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) to reduce the burden of disease and promote healthy communities and families around the world. The President's Malaria Initiative (PMI) is a core component of the GHI, along with Human immunodeficiency virus/acquired immunodeficiency syndrome, tuberculosis, maternal and child health, family planning and reproductive health, nutrition, and neglected tropical diseases. 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 the passage of the 2008 Lantos-Hyde Act, funding 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. 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 (M&E); and promoting research and innovation. In June 2011, Guinea was selected to receive funding during the sixth year of PMI. Guinea has year-round malaria transmission with high transmission from July through October in most areas. Malaria is considered the number one public health problem in the country. National statistics in Guinea show that among children less than five years of age, malaria accounts for 31% of consultations, 25% of hospitalizations, and 14% of hospital deaths in public facilities. A Demographic and Health Survey (DHS) was carried out in mid-2012, and the results provide concrete baseline information for key malaria indicators. The DHS reported a wide range of malaria prevalence across Guinea's regions, ranging from 66% in Faranah to 3% in Conakry, but with a relatively high prevalence of 44% as the national average. Survey estimates show that approximately 47% of households own at least one insecticide-treated net (ITN), and 26% and 28% of children under five and pregnant women, respectively, slept under an ITN the night before the survey. Roughly 18% of women surveyed had received at least two doses of intermittent preventive treatment during their last pregnancy, and less than 1% of children under five with fever in the two weeks preceding the survey received artemisinin-based combination therapy (ACT) on the same or next day of fever development.