The President’s Malaria Initiative (PMI)
Malaria prevention and control is a major U.S. foreign assistance objective, and PMI’s strategy fully aligns with the U.S. Government’s vision of ending preventable child and maternal deaths and ending extreme poverty. Under the PMI Strategy for 2015–2020, the U.S. Government’s goal is to work with PMI-supported countries and partners to further reduce malaria deaths and substantially decrease malaria morbidity toward the long-term goal of elimination.
After years of economic crisis marked by high inflation and resource shortages, Zimbabwe and its economy seem to be stabilizing. There are approximately 1,500 primary health facilities in the country, each linked to a Ward Health Team (WHT) comprising community members. The health facility staff is responsible for overseeing program implementation in conjunction with the WHT.
Malaria is a major health problem in Zimbabwe with almost half of the population at risk. Its epidemiology varies greatly in the different regions of the country, ranging from year-round transmission in the lowland areas to endemic-prone areas in the highlands. Transmission is seasonal and occurs primarily between November and April, correlating closely with rainfall. Approximately 86 percent of all malaria cases and 60 percent of all malaria deaths in 2013 originated from three provinces: Manicaland, Mashonaland East, and Mashonaland Central, with 51 percent of all cases and 35 percent of all deaths coming from Manicaland. Plasmodium falciparum is the main source of infection.
Zimbabwe has seen impressive declines in transmission and disease burden. As malaria prevalence declines, a number of districts are shifting from control to pre-elimination activities. Though malaria incidence in Zimbabwe appears to be decreasing overall, it remains a major challenge in certain provinces, districts, and wards. Recent PMI-supported activities include: insecticide-treated net (ITN) distribution in 47 districts with moderate to high malaria transmission and free routine distribution through antenatal care and immunization clinics; comprehensive indoor residual spraying (IRS) support of four high burden districts of Manicaland Province; procurement of intermittent preventive treatment for pregnant women (IPTp) treatments; extension of the National Malaria Communication Strategy; and capacity building through the Field Epidemiology Training Program, designed to train leaders in applied epidemiology.