Community-based malaria control in India.

India launched its National Malaria Eradication Programme (NMEP) in 1958, designed to interrupt transmission with residual insecticide spraying coupled with chemotherapy and anti-larval methods in urban areas. The strategy produced spectacular results. By 1965 malaria was reduced from around 75 million cases annually (with 800 000 deaths) to about 100 000 cases per year. Unfortunately, even under the subsequent maintenance phase, malaria began to resurge in many foci, and in 1976 the NMEP reported 6.4 million parasite positive cases. In this article, V.P. Sharma looks at some of the problems faced by the NMEP strategy, and discusses the alternative community-based approach now being evaluated in the northwestern state of Gujarat.