According to the national program against malaria (PNILP), malaria has decreased significantly over the past years. The reported number of malaria cases treated in public sector health facilities fell from 1.5 million in 2005 to 633,039 in 2008.

In 2006, malaria was the leading cause of mortality representing 41% of hospital deaths; by 2007, this figure had fallen dramatically to 15%.

Furthermore, the number of severe malaria cases fell by 32.2% during the same period. This was even the case among groups that are more vulnerable to the disease: the number of severe cases among pregnant women dropped by 8% and among children under five by 34%.

The recent reductions in malaria morbidity and mortality are largely due to improvement of the malaria program, which involves the distribution of insecticidal nets and indoor resident spraying, as well as the overall extension of the health system.

As a result of the combined efforts and interventions, the malaria case fatality rate reduced by more than half in children under five, falling from 4.6/100 in 2005 to 2/100 in 2006.

Simple preventive measures are also having their impact: in 2000, only 5% of households owned an insecticide treated mosquito net, 15% did so in 2005 and 33% in 2006; in the latter year, 13% of children under five and 17% of pregnant women reportedly slept under such nets.

According to Emmanuel Hakizimana, vector control manager in PNILP, the integrated national malaria program distributed 1,600,000 nets during the 2006 measles campaign. In 2007, the Malaria Indicator Survey found that 54% of households owned at least one insecticidal treated net, 60% of children under five and pregnant women now sleep under those nets.

Hakizimana further explains that the various systems of health insurance schemes have increased the financial accessibility of the general health services to the population.

Zozimo Mpatswenumugabo, the health director in Rubavu who also works in the local health center, explains that the number of cases in his district has reduced by 80%.

"People in this district have come to be fully mobilized concerning malaria; today 70% of residents possess insecticidal nets," he says.

In his district, the residual indoor spraying campaign has not yet been held. If that were the case, Mpatswenumugabo believes that malaria can be nearly entirely eradicated.

Janette Mujawamaria, a mother of three children visiting the health center, says that all her children sleep under a treated net, adding that she received two of them for free. "I received one when I came here to give birth to one of my children, and the second after the one of the kids' last vaccine," Mujawamaria explains.

Free distribution of mosquito nets at such occasions is indeed part of PNILP's program nationwide.

Meanwhile, all health facilities in the country will continue to strengthen preventive measures, promoting community based interventions and improving management cases at all level.