MIN/Sp/AU/CAMH3/6 Malaria Page 19 Namibia, South Africa, Swaziland and Zimbabwe IRS is routinely applied to prevent and control malaria epidemics. In Equatorial Guinea, Mozambique, Sao Tome & Principe, Tanzania (Zanzibar Island) and Zambia IRS is applied mainly in stable malaria transmission areas. With the exception of in Equatorial Guinea, some places in Ethiopia, Lubombo Spatial Development Initiative (LSDI) and Zanzibar Island IRS campaigns are conducted once a year. In Ghana, a mining company has introduced IRS to protect a whole municipality where its staff lives. In the 2006-2007 malaria season a total of about 5 million units/structures were sprayed using different groups of insecticides. Average operational coverage 10 in target areas was 83% ranging from 16% in Kenya to 98% in Madagascar. A total of about 21 million people were protected as shown in table 2. Reduction in malaria cases and deaths in countries deploying IRS has been documented in Botswana, Equatorial Guinea, Eritrea, Madagascar (in the IRS targeted areas), Mauritius, South Africa, Swaziland and Tanzania (Zanzibar), where the IRS programs are generally adequately resourced technically and financially. Although there is a renewed interest in scaling up IRS even in highly endemic areas in Africa, there are several challenges to overcome before full scale up. In most of the countries that have just adopted IRS, there is limited technical capacity for effective and efficient management of IRS programmes. Clearly if the African region is to go to scale with IRS considerable and sustained investments will be needed. 10 Number of structure actually sprayed in comparison to the number that was planned to be sprayed Status Report on Malaria in Africa 2008