Introduction
According to the World Health Organization (WHO) 2010 World Malaria Report, the estimated number of global malaria deaths has fallen from about 985,000 in 2000 to about 781,000 in 2009. Similar improvements were also documented in the 2010 United Nations Children’s Fund (UNICEF) Progress for Children report 2 and in a 2009 Lancet article, “Levels and trends in under-5 mortality, 1990–2008.”
In spite of this progress, malaria remains one of the major public health problems on the African continent, with about 80 percent of malaria deaths occurring in African children under ive years of age. Malaria also places a heavy burden on individual families and national health systems. In many African countries, 30 percent or more of outpatient visits and hospital admissions in children under ive are reported to be caused by malaria. Economists estimate that malaria accounts for approximately 40 percent of public health expenditures in some countries in Africa and causes an annual loss of $12 billion, or 1.3 percent of the continent’s gross domestic product. Because most malaria transmission occurs in rural areas, the greatest burden of the disease usually falls on families who have lower incomes and whose access to health care is most limited.
The President’s Malaria Initiative was launched in June 2005 by President George W. Bush with a vision of ive years of funding (iscal year [FY] 2006–2010). his represented a $1.265 billion expansion of USG resources to reduce the intolerable burden of malaria and help relieve poverty on the African continent. he goal of PMI was to reduce malaria-related deaths by 50 percent in 15 countries that have a high burden of malaria by expanding coverage of four highly efective malaria prevention and treatment measures to the most vulnerable populations—pregnant women and children under ive years of age.
PMI is a major component of the U.S. Government’s Global Health Initiative (GHI) announced by President Barack Obama in May 2009. he GHI builds on the commitment of the USG to address major global health concerns—including malaria, HIV/AIDS, tuberculosis, maternal and child health, nutrition, and neglected tropical diseases. Under the GHI, PMI is expanding its integration with maternal and child health and HIV/AIDS programs, strengthening partnerships, and continuing to build capacity in health systems.
With the Lantos-Hyde United States Leadership against HIV/AIDS, Tuberculosis, and Malaria Act and the launch of the GHI, PMI’s goal has been expanded to achieve Africa-wide impact by halving the burden of malaria in 70 percent of at-risk populations in subSaharan Africa, i.e., approximately 450 million residents (see map on page 10).