To assess interventions for malaria in India and Pakistan

Malaria remains a major global health problem, and one of the leading causes of death and disease across many tropical and subtropical countries. India possesses the largest burden of malaria outside of Africa, with an estimated 400 million at risk of infection and 1.1 million cases in 2014 alone. Recent years have seen control efforts achieve large reductions in the burden of disease, although achieving elimination is likely to prove more difficult. The ecology of malaria in India is highly complex, and characterised by a diversity of vectors and parasites whose relative contributions vary significantly depending on the setting.

Whilst the centre of the country is characterised by endophilic vectors and a high Plasmodium vivax burden, in other areas, Plasmodium falciparum dominates and is transmitted by a variety of exophagic and exophilic vectors. This diversity has material consequences for interventions aimed at controlling the disease, with impact likely to be significantly influenced by the local malaria context. Mathematical models provide useful tools to understand the transmission dynamics of infectious diseases, and have been used extensively in African contexts to guide and shape the deployment of interventions aimed at controlling malaria. Despite this, development of a mathematical model of malaria in India remains outstanding- motivated by this absence, this thesis seeks to construct a model of malaria transmission that encompasses the diverse ecological settings seen across India.

This model will then be used to help navigate the complex interplay between the ecological setting and the impact of control efforts, and assist mapping of where particular control efforts would best be deployed. Such work will enable intervention deployment to be carried out in a manner sensitive to local and regional malaria contexts, and ultimately inform eradication efforts.