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2+ Years Later: The President's Malaria Initiative

The President's Malaria Initiative (PMI), created in June 2005 to cut malaria deaths in half in 15 African countries, has already reached millions with lifesaving malaria prevention and treatment services. PMI has started to see early evidence of impact, with the first data coming from the archipelago of Zanzibar, part of the United Republic of Tanzania.	In Kibiti Health Centre in Rufiji District, Tanzania, health worker Aggrey Ngajilo gives a baby a dose of an ACT to cure his malaria. Credit: Patrick Kachur, CDC.

Partnerships Key to Success of PMI

PMI partnered with the Global Fund, Canadian Red Cross, American Red Cross, UNICEF, WHO, Ministry of Health and others on an integrated health campaign in Madagascar. Above, in Dabolava, children under 5 years receive for free a measles vaccine, mebendazole to treat worm infections, vitamin A, and a LLIN to prevent malaria. Credit: Julie Thwing, CDC

PMI is an interagency initiative led by the U.S. Agency for International Development (USAID) and implemented together with CDC. It is overseen by a PMI Coordinator and an Interagency Steering Group made up of representatives of USAID, CDC/HHS, Department of State, Department of Defense, National Security Council, and Office of Management and Budget.

In addition, PMI works with several other national and international partners, including the Roll Back Malaria Partnership; the Global Fund to Fight AIDS, Tuberculosis and Malaria; the World Bank Malaria Booster Program; UNICEF; World Health Organization’s Global Malaria Program; and nongovernmental organizations (NGOs), including faith-based and community groups, academia, and the private sector. PMI continues to expand its partnerships with the NGOs, faith-based organizations, and the private sector.

PMI works in close partnership with host country governments in Africa and builds on existing national strategies, plans, and programs to achieve PMI’s goal.

PMI’s $1.2 billion investment over 5 years complements other donors’ investments.

PMI Target Countries

PMI is now at work in 15 target countries:

• Beginning in FY 2006: Angola, Tanzania, and Uganda
• Beginning in FY 2007: Malawi, Mozambique, Rwanda, and Senegal
• Beginning in FY 2008: Benin, Ethiopia (Oromia region), Ghana, Kenya, Liberia, Madagascar, Mali, Zambia

PMI Interventions

PMI’s goal is to provide 85% of those especially vulnerable to malaria—pregnant women and children under 5 years—with the treatment and prevention interventions they need:

• Treatment of malaria cases with the new artemisinin-based combination therapies (ACTs)
• Personal protection and transmission reduction through insecticide-treated nets (ITNs) and indoor residual spraying (i.e., spraying the inside of homes with an approved insecticide)
• Intermittent preventive treatment of malaria for pregnant women

PMI’s Reach

This little girl received a free LLIN through the integrated campaign in Madagascar. Credit: Julie Thwing, CDC

As of January 2008, more than 30 million people in Africa have benefited from PMI interventions.

• IRS has been conducted in 10 PMI countries, benefiting more than 17 million people.
• PMI has procured and distributed 4.3 million long-lasting insecticide-treated mosquito nets (LLINs), supported retreatment of more than 1.1 million regular nets, procured more than 1.3 million tablets of sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria in pregnancy to reduce the impact of malaria in pregnancy, and procured 12.7 million treatment courses of highly effective ACTs, of which 7.4 million have already been distributed.
• PMI has trained more than 29,000 health workers in the correct use of ACTs.

Impact of Malaria Control Efforts

PMI has already reached millions of people with lifesaving services, and there is evidence that the scaled-up interventions made possible by the investments of PMI and its partners in support of the Ministries of Health are having an impact in several countries.

This sprayer covers the interior walls of a typical home in Zanzibar with ICON insecticide to kill mosquitoes that rest on the walls as part of an IRS program to reduce malaria transmission. Credit: Bob Wirtz, CDC

For example, during the past two years, Zanzibar’s Malaria Control Program, PMI, the Global Fund, and other partners supported a rapid scale-up of ITNs, IRS, and ACTs on the islands of Zanzibar, part of the United Republic of Tanzania.

• In July-August 2007, a survey of ten health facilities showed a greater than 90% decline in malaria infections in children under 2 years—from 22% in 2005 to 0.7% in 2007.

How Do CDC's Malaria and Entomology Branches Contribute to PMI?

As a public health agency with wide experience in malaria prevention and control, CDC brings to PMI strong and varied technical expertise that complements the contributions of other PMI partners.

Specialists in these branches:

• Work in collaboration with USAID to implement PMI activities; As of March 2008, CDC has a PMI Resident Advisor in seven PMI countries and plans to have advisors in all PMI countries by the end of 2008.


An Ethiopian girl stands behind the ITN that she will sleep under in the evening. Credit: Steve Smith, CDC

• Help design PMI technical and programmatic strategies, such as training and supervision of health workers, laboratory, communications, monitoring and evaluation, and surveillance systems.
• Develop plans, advise, and help conduct surveys to estimate the impact of malaria control and prevention efforts, including those supported by PMI.
• Develop and implement cutting-edge survey methods utilizing personal digital assistant (PDA) hand-held computers equipped with global positioning systems to conduct household surveys in remote villages.
• Provide overall entomologic support to PMI, including the evaluation of insecticidal efficacy of long-lasting ITNs and monitoring of the spread of insecticide resistance.
• Design and execute operations research activities to fill critical knowledge gaps and speed the scale-up of life-saving malaria control interventions.
• Evaluate the performance of health workers who treat patients with suspected malaria.

For more information on PMI, see PMI’s Web page and CDC’s PMI page.