Malaria prevention and control is a major foreign assistance objective of the U.S. Government (USG). In May 2009, President Barack Obama announced the Global Health Initiative (GHI), a comprehensive effort to reduce the burden of disease and promote healthy communities and families around the world. Through the GHI, the United States will help partner countries improve health outcomes, with a particular focus on improving the health of women, newborns and children.
The President's Malaria Initiative (PMI) is a core component of the GHI, along with HIV/AIDS, tuberculosis, maternal and child health, and nutrition. PMI was launched in June 2005 as a 5-year, $1.2 billion initiative to rapidly scale up malaria prevention and treatment interventions and reduce malaria-related mortality by 50% in 15 high-burden countries in sub-Saharan Africa. With passage of the Lantos-Hyde Act, the PMI goal was adjusted to halve the burden of malaria in 70 percent of the at-risk populations of sub-Saharan Africa, thereby removing malaria as a major public health problem and one of the two objectives for sub-Saharan Africa is to reduce malaria-related mortality by 70% in the original 15 countries by the end of 2015, of which Uganda is one.
Malaria is Uganda's leading cause of morbidity and mortality. According to the Ministry of Health (MOH), malaria accounts for 25-40% of outpatient visits to health facilities and is responsible for nearly half of inpatient pediatric deaths. Results of the 2011 Demographic and Health Survey (DHS) show an improvement over the 2009 Malaria Indicator Survey (MIS) with 60% of households nationwide owning at least one insecticide-treated net (ITN); 47% of pregnant women and 43% of children under five having slept under an ITN the night before the survey. In addition, the DHS shows that 43% of children under five had been treated with an antimalarial drug on the same day or the next day after the onset of fever, while the proportion receiving an artemisinin-based combination therapy (ACT) was 30%. However, the UDHS report shows a decline in women receiving intermittent preventive treatment during pregnancy (IPTp) from 32% to 25%.
Alongside the efforts of the Government of Uganda, PMI, the Global Fund and the United Kingdom's Department for International Development (DFID) are the three main contributors to malaria control in Uganda, with additional support from a range of other donors. Uganda has three active grants from the Global Fund: Round 7 Phase 2 which will provide an additional 15.5 million ITNs to achieve universal coverage; Round 10 Phase 1 and 2 will cover approximately 45 million ACT treatments, 6.7 million ITNs and 45 million rapid diagnostic tests (RDTs) through 2016. In calendar year 2013, DFID in collaboration with PMI Uganda, will provide 5 million ITNs to contribute to the universal coverage campaign planned for later in the year. World Vision is providing additional 500,000 ITNs.
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