every state has State vector borne disease control unit under the state Directorate of Health Services with stipulated technical components. There is a State Programme Officers and system of coordination between the state and centre for effective implementation and monitoring of Programme.At the district level, under District Chief Medical and Health Offices by the states. The key unit for planning and monitoring of Programme a district/reporting malaria unit is established under a technical officer called as District VBD Officer (DVBDO)/erstwhile District Malaria Officer (DMO). At present 677 District/reporting Malaria Units are functioning.
• At the peripheral level, there are 152326 Sub-centres (ref. NHM statistics 2014 -MOH&FW, GOI) which are the village level health institutions for delivery of primary health care. There are 5363 Community Health Centres functioning in the country as the first Referral Unit (FRU) in rural areasthere are 25020 Primary Health Centres.The basic units at the rural area for delivery of primary health care in an integrated manner.
• Passive surveillance for malaria is carried out by PHCs, Malaria Clinics, CHCs and other secondary and tertiary level Health institutions to which patients visit for treatment.Active surveillance is carried out by Health workers through fortnightly unit. However due to shortage of health workers the active surveillance is not carried out as per norms of Govt. The ASHAs are the biggest component of passive surveillance at village level.
• To strengthen research and to meet the threat posed by resurgence of malaria, the Indian Council of Medical Research (ICMR) institute, National Institute of Malaria Research (NIMR)has mandate to provide technical support to the National Programme in the control of malaria. Its research activities focus on vector biology and control; genetics, cellular and molecular biology; parasitology; biochemistry; pharmacology and epidemiology. Malaria Research Centre has 12 field stations in different parts of the country. NIMR through its field stations evaluates new insecticides & diagnostic kits, conducts drug trials and monitors resistance to insecticides in vectors and to drugs in parasites. In addition, there are other Institutes of ICMR likeNational Institute for Research in Tribal Health (NIRTH) at Jabalpur, Madhya Pradesh; Vector Control Research Centre atPuducherry; Dibrugarh, (Assam), Bhubaneswar, Orissa; and Desert Medical Research Centre, Jodhpur, Rajasthan which carry out research on various aspects of malaria in addition to their other activities. It has now been envisaged to better utilize these centres/field units for monitoring/supervision of implementation of NVBDCPactivities in collaboration with States/UTs apart from carrying out operational research. The detection and treatment of Malaria is available upto community level through  ASHA (Accredited Social Health Activist).

Contents

• The Website of NVBDCP as per guidelines of GIGW compliant contains all the epidemiological data of Six Vector Borne Diseases (VBD) viz. Malaria, Dengue, Chikungunya, Kalar-azar, Lymphatic Filariasis & Japanese Encephalitis. The data gets updated on monthly basis except Lymphatic Filariasis.
• It contains various technical guidelines for prevention and control of vector borne diseases in India. Technical specification of vector borne Drugs and commodities are available on website.
• Various IEC/BCC toolslike Booklet,Stickers, Leaflets, Posters, Hordings,Audio/Video etc.of VBD are available on website.
• More information are available on NVBDCP website

(URL: www.nvbdcp.gov.in)