The OP4 project is piloting a program targeting improved access to and capacity of health care services in two study areas in rural Tanzania towards the end goal of lessening the burden of malaria in the study areas as well as yielding broader lessons for potential replicability and scale-up in the future. The project will draw on the historical experiences of China's malaria control initiatives to inform the strategies implemented in this pilot project. The overall aim of the pilot project is to achieve at least a 30% reduction in malaria-related morbidity and mortality in the targeted study areas as well as build local capacity in malaria control. This overall objective will be pursued through the specific objectives of the project, which are stated in the proposal as follows: a. To increase the parasitological examination rate of suspected malaria cases at community-based health facilities in the pilot areas. b. To reduce morbidity and mortality by improving malaria case management including the appropriate treatment of confirmed and unconfirmed malaria cases in the pilot areas. c. To establish a platform for entomological and parasitological surveillance as well as information reporting. d. To assess implementation of the WHO T3 strategy integrated with Chinese experiences. Through pursuing these objectives, the project also expects to achieve broader improvements in capacity of local health care services and personnel. The role of the Duke Global Health Institute is focused on: 1) providing consultation on the baseline household survey, 2) technical reporting on the mid-term external evaluation, and 3) overall collaboration on the project and manuscripts.

The main issues to be addressed through the project are to summarize the relevant experiences and lessons from China's malaria control activities applicable to the pilot study areas, to sesign a malaria prevention and control strategy reflective of the local context, and to adapt the local strategy to accommodate and capitalize on local infrastructure and resources. It is anticipated that the project will also yield broader lessons for potential replicability and scale-up in the future.