Greater Mekong Subregion

Malaria prevention and control are major foreign assistance objectives 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 and tuberculosis. 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 2008 Lantos-Hyde Act, funding for PMI was extended and, as part of the GHI, the goal of PMI was adjusted to reduce malaria-related mortality by 70% in the original 15 countries by the end of 2015. In addition, PMI will work to limit the spread of antimalarial drug resistance in two United States Agency for International Development (USAID)-supported regional programs, the Mekong Regional Initiative in six Southeast Asian countries and the Amazon Malaria Initiative in seven South American countries. In line with the USG Lantos-Hyde Malaria Strategy, PMI support extends to the Greater Mekong Subregion (GMS), which is made up of six countries: Burma, Cambodia, China (Yunnan Province), Lao People's Democratic Republic, Thailand, and Vietnam. Although considerable progress has been made in malaria control in the GMS during the past 10 years, malaria remains a major concern for the international community, ministries of health, and the people of the region. This is due primarily to the development and possible spread of resistance to artemisinin drugs, the principal component of the combination therapies for malaria that now are the first-line treatment for malaria throughout the GMS and the world. Plasmodium falciparum resistance to artemisinin drugs has now been confirmed in western Cambodia; failures in artemisinin-based combination therapy (ACT) have been reported from multiple sites on the Thai-Cambodian border; and an early warning sign of artemisinin resistance - prolongation of parasite clearance times - has been reported from the Thailand-Burma and Burma-China borders and in southern Vietnam. The USG has supported malaria control efforts in the GMS since 2000. These regional efforts have focused on antimalarial drug resistance monitoring and drug quality surveillance. All GMS countries have received Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund) support. The other major source of funding for artemisinin resistance containment in Burma is the multi-donor initiative, Three Millennium Development Goal Fund, formerly known as the Three Diseases Fund. In addition, Global Fund has launched a 3-year $100 million Regional Artemisinin Initiative to reduce malaria transmission and respond to resistance in GMS countries.