President’s Malaria Initiative
Malaria in Rwanda
The entire population of Rwanda is at risk for malaria, of which an estimated 1.55 million are children under five and 390,000 are pregnant women. Malaria is the leading cause of death among Rwandan children under the age of five. In 2004, 54 percent of hospital cases and 53 percent of the deaths due to malaria occurred among children under five. In 2005, the number of episodes of uncomplicated malaria treated in public sector health facilities was 1.5 million.
Response
The U.S. President’s Malaria Initiative (PMI) was launched in 2005 with the goal of reducing malaria-related mortality by 50 percent in target countries by reaching 85 percent of the most vulnerable groups – principally pregnant women, children under five years of age, and people living with HIV/AIDS – with lifesaving services, supplies and medicines.
PMI began implementation in Rwanda in December 2006. In support of Rwanda’s national malaria control program and in coordination with all development partners, including nongovernmental organizations, faith-based organizations, and the private sector, PMI backs four key intervention strategies to prevent and treat malaria:
- Indoor residual spraying (IRS);
- Insecticide-treated bed nets (ITNs);
- Prompt and effective case management with artemisinin-based combination therapies (ACTs); and
- Prevention of malaria in pregnant women with intermittent preventive treatment (IPT).
In Fiscal Year (FY) 2007, PMI provided $20 million to Rwanda to support the Government of Rwanda’s malaria prevention and treatment goals. In FY 2008, PMI plans to provide approximately $17 million.
PMI/Rwanda is led by the U.S. Agency for International Development (USAID) in collaboration with the Centers for Disease Control and Prevention (CDC).
Results
Indoor Residual Spraying
As of October 2007, over 160,000 houses were sprayed in three districts (Gasabo, Kicukiro and Nyarugenge) and more than 700,000 people are now protected from malaria. Spraying is expected to expand in rural Rwanda in 2008.
Insecticide-Treated Bed Nets
In September 2006, the Government of Rwanda distributed nearly 1.4 million free nets to children under five through an integrated measles/ITN campaign. The U.S. Government provided financial support to the distribution and follow-up activities. In early 2008, PMI is procuring 550,000 long-lasting nets that will be distributed to the poorest of the poor households in Rwanda.
Case Management
PMI works with the Government of Rwanda, private sector and implementing partners to provide lifesaving drugs. Over 71,000 treatments of injectable artemether have been procured and distributed to health facilities for treatment of severe malaria. A total of 715,000 ACT treatments were procured, repackaged and available for distribution to trained community health workers. PMI also supports the training of community health workers and implementation of home-based management of fever in 10 districts.
Prevention of Malaria in Pregnancy
In order to prevent malaria in pregnant women, 550,000 doses of sulfadoxine-pyrimethamine (SP) have been procured and distributed to all health facilities nationwide. PMI also supported national and district level training for integrated antenatal health services which includes intermittent preventive treatment, provision of nets and promoting early antenatal care visits.
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