Although eradicated almost 60 years ago in the United States, malaria remained a serious problem in 109 countries in 2008. Malaria is a disease caused by a parasite that is transmitted to a person through the bite of a particular mosquito. It can lead to fever, muscle aches, and, without effective treatment, sometimes death. Globally, an estimated 247 million people become ill due to malaria every year; of these, nearly 1 million die, mostly children younger than five years old. Approximately 40% of the world's population is at risk of malaria, but most cases and deaths are in sub-Saharan Africa. In the past decade, the U.S. government and international community have increasingly recognized malaria prevention, treatment, and control as a fundamental factor in community health and economic growth in developing countries. Many U.S. policymakers have, likewise, demonstrated a strong interest in combating malaria. In recent years, Congress has passed legislation that states that a major objective of the U.S. foreign assistance program is to provide aid for the prevention, control, and cure of malaria; required the development of a U.S. global malaria strategy; and appropriated increased funding for U.S. programs that fight the disease globally. This report provides background on malaria's cause, consequences, and impact as well as key interventions for its prevention, control, and treatment. It examines congressional activities related to global malaria, and then it describes U.S. programs through the U.S. Agency for International Development (USAID) and the Centers for Disease Control and Prevention (CDC) that address the disease internationally. It also raises possible issues for Congress related to U.S. funding levels, U.S. program priorities and strategies, access to and effectiveness of commodities, and oversight of U.S. programs. The incidence of malaria appears to correlate to many other factors affecting the health, economic development, and social well being of people and communities in many developing countries. 106-570 ) and the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (Leadership Act, P.L. 108-25 ). That year, President George W. Bush also proposed the President's Malaria Initiative (PMI), a five-year initiative to halve the number of malaria-related deaths in 15 sub-Saharan African countries by 2010, and pledged an additional $1.2 billion over the five years for U.S. global malaria programs through PMI. In 2008, Congress passed the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act (Lantos-Hyde Act, P.L. 110-293 ), which authorizes $5 billion from FY2009 through FY2013 for U.S. global malaria efforts. It also directs the U.S. President to develop a comprehensive, five-year U.S. government strategy to fight global malaria and authorizes the position of a Coordinator of U.S. Government Activities to Combat Malaria Globally (U.S. Global Malaria Coordinator at USAID oversees and coordinates all U.S. government activities to fight malaria globally, including U.S. global malaria efforts in not only the 15 PMI countries in sub-Saharan Africa but also in other countries and regions that are not part of PMI. PMI is led by USAID and implemented by USAID in conjunction with CDC. It also authorizes up to $2 billion for U.S. contributions to the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund) in FY2009 and such sums as may be necessary from FY2010 through FY2013. From FY2004 through FY2008, USAID and CDC received more than $915 million for U.S. efforts to fight global malaria ( Table 1 ). Of this, more than $484 million was directed to the President's Malaria Initiative from FY2005 through FY2008. For FY2009, Congress has appropriated $391.9 million for U.S. global malaria programs.
In 2008, malaria remained a serious problem in 109 countries, although it was eradicated almost 60 years ago in the United States. Malaria sickens an estimated 247 million people every year; of these, nearly 1 million die, mostly children younger than 5 years old. The disease is caused by a parasite that is transmitted to a person through the bite of a particular mosquito. Infection can lead to fever, muscle aches, and, without effective treatment, organ failure and sometimes death. Although approximately 40% of the world's population is at risk of malaria, most cases and deaths are in sub-Saharan Africa. In the past decade, the U.S. government and international community have increasingly recognized the impact of malaria prevention, treatment, and control on the health, economic development, and social well-being of people and communities in many developing countries.
U.S. policymakers have demonstrated a strong interest in combating malaria. In May 2003, Congress passed the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act (P.L. 108-25), which states, among other things, that a major objective of the U.S. foreign assistance program is to provide aid for the prevention, control, and cure of malaria, and authorizes funds to carry out these programs. In 2004-2006, congressional hearings on U.S. global efforts to combat malaria, especially those of the United States Agency for International Development (USAID), discussed USAID policies associated with purchasing and distributing commodities like antimalarial drugs and insecticides, providing technical assistance, and promoting program transparency, and questioned the U.S. strategy for fighting global malaria. In July 2008, Congress passed the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act (P.L. 110-293), which authorizes $5 billion from FY2009 through FY2013 for U.S. global malaria efforts. It also directs the President to develop a comprehensive, five-year U.S. government strategy to fight global malaria, and authorizes the position of the U.S. Global Malaria Coordinator to oversee and coordinate all U.S. government programs to fight malaria globally.
In June 2005, President George W. Bush announced the President's Malaria Initiative (PMI), a $1.2 billion, five-year initiative to reduce the number of malaria-related deaths in 15 sub-Saharan African countries by 50% by 2010. U.S. global malaria efforts include PMI, which is led by USAID and implemented in conjunction with the Centers for Disease Control and Prevention (CDC); other USAID malaria programs; and CDC's global malaria activities.
From FY2004 through FY2008, USAID and CDC received $915 million for U.S. global malaria programs, of which more than $484 million was directed to PMI. During this time, the U.S. government also contributed more than $3 billion to the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund), which funds malaria projects among other projects. For FY2009, Congress has appropriated $391.9 million for U.S. global malaria programs and $900 million for U.S. contributions to the Global Fund.
This report provides background on malaria's cause, consequences, and impact as well as ways to prevent, treat, and control it. The report discusses not only USAID malaria programs and CDC's Malaria Branch, but also efforts to coordinate these bilateral efforts with multilateral efforts. The report describes funding for U.S. efforts to fight malaria. Finally, it raises possible issues related to these efforts for the 111th Congress, such as U.S. malaria funding levels, U.S. program priorities and strategies, access to commodities, and oversight of U.S. programs.