Malaria prevention and control are major foreign assistance objectives of the U.S. Government (USG). 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 (TB) programs. 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 the GHI, the goal of PMI was adjusted to reduce malaria-related mortality by 70% in the original 15 countries by the end of 2015. In mid-2011, Zimbabwe was selected to join the initial 15 PMI countries. Malaria is a major health problem in Zimbabwe with 50% of the population at risk, although its epidemiology varies in the different regions of the country, ranging from year-round transmission in the lowland areas to epidemic-prone areas in the highlands. The WHO estimates that there are more than 400,000 malaria cases among all age groups each year. Zimbabwe's Malaria Strategic Plan does not call for the implementation of all interventions in all malarious districts; hence the targeted number of districts varies by intervention, as detailed below. Zimbabwe has seen robust declines in transmission and disease burden. Today, malaria is the 5th leading cause of morbidity (compared to 2nd leading cause at the start of the implementation period). In 2013, incidence was reported at 29 per 1,000 (down from 58 per 1,000 in 2009); 351 malaria deaths were recorded (down from 375 deaths in 2009). Zimbabwe's malaria program receives support from two major donors, the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and PMI. The United States Agency for International Development (USAID) provided targeted support to Zimbabwe's National Malaria Control Program (NMCP) through an emergency round of indoor residual spraying (IRS) in 2009 and in 2011 with a procurement of malaria commodities. Prior to 2011, other malaria donors included the United Nations Children's Fund (UNICEF), the United Kingdom Department for International Development (DfID), and the European Commission. However, these European donors have shifted their funds to a new multi-donor fund designed to strengthen health systems in Zimbabwe, the Health Transition Fund. The Health Transition Fund is operating from 2011-2015 and aims to improve access to all types of quality health care for Zimbabweans and to harmonize donor support, practices, and requirements.