MIN/Sp/AU/CAMH3/6 Malaria Page 2 All countries except 2 have adopted ACTs as 1st line treatment for malaria, with 25 already implementing the policy. Across the region, 34% of children with fever received an anti-malarial treatment. However, in the Gambia (52%), Tanzania (51%), Ghana (48%) and Sierra Leone (45%) received anti-malarial treatment within 24 hours mostly with chloroquine which is no longer effective. Use of ACT is very low; in some 14 countries with 2005-7 data, the median proportion of children under five years with fever receiving an ACT was only 2%. By end of 2007, 25 out of the 42 malaria endemic countries in the region had included IRS in their national strategy. Of these, 17 routinely implement IRS as a major malaria control intervention while six are piloting IRS in a few districts. In the 2006-2007 malaria season a total of about 5 million units/structures were sprayed with an operational coverage in target areas of about was 83% protecting about 21 million people. Several initiatives to increase access to malaria control commodities have emerged. The Affordable Medicines facility for Malaria (AMFm) was established to bring down the cost of ACTs and help phase out the monotherapies to avoid the development of resistance. The Global RBM partnership was established in 1998. Consequently, all countries in the African region have established partnerships at the country level. Also, sub-regional RBM partnerships networks (SRNs) have been established that bring together all key partners in the sub-region to consolidate support for malaria control in the respective countries. Since 2000, 25 April has been commemorated as Africa Malaria Day. Regional events have been held across the sub-region and nationally. The commemoration of Africa Malaria day has firmly place malaria on top of the agenda in many countries. In 2007, 25 April was also declared World Malaria Day and the 1st anniversary of the World Malaria was marked on 25 April 2008 with the theme “A Disease Without Borders”. Data from over 25 household surveys conducted in 2005-2007 has been used to compile this report. All the countries in the sub-region have functional HMIS although interpretation of the trends in malaria cases and deaths is difficult due to incomplete reports, non-standardized reporting and reliance mostly on clinical diagnosis. However, in selected countries that have scaled up interventions but also have more consistent and complete data, such as Eritrea, Kenya, Rwanda, Sao Tome and Principe, South Africa, Swaziland and Zanzibar Island in the United Republic of Tanzania, there have been reductions in malaria cases and deaths at health facility level. Most countries in Africa are moving towards universal access to malaria prevention and control among all at risk of malaria. Malaria Elimination has been discussed in several AU sessions but much needs to be done before many countries are ready for malaria elimination and subsequently, eventual eradication. Member states have made moderate progress towards achieving targets set at the Abuja 2000, 2001 and 2006 and by RBM Partnership and the MDGs. Great political Status Report on Malaria in Africa 2008