Malaria Control in Papua New Guinea: Scaling up for Impact 1. Background and Summary:    Malaria is one of the major causes of illness and death in Papua New Guinea (PNG). Vulnerable populations of children under 5, pregnant women and HIV positive people inequitably carry this burden. PNG has a complicated malaria profile with both falciparum and vivax malaria as major problems and malariae and ovale playing a minor role. Areas of hyperendemic, endemic and epidemic malaria exist in PNG. In recognition of this, the Government of Papua New Guinea has declared malaria one of the 5 public health strategic directions for attention. However, the level of resources required to implement the required response to this public health priority have not been achieved. To complicate the situation, drug resistance to first line treatment regimens for malaria has increased to such levels that the country must now roll-out a new ACT based malaria first line treatment protocol.   Based on the achievements gained through the universal bed net coverage program of the last 4 years supported through the Global Fund in Round 3, the Government of Papua New Guinea, the Rotary Club of Port Moresby Inc. (RAM) and other development partners, the CCM has developed a further program for Round 8 funding to scale up the successful universal bed net program, already impacting upon malaria incidence, severe malaria morbidity rates and supporting positive behavior change in the broader population of Papua New Guinea. The program also focuses on the need to introduce nationally the new malaria treatment protocol  and to improve the quality of preventive, diagnostic and treatment skills in the public health workforce for recognition and management of fevers in children (through integrated management of childhood illnesses IMCI), pregnant women (through essential obstetric package of care), HIV positive people (through integrated management of adult illnesses IMAI) and adults in general, thereby maximizing the synergies between broader primary health care programs (and support of the Global Fund and other development partners) and the management of vector borne diseases. The proposal, based upon the recently developed Draft National malaria control program, also supports systems strengthening in laboratory diagnosis, from rural health facilities to the Central Public Health Laboratory CPHL, and quality assurance for malaria, other vector borne illnesses, TB , STIs and HIV; improving the capacity to provide in-service training in national and regional health training facilities, and broadening the successful partnerships for the health sector through Faith-based organizations (FBOs), Community Supported Organizations CSOs, Non-governmental organizations (NGOs) and the private sector, providing capacity building of these partners for future outsourcing roles in the sector; and major focus on sustainable in-country capacity development for effective behavior change communications for health.   Objectives:  • Strengthen political commitment for malaria control in PNG • Maximize access to prompt quality malaria diagnosis and appropriate treatment for malaria • Improve vector control measures • Improve knowledge, behavior and participation of communities and individuals in the national malaria control effort; and • Strengthen technical and administrative management capacity for malaria control.   Three principal recipients have been identified through a transparent and competitive process, informed of the Global Fund and Government of Papua New Guinea guidelines, to implement this program namely, the Department of Health of the Government of Papua New Guinea (NDoH), Population Services International (PSI), and the Rotary Club of Port Moresby Inc (RAM). Key sub-recipients have also been identified to support the implementation: Divine Word University in Madang (DWU) and the PNG Institute of Medical Research (IMR). Several other partners have expressed their interest, and will be involved in implementing the program, including th