Zimbabwe New Global Fund Grant Launch Rainbow Towers - Harare 17 January 2018 Rainbow Towers - Harare

PMI Strategy 2015 - 2020 Vision A world without malaria Goal Work with PMI-supported countries and partners to further reduce malaria deaths and substantially decrease malaria morbidity towards the long-term goal of elimination PMI is guided by the current PMI Strategy 2015-2020. PMI continues to share the global long-term vision of a world without malaria and remains committed to working with PMI-supported countries and partners to further reduce mortality from malaria and to substantially decrease malaria morbidity. For those countries who have had success in reducing morbidity and have appropriately shifted their strategies towards national or sub-national elimination, PMI will support those countries toward achieving those goals.

PMI’s Five Strategic Areas of Focus Build on PMI successes to date and address challenges Achieving and sustaining scale of proven interventions Adapting to new epidemiology and incorporating new tools Improving country capacity to collect and use information Mitigating risks against the current malaria control gains Building capacity and health systems The 2015 – 2020 strategy is organized around five strategic areas of focus. In order to achieve the targets we are setting forth, PMI will focus its support to countries in the five key areas shown on this slide.

PMI Country Funding: 2005 – 2016 in USD, millions Greater Mekong Subregion PMI was launched with a vision to rapidly increase funding in the initial years to reach the original goal of 15 PMI countries. Further increases to now sustained levels have allowed PMI to expand beyond the original planned 15 countries. PMI now supports programs in 22 countries in SS Africa and the Greater Mekong Subregion. The FY17 budget appropriation for the US Federal Government is anticipated to be completed by Congress in April 2017. PMI remains ready to continue to partner with PMI countries to continue implementation of critically important malaria efforts together. To tailor by country: [Country] has received a total of over $[X million] since FY [XXXX] with an average annual budget of $[X million]. 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 President Bush launches PMI PMI begins operations Lantos/ Hyde Act Launch of U.S. Government Malaria Strategy 22 countries in Africa & Greater Mekong Subregion receiving PMI support Launch of PMI strategy (2015-2020)

Continued Commitment to Current PMI Focus Countries Angola Benin DRC Ethiopia Ghana Guinea Kenya Liberia Madagascar Malawi Mali Mozambique Nigeria Rwanda Senegal Tanzania Uganda Zambia Zimbabwe PMI currently has programs in 19 focus countries in sub-Saharan Africa as well as two countries (Burma and Cambodia) and a regional program in the Greater Mekong Subregion. Burma Cambodia Thailand regional program

The Strategy Builds on Progress from 2000-2015 The momentum exists because we – as a malaria control community – have demonstrated that it is possible to reduce the scourge of malaria. In fact, progress in combatting malaria over the past 10-15 years represents one of the greatest success stories in the history of public health. You have likely seen this, but in case not, this graph from the most recent World Malaria Report illustrates declines in malaria incidence and death rates from 2000 to 2015. It is estimated that 6.2 million malaria deaths were averted between this period. Malaria is no longer the leading cause of death in children under five in Africa. WHO estimates that 6.2 million malaria deaths were averted between 2001-2015 The estimated malaria mortality rate fell by 60% worldwide (66% in SSA) in all ages and by 65% worldwide (71% in SSA) in children under 5 years of age

Evidence of Dramatic Progress in PMI Focus Countries Reductions in ACCM of children under five years of age In eighteen PMI focus countries, we have seen impressive reductions in all cause child mortality, ranging from 8% in Benin to 67% in Rwanda. It is critical that we continue to work together to achieve and demonstrate progress in coverage of malaria interventions and document their impact. It is our ability to demonstrate progress and impact on malaria that will ensure ongoing support for PMI funding by Congress and the Administration. Source: Nationwide household surveys

Evidence of Dramatic Progress in PMI Focus Countries Improvements in percentage of reported malaria cases confirmed by diagnostic test The proportion of suspected malaria cases that are confirmed with laboratory tests and treated with a recommended antimalarial drug combination continues to increase in nearly all focus countries, with 15 countries reaching over 60 percent confirmation of malaria cases by diagnostic test, 10 of which exceed 80 percent confirmation. [Note: Countries included on this slide are those for which there is data from at least 2012. Data sources: DHIS2/HMIS, implementing partners, NMCPs, and MOPs.] Sources: DHIS2/HMIS, implementing partners, NMCPs, MOPs

Stay Focused: Our model serves us well A foundation of PMI’s approach is support to countries for scale up of proven, evidenced-based interventions (e.g. LLINs, IPTp, diagnosis and treatment with ACTs, and SMC in parts of West Africa) PMI will continue routine reviews of country budgets and pipelines and activity implementation progress, to ensure efficient and effective use of PMI resources PMI continues to focus support on those interventions that are proven effective (ITNs, IRS, case management, and IPTp) – with the recent addition of SMC in West Africa. PMI incorporates new tools into PMI country program implementation support following their global technical recommendation from WHO Global Malaria Programme. A hallmark of PMI’s success is our careful review of budgets and pipelines, making adjustments as necessary. Ensuring continued efficient use of resources remains critical and remains of interest to the US Congress.

USG Support to National Malaria Programs – Through PMI and USG Contribution to the Global Fund The USG, through PMI and the USG contribution to the Global Fund, provides approximately 50% of the resources for malaria control to endemic countries worldwide The USG expects investments in PMI and Global Fund to be well-coordinated and synergetic, in order to maximize impact and achieve value for money Therefore, PMI will continue to partner with NMCPs and the Global Fund to ensure that resources are programmed in a complementary manner PMI leadership expects PMI and Global Fund-financed programs to be closely interlinked in all PMI focus countries. PMI will continue to partner with NMCPs and the Global Fund to ensure that resources are programmed in a coordinated and complementary fashion to maximize the impact on the malaria burden at the country and global levels. Because the Global Fund does not have in-country technical staff, PMI has played a leading role in providing interagency malaria expertise to help coordinate and advise on planning, implementation, and evaluation of malaria activities. This has been especially critical in the area of commodities; in order to accurately forecast commodity needs, transparent accounting of commodities from all partners is needed.

President’s Malaria Initiative Zimbabwe Accomplishments and FY2017 / FY2018 Malaria Operational Plans

Malaria Trends in PMI-Supported IRS Districts, 2014-2016

PMI Funding in Zimbabwe

Planned Future Funding FY 2017 MOP 15 million USD Implementation October 2017 to September 2018 FY 2018 MOP 13.5 million USD (conservative planning budget) Implementation October 2018 to September 2019

FY2017 & FY18 Planned Activities Vector Control - Entomology Entomological surveillance and monitoring Laboratory capacity building Entomological supplies FY 2018 - $449,000

FY2017 & FY18 Planned Activities Vector Control - IRS IRS with OPs and full package of support in 4 districts in Manicaland Environmental compliance assessment FY 2018 - $4,533,687 IRS and full package of support in selected districts based on NMCP insecticide resistance management planning

FY2017 & FY18 Planned Activities Vector Control - LLINs Procurement and distribution of approximately 800,000 LLINs through routine distribution ITN durability monitoring FY 2018 - $2,700,000 Procurement and distribution of approximately 700,000 LLINs through routine distribution

FY2017 & FY18 Planned Activities Malaria in Pregnancy Procure approximately 870,000 SP treatments Procure approximately 3,300 clindamycin doses FY 2018 - $172,000

FY2017 & FY18 Planned Activities Case Management Procure approximately 500,000 RDTs Procure malaria diagnostic supplies Training and supervision of HCWs and VHWs and launching mentorship pilot Strengthen malaria diagnostic capacity FY 2018 - $2,035,313 Procure approximately 615,000 RDTs Procure approximately 310,000 ACTs Training and supervision of HCWs and VHWs

FY2017 & FY18 Planned Activities Pharmaceutical Management Support for ZAPS and supply chain strengthening FY 2018 - $900,000

FY2017 & FY18 Planned Activities SBCC Support malaria SBCC activities FY 2018 - $400,000

FY2017 & FY18 Planned Activities SM&E End use verification exercises Epidemic investigation and response Support and facilitate SM&E activities Supervision and quality assurance for SM&E FY 2018 - $610,000

FY2017 & FY18 Planned Activities Pre-elimination Support for pre-elimination activities through activities already described (e.g. commodity distribution, SBCC, SM&E) FY 2018 - $100,000 Reactive case detection and foci investigation

Collaborate to Overcome Challenges PMI is committed to collaboration and understanding: where we are not making the progress we expect program bottlenecks and working together to tackle them A key component of PMI’s commitment to achieving results is an honest commitment to working with partner countries to understand and then tackle challenges and bottlenecks that impede progress and desired results.

Thank You! Questions?