NEW DELHI: India remains the centre of malaria transmission in the WHO South-East Asia Region, accounting for 73.3% of all estimated cases and nearly 89% of malaria deaths in 2024, even as the region records one of the world’s steepest declines in malaria, World Malaria Report 2025 showed.The region logged 4.79 lakh cases in 2024 — a 65.7% fall since 2015 — and just 99 reported deaths, but WHO estimates indicated a far larger burden of 2.7 million cases and 3,900 deaths, with India driving most infections and fatalities.Despite this dominance, India remains on track to meet the 2025 Global Technical Strategy goal of a 75% drop in incidence, having crossed a 70% reduction by 2024. Most districts continue to report sustained declines, tho-ugh localised outbreaks in forest belts and cross-border spillover from Nepal persist as major challenges.Children under 5 accounted for 8.7% of cases and 18% of deaths, while P.vivax, notoriously difficult to eliminate, caused nearly two-thirds of infections. The report credits the gains to aggressive interventions — large insecticide-treated net drives in India, Myanmar and Nepal; 143% growth in rapid testing since 2015; and 100% treatment coverage. Low-level pfhrp2/3 gene deletions were detected in India, but treatment failure for key ACTs remained below 5%, indicating continued drug efficacy.A key milestone highlighted was India’s exit from High Burden to High Impact group in 2024, marking its shift from a global high-burden nation to one nearing elimination in several states — a transformation few countries have achieved at this scale. Bhutan, Sri Lanka and Timor-Leste are malaria-free. WHO warns drug resistance, climate-related outbreaks and declining international funding threaten global progress.Dr Sunil Rana of Asian Hospital said malaria persists in India because timely healthcare fails to reach tribal and forest communities. “Longer mosquito-breeding seasons, delayed care-seeking, weak surveillance and unchecked migration through border zones keep outbreaks alive,” he said.