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 multi-year, comprehensive effort to reduce the burden of disease and promote healthy communities and families around the world. Through the GHI, the United States is helping 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 Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (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 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. Expansion was authorized to additional PMI countries, including Nigeria, the Democratic Republic of Congo and up to seven additional high-burden countries. The goal for any new countries added after the initial 15 is to achieve a 50% reduction in malaria-related mortality in at-risk population by 2015 as compared with 2009-2010 baseline levels. These goals will be achieved by reaching 85% coverage of the most vulnerable groups - children under five years of age (under five) and pregnant women - with proven preventive and therapeutic interventions, including artemisinin-based combination therapies (ACTs), insecticide-treated nets (ITNs), intermittent preventive treatment for pregnant women (IPTp), and indoor residual spraying (IRS). With a population of about 172 million and reporting more deaths due to malaria than any country in the world, Nigeria became the seventeenth PMI country in 2010. Malaria accounts for 60% of outpatient visits and 30% of hospitalizations among children under five in Nigeria. The Demographic and Health Survey (DHS) 2008 reported an infant mortality of 75 per 1000 live births and an under five mortality of 157 per 1000 live births in the preceding five-year period. Impressive progress has been made in malaria control efforts in recent years. The proportion of households owning one or more ITNs increased from just 8% in the DHS 2008 to 42% in the Malaria Indicator Survey (MIS) 2010, and the proportion of children under five reported to have slept under an ITN the night before the survey increased from 6% in the DHS 2008 to 29% in the MIS 2010.