Elsevier

The Lancet

Volume 368, Issue 9529, 1–7 July 2006, Page 1
The Lancet

Editorial
The US President's Malaria Initiative

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    This stark reduction observed across the whole country is probably a result of the implementation of the President's Malaria Initiative (PMI). Since 2005, this initiative employed an integrated approach, emphasising prevention through ITNs nets, IRS, and prevention of malaria in pregnancy at a national scale (USAID, 2006). Studies investigating the impact of these interventions have found they are highly effective in reducing malaria burden (Bonner et al., 2011; Masanja et al., 2012; West et al., 2014).

  • The uncertain burden of Plasmodium falciparum epidemics in Africa

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    For Africa, this is evident at the continental level but it is especially apparent at national level (Figure 1), where the design of more-specific policy measures is required. The current lack of credible burden data is particularly unfortunate given recent initiatives in some countries to strengthen disease surveillance or early warning systems for epidemics [34,35] and/or to reintroduce malaria prevention strategies in epidemic-prone areas [36]. In the absence of accurate data on burden, evidence-based planning of malaria control and rational targeting of epidemic prevention and control measures are difficult to achieve and the basis for evaluating the cost effectiveness of such measures is limited.

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    In 2007, my colleagues and I outlined a biological rationale1 for universal coverage with insecticide-treated nets (ITNs) that was rapidly adopted as global policy.2 Specifically, we developed behaviourally explicit mathematical models of malaria transmission and control to illustrate why the personal protection provided by ITNs is insufficient, and challenged the global strategy of selectively targeting these nets to vulnerable young children and pregnant women.1,3–6 Instead, we outlined why even imperfect coverage of all age groups, regardless of their malaria risk status, is essential to achieve community-wide protection of net users and non-users alike by killing vector populations en masse.1

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