The Republic of Malawi has a population of nearly 16 million people living in an area of 118,484 square kilometers (approximately the size of Ohio). As one of the poorest countries in the world, currently ranked 171 out of 187 on the Human Development Index, Malawi has faced an uphill battle to achieve improvements in key health indicators. Malawi is faced with double-digit HIV prevalence, one of the highest malaria prevalence rates in the world, and a population that is expected to double by 2030. These challenges are putting increasing pressure on land, natural resources and social services. Malawi is well known in the region for its innovations in public health programming, and maintains a well-coordinated health donor environment, under the leadership of the Sector Wide Approach (SWAp) Secretariat in the Ministry of Health (MoH). The strong national commitment and leadership to improved health outcomes, with support from development partners, has significant achievements to show for it: Malawi is on track to meet MDG 4, reducing child mortality by two-thirds by 2015 HIV prevalenceamongst 15-49 year olds has declined from 11.8 % in 2004 to 10.6% in 2010 per the Malawian Demographic and Health Survey (MDHS) Maternal mortality has decreased from 1,120 per 100,000 live births in 2000 to 675 in 2010 Fertility has declined from 6.3 births in 2000 to 5.7 births per woman in 2010 Modern contraceptive use has increased from 26% in 2000 to 42% in 2010. Modeling of 2010 ANC data and the 2010 MDHS data shows just under one million Malawians living with HIV, 19% of whom are children under 15, and 47% of whom are adult women. AIDS is the leading cause of death, with an estimated 44,000 deaths in 2011, and is a major contributing factor to Malawi's low life expectancy of 54 years. TB continues to be a challenge and co-morbidity with HIV is common. The WHO estimated 29,000 new cases of all forms of TB in 2011, with approximately 62% in PLHIV. While there has been a significant increase in TB treatment success rate of 87% (up from 67% in 2001), the overall case detection rate remains about 66%.