Malaria prevention and control are major foreign assistance objectives of the U.S. Government. In May 2009, President Barack Obama announced the Global Health Initiative (GHI), a six-year, 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 five-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 GHI, the goal of PMI was adjusted to reduce malaria-related mortality by 70% in the original 15 countries by the end of 2015. Programming of PMI activities follows the core principles of GHI: encouraging country ownership and investing in country-led plans and health systems; increasing impact and efficiency through strategic coordination and programmatic integration; strengthening and leveraging key partnerships, multilateral organizations, and private contributions; implementing a woman- and girl-centered approach; improving monitoring and evaluation; and promoting research and innovation. Angola was selected as one of the first three countries in PMI in June 2005. Given the almost three-decade-long civil war, which ended in 2002, implementation of large-scale malaria control activities in Angola has faced serious challenges. The country's health infrastructure was severely damaged during the war, and it is estimated that only about 40% of the population has access to government health facilities. Significant progress has been made in malaria control, with the decrease in malaria parasitemia falling from 21.1% in the 2006/7 Malaria Indicator Survey (MIS) to 13.5% in the 2011 MIS, a reduction of almost 40%. However, malaria continues to be a major health problem, accounting for an estimated 35% of the overall mortality in children under five years of age, 25% of maternal mortality, and 60% of hospital admissions for children under five years of age. Malaria transmission is highest in northern Angola, while the southern provinces have highly seasonal malaria. In February 2009, Angola signed a five-year, $78-million Round 7 malaria grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). Angola was also successful in a Global Fund Round 10 grant for malaria for $111 million. The grants were consolidated and after some delays, were signed on June 15, 2012. The United Nations Children's Fund and the World Health Organization have been major partners of the National Malaria Control Program (NMCP) in scaling up interventions. An effective partnership with ExxonMobil has resulted in donations of $4.5 million to the United States Agency for International Development (USAID) over the last seven years to further PMI and Government of the Republic of Angola's (GRA) efforts in the fight against malaria.