Compassion Spotlight
	In 2005, President Bush pledged to increase U.S. funding by more than $1.2 billion over 5 years to reduce malaria-related deaths by 50% in 15 African countries. The President’s Malaria Initiative has reached more than 25 million Africans with lifesaving prevention and treatment services. In Uganda, between 2006 and 2007, there was a 58% reduction in individuals testing positive for malaria. Between 2005 and 2007, following aggressive multipartner efforts on the island of Zanzibar, there was greater than 90% decline in children under age 2 testing positive for Malaria.

The Need
The Response

The Need

• Malaria, a blood-borne infection transmitted to human beings by mosquito bite, is typically found in tropical and subtropical regions of the world, particularly Sub-Saharan Africa, where the mosquito and the malaria parasite thrive.
• Each year between 300 million and 500 million people worldwide become ill with malaria; more than 1 million die from this disease.
• While all persons living in areas where malaria is transmitted can be infected, three populations are particularly vulnerable: children under 5 years of age, pregnant women, and people with HIV/AIDS.
• Although malaria is preventable and treatable, every 30 seconds an African child dies of this disease.
• Malaria accounts for approximately 40% of public health expenditures in Africa and causes an annual loss of $12 billion—1.3% of Africa’s gross domestic product.

The Response

In June 2005, President Bush launched the President’s Malaria Initiative (PMI), pledging to increase U.S. malaria funding by more than $1.2 billion over 5 years to reduce malaria-related deaths by 50% in 15 African countries. He also challenged other donor countries, private foundations, and corporations to help reduce the suffering and death caused by this disease.

The PMI aims to reach 85% of the most vulnerable groups using proven and cost-effective prevention and treatment measures:

• insecticide-treated mosquito nets (ITNs),
• indoor residual spraying (IRS) of insecticides,
• intermittent preventive treatment for pregnant women (IPTp), and
• prompt use of artemisinin-based combination therapies (ACTs) for people with malaria.

The PMI focuses on 15 African countries with a high burden of malaria. The program is being phased in over 3 years:

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

The PMI assists National Malaria Control Programs (NMCPs) in each target country to achieve the overall program goals. In the 15 target countries, the PMI also coordinates with other national and international partners, including the Global Fund, UNICEF, and the World Bank.

The PMI’s ambitious objectives can best be achieved through close partnerships with civil organizations, such as nongovernmental organizations (NGOs) and FBCOs, that are uniquely placed to deliver services in remote areas and offer a high degree of community credibility. These organizations make up more than 75% of PMI partners.

These partnerships have helped PMI realize significant results in target countries.

• More than 17 million people have benefited from indoor residual spraying (IRS) in 10 PMI countries.
• 12.7 million treatment courses of highly effective antimalarials (known as artemisinin-based combination therapies, or ACTs) have been procured, of which 7.4 million have already been distributed to health facilities. The PMI has trained more than 29,000 health workers in the correct use of ACTs.
• More than 1.35 million treatments for of sulfadoxine-pyrimethamine for intermittent preventive treatment have been procured to reduce the impact of malaria in pregnancy. The PMI has also provided training for more than 5,000 health workers on how to administer these treatments correctly.
• The PMI has built the capacity of NMCPs in the areas of pharmaceutical management, diagnosis, IRS, malaria in pregnancy, and monitoring and evaluation.
• In more than half of the PMI countries, at least 70% of households in malaria-endemic areas will own an ITN and more than 70% of public health facilities will have ACTs available by December 2008.

Results for Tanzania and Uganda highlight the impact of PMI for target counties.

Tanzania—In 2007, the PMI worked with the NMCP to launch IRS in Muleba District in northwest Tanzania, an area with highly seasonal malaria transmission. There was a 37% reduction in patients of all ages who tested positive for malaria during the peak transmission season when compared with previous years, and a 70% reduction in severe anemia, to which malaria is a major contributing factor.   In July–August 2007, a survey of 10 health facilities showed a greater than 90% decline in children under 2 years old testing positive for malaria: from 22% in 2005 to 0.7% in 2007.

Uganda—The PMI and the NMCP supported an IRS campaign in Kanungu District, Uganda, during February–March 2007. Data collected from the Kihihi Health Center showed a 58% relative reduction in individuals testing positive for malaria in August–October 2006 compared with the same period in 2007.

To highlight this work, President and Mrs. Bush hosted the White House Summit on Malaria in December 2006. The Summit brought together international experts, corporations, foundations, African civic leaders, and FBCOs to raise awareness of malaria and to mobilize community-level efforts to save millions of lives in Africa.

At the Summit, First Lady Laura Bush announced the $30 million Malaria Communities Program (MCP), which supports the efforts of communities and indigenous organizations to combat malaria in Africa. The MCP will identify and enable FBCOs to become new partners in the effort to extend malaria prevention and control activities to reach a larger proportion of those most affected by malaria, particularly children under age 5 years and pregnant women. MCP is designed to

• identify and support potential partner organizations and networks of FBCOs uniquely positioned to work at the community level in the PMI focus countries,
• increase local and indigenous capacity to undertake community-based malaria prevention and treatment activities,
• build local ownership of malaria control for the long term in partnership with communities and NMCPs, and
• extend coverage of the PMI and NMCP’s efforts to reach a larger beneficiary population with malaria prevention and control interventions.