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PMI Evolve: Evolving Vector Control to Fight Malaria


  • Malaria caused an estimated 608,000 deaths globally in 2022, with an estimated 249 million cases worldwide; African countries are hardest hit.
  • Indoor residual spraying and insecticide-treated nets help reduce the malaria burden.
  • Entomological surveillance is critical to understanding the challenges that undermine sustained progress in the fight against
The Challenge

The World Health Organization estimates that about 608,000 people died from malaria in 2022, a slight decrease from the prior year, but still higher than before the onset of the global COVID-19 pandemic. Young children and pregnant women are among the most vulnerable to the disease, especially in Africa, which accounts for 96% of malaria deaths and 95% of illnesses.

Before the pandemic, investments in malaria vector control interventions by the U.S. President’s Malaria Initiative (PMI), the Global Fund, and country governments had resulted in major reductions in morbidity and mortality. However, progress has slowed since 2020, and new threats are emerging. These include mosquitoes’ increasing resistance to the insecticides used in vector control measures, the spread of the invasive Anopheles stephensi mosquito within Africa, and climate changes that affect the geographical range, intensity, and seasonality of all vector-borne diseases.

The Approach

Since 2006, PMI has protected millions of people in sub-Saharan Africa from malaria through three vector control initiatives. Indoor residual spraying (IRS) sprays insecticide on walls, ceilings, and other indoor resting places to kill mosquitoes that transmit malaria. Insecticide-treated bed nets (ITNs) protect people as they sleep. And entomological monitoring helps countries monitor, adapt, and respond to changes in mosquito populations, including their resistance to insecticides. Abt Global has contributed to this work since 2011 by leading the Africa Indoor Residual Spraying (AIRS), PMI AIRS, and PMI VectorLink projects.

In December 2022, PMI awarded Abt the PMI Evolve Project, which supports PMI and U.S. Agency for International Development (USAID) missions and bureaus with the planning, implementing, and monitoring of malaria vector control programs in 21 countries. PMI Evolve is building on the prior projects’ IRS, ITN, and larval source management (LSM) activities and entomological monitoring. The new project is strengthening the capacity of local institutions, including national malaria programs, district health offices, and research institutions, to independently conduct vector control programs. PMI Evolve is also responsible for program evaluation and conducting operations research on new vector control innovations. The project is incorporating gender equity and social inclusion (GESI) and climate change initiatives as cross-cutting themes with the overall goal of ending malaria faster.

The Abt-led consortium of implementing partners includes:  BAO Systems, Dimagi, EnCompass, Health Information Systems Program (HISP) Centre at the University of Oslo (UiO) and its affiliates in West and Central Africa and Uganda, PATH, Population Services International (PSI), Tropical Health, and University of California, San Francisco (UCSF), Malaria Elimination Initiative (MEI). The project also is engaging regional partners to lead capacity-strengthening and localization efforts for entomological monitoring.

The Results

In its first year, PMI Evolve conducted IRS campaigns in four countries—Madagascar, Malawi, Rwanda, and Zambia—protecting 4.8 million people from malaria; and distributed 2.7 million ITNs in Zambia, protecting 5.4 million people, while supporting the country’s nationwide ITN campaign that distributed more than 11.5 million ITNs. The project also worked with national malaria programs (NMPs) to support school-based distribution of ITNs in Ghana, Senegal, and Sierra Leone, and routine distribution of ITNs through health facilities in Senegal. The project supported ITN durability monitoring in 10 countries, an activity that generated valuable data on ITN performance to aid countries’ decision-making around future ITN deployment. PMI Evolve worked with NMPs to support entomological monitoring of vector bionomics in 160 sites and for insecticide resistance in 280 sites. 

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