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 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. 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. 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; and promoting research and innovation. In June 2005, the United States Government (USG) selected the United Republic of Tanzania (including the Mainland and Zanzibar) as one of the first of three countries to be included in PMI. Malaria is a major public health problem in Tanzania. Although dramatic progress in malaria control has been made in recent years with the scale up of malaria prevention and treatment interventions, nearly all 42 million residents on the Mainland and all 1.3 million persons in Zanzibar are still at risk of infection. The most recent national-level data for malaria interventions in Tanzania comes from the 2011- 12 Tanzania HIV/AIDS-Malaria Indicator Survey (THMIS) and shows further impressive improvements in nearly all malaria indicators when compared with 2005 and 2008-09 figures. Ninety-one percent of Mainland households owned at least one insecticide-treated mosquito net (ITN), with 72% of children under five and 75% of pregnant women sleeping under an ITN. This compares with just 63% ownership and 64% and 57% usage in the 2008-09 DHS. In Zanzibar, ITN ownership and usage fell somewhat when compared with the 2008-08 DHS; 74% of households now own at least one ITN and estimates of use among children under five and pregnant women are 51% and 36%, respectively. Malaria prevalence in Zanzibar remained extremely low at less than 1% in the 2011-12 THMIS.