Figure 1. Malaria by Annual Parasite Index (API) at Malaria is endemic in the Moskitia area along the municipality level (ADM2), Nicaragua, 2014 Atlantic coast in the northwestern part of the country that shares a border with Honduras (Figure 1). In 2014, Nicaragua had reported 1,163 cases of malaria and no deaths (Figure 2). The department of North Caribbean Honduras Coast Autonomous Region (RACCN) has the highest amount of cases and is home to some of the country’s most affected municipalities such as Waspan (26.2% of all 2014 malaria cases), Rosita (22.6%), Puerto Cabezas (15.4%), and (9.8%) (Figure 3). However, malaria is also present in other parts of the Nicaragua country including along the northern Pacific coast in the department of Chinandega where sugar-cane plantations are areas of mosquito proliferation. The department of South Caribbean Coast Autonomous API Region (RACCS) has had an increase in the past few per 1,000 people years. Cases in Desembocadura de la Cruz de Rio Grande No cases ≤ 0.1 0.11 - 1 1.01 - 5 Figure 2. Number of cases and deaths due to 5.01 - 10 Costa Rica ® malaria in Nicaragua, 2000-2014 0 25 50 100 10.01 - 50 Kilometers Longitude/Latitude >50 Datum WGS84 25,000 10 Source: PAHO/CHA/VT

20,000 8

s 25,000 10 s e municipality almost tripled in 2014 from the previous 15,000 6 s

20,000 t h 8 o f c a a year. Together, RACCN and RACCS account for 90% s D e of all malaria cases in Nicaragua. During 2012-2014, 10,000 s e 4

15,000 6 s

N umbe r there were 7 municipalities reporting more than 1 case t h o f c a a 5,000 2 per 1,000 inhabitants in one or more years (stratum 10,000 3)4 (FigureD e 4). Main factors contributing to malaria in

0 N umbe r 0 Nicaragua are migration, natural disasters (floods), and 0 1 2 3 4 5 6 7 8 5,000 9 0 1 2 3 4 drug2 trafficking. Improved surveillance has also led to 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 1 20 1 20 1 20 1 20 1 the detection of more cases. Approximately 2% of cases Confirmed Cases 0 P. falciparum & Mixed Deaths 0 ■ P. falciparum & mixed ■ Confirmed cases ■ Deaths were reported imported in 2014. On the contrary, Costa 0 1 2 4 8 1 2 3 4 3 6 7 9 0 5 Rica has reported five imported cases from Nicaragua 20 0 20 0 20 0 20 0 20 0 20 1 20 1 20 1 20 1 20 0 20 0 20 0 20 0 20 0 20 1 since 2011. Confirmed Cases P. falciparum & Mixed Deaths Municipality Department Waspan FigureRACCN 3.** Municipalities with336 the highest3 9number8 of malaria305 cases in Nicaragua, 2012-2014 Rosita RACCN ** 115 238 263 Puerto Cabezas MunicipalityRACCN ** Department253 171 179 336 398 305 Prinzapol ka WaRACCNspan ** 86RACCN ** 35 114 115 238 263 Bonanza RoRACCNsita ** RACCN135 ** 127 51 253 171 179 Desembocadura* PuRACCS‡erto Cabezas 32 RACCN ** 17 50 86 35 114 Wiwili de Jinotega PrJiinznoatpolegaka 2 RACCN ** 6 40 135 127 51 El Viejo BonCahnzainandega 9RACCN3 ** 78 32 32 17 50 Siuna DeseRACCNmboc*a*dura* 37 RACCS‡ 23 28 2 6 40 Laguna d e Perlas WiwiliRACCS‡ de Jinotega9 Jinotega 1 15 El Viejo C hinandega 93 78 32 0 200 400 0 200 400 0 200 400 Decrease 37 23 28 Siuna RACCN2012** 2013 2014 Increase Laguna d e Perlas RACCS‡ 9 1 15 *Desembocadura de Rio Grande Decrease 0**North2 0C0aribbea4n0 0Co0ast Aut2onomo00 us 4R0e0gi0on 200 400 ‡South20 Ca1r2ibbean Coast Autonomo2013 us Region 2014 Increase *Desembocadura de Rio Grande **North Caribbean Coast Autonomous Region 86 ‡South Caribbean Coast Autonomous Region

86

- 84 - onon the the Situation Situation of Malaria of Malaria in the in Americas, the Americas, 2000-2014 2000-2014 (DRAFT (DRAFT V.3) V.3) Figure 4. Number of municipalities (ADM2) by strata Figure 5. Malaria cases by age and sex in in Nicaragua, 2012-2014 Nicaragua, 2014

Stratum 1 90 Age groups Stratum 1 90 Age groups 50+ Stratum 2 56 50+ Stratum 2 56 45-49 years Stratum 3 7 45-49 years Female Stratum 3 7 40-44 years Female 40-44 years Male 0 20 40 60 80 100 35-39 years Male on the Situation of Malaria in the Americas,0 2000-201420 (DRAFTNumbe V.3)40r of municipaliti6e0s 80 100 35-39 years Number of municipalities 30-34 years on the Situation of Malaria in the Americas,30-34 yea 2000-2014rs (DRAFT V.3) *Stratum 1: No autochthonous malaria case in 2012-2014; 25-29 years *StStraturatumm 1: 2: N <1o autochthonouscase per 1,000 inhab malaitantsria case in 2012 in 2012-2014;-2014; 20-24 25-2years9 years StStraturatumm 3: 2:>1 <1 case case pe rpe 1,000r 1,000 ionnhab ithenhabitants Situationitants in 2012 in 2012of-2014. Malaria-2014; in the Americas, 2000-2014 (DRAFT V.3) Stratum 3: >1 case per 1,000 inhabitants in 2012-2014.15-19 20-2years4 years Stratum 1 90 Age groups 10-14 15-1years9 years Stratum 1 50+ 90 Age groups Stratum 2 56 5-9 10-1years4 years Men were45-4 more9 yea affectedrs than women in 2014 (Figure 5), 50+ Stratum 3 7 Stratum 2 56 Female Unde5-r 59 years 40-44 years 45-49 years and wereStratum Sfound t3ratum 1to7 have incidence rates of 17.7 andM 14.9ale 90 Age groups Female 0 20 40 60 80 100 UnknownUnder 5 cases per35-3S 100,000tra9t uyeam 2rs people, respectively. Analysis by56 age 40-44 years 50+ 0 0 0 0 0 Number of municipalities 5 5 5 5 Male 0 Unknown0 5 5 0 20 40 60 80 100 45-49 yea7 rs 2 2 7 1 30-34 years 35-39 yea1 rs Female groups showsStratum that 3 men7 have higherNumbe rincidence of municipa litiate smost 0 0 0 0 0 *Stratum 1: No autochthonous malaria case in 2012-2014; 40-44 years 5 Confirmed c5 ases 5 5 0 5 5 0 25-29 years 30-34 years 7 2 2 7

ages (Figure 6). Children (10-14) and adolescents (15- 1 Male1 Stratum 2: <1 case per 1,000 inhabitants in 2012-2014; 0 *Stratum20 1: No autochthonous40 mala6r0ia case in 201280 -2014; 100 20-24 years 25-29 yea35-3rs9 years Confirmed cases Stratum 3: >1 case per 1,000 inhabitants in 2012-19)2014. had the highest incidenceStratu mof 2:malaria. <1 caseNumbe peTherer ro 1,000f mu nici iwerenhabpaliti ietantsans in 2012-2014; 30-34 years 15-19 years Stratum 3: >1 case per 1,000 inhabitants in 2012-2014. 20-24 years estimated 17 malaria cases*St perratu m100,000 1: No autochthonous pregnancies mala ria case in 2012-2014; in 2014,10-1 which4 yea rswas similar to the incidence in non- 35 15-19 yea25-2rs9 years Stratum 2: <1 case per 1,000 inhabitants in 2012-2014; 30 Female 5-9 years Stratum 3: >1 case per 1,000 inhabitants30 in 2012Priority-2014.10-1 Groups4 yea20-2rs4 yea rs

pregnant women of child-bearing age, implying that le Under 5 35 The Miskito5-9 yea15-1r s9people years of Nicaragua are Mdisproportionallyale pregnant women were not at a higher risk of having 25 30 Female Unknown peo p 30 Und10-1er 54 years

le affected by malaria due to poverty, underdevelopment, malaria. 26 Male 0 0 0 0 0 5 5 5 5 5-9 years , 00 0 20 and limitedUnknown access to healthcare compared to the rest 0 5 5 0 7 2 2 7 25 21 1 1

peo p 0 0 0 0 Under 5 0 5 5 5 5 10 0 of the country. 26The area they inhabit traverses the 0 5 5 0 7 2 2 Figure 6. Malaria incidence by ageConfi rmeandd csexases in 15 7 1 1

, 00 0 1320 Unknown Honduran border, which poses21 a problem for disease

s pe r Confirmed cases Nicaragua, 2014 10 0 0 0 0 0 5 5 5 11 5

s e 9 10 0 0 5 5 0 7 2 2 1105 tracking. 7 1 1 C a 13 8 5 Confirmed cases 35 s pe r 10 11

s e 9 30 Female 0 Diagnosis10 and Treatment

30 C a 35 8

le Unde 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50+ Male 5 Microscopy is the3 0primary method of diagnosisFem ina lethe r 530 yrs yrs yrs yrs yrs yrs yrs yrs yrs yrs 25 le 0 country, though RDTs were introduced in 2006 forMa leuse in peo p 35 26 25placesUnde 5 that-9 10- are14 15-difficult19 20-3204 to25- 2access9 30-3 4 (Figure35-39 40- 7).44 45-Nicaragua’s49 5F0em+ a le peo p

, 00 0 20 30 21 first-liner 5le yrs treatmentyrs yr2s6 isyrs chloroquineyrs yrs yandrs yprimaquiners yrs yMr sforale

, 00 0 20 10 0 15 both2 5P. falciparum and P. vivax21 infections. An observed 13 peo p 10 0 s) 2.5M 26

s pe r 15 n dosage of chloroquine and primaquineFirst-line tre (30atme nmg/kg/day)ts 10 11 1, 00 0 320 s e 9 21

10 illi o

2.0M s pe r is given over the course of 7 daysCo fornfirme treatmentd Cases of P. vivax C a 8 10 m

6% 10 0 11 600,5000 s e 1015 9 i n in Nicaragua as compared to a 15 mg/kg/day dosage

C a 13 1.5Ms) 2.5M 8 l e ( n 0 5 s pe r First-line treatments SPR) for 14 days that is given in Honduras. The difference in d 10

( 11 s e e 9 illi o 2.0M 10

Unde 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49t e 50+ 0 i n 1.0M dosage may cause confusion along theCo bordernfirmed C forase thoses C a f peo p 4% m 8 m 400,000 6% 600,000 r 5 yrs yrs yrs yrs yrs yrs yrs yrs yrs yrs 5 o i n Unde 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50+ x a with P. vivax infections due to the varying treatment 1.5M r 5 yrs yrs yrs yrs yrs yrs yrs yrs yrs yrs 0.5Ml e ( 0 l e SPR)

d schemes. ( umbe r e Unde 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50+ N t e i n 0.0M 200,000 2% P o sitivity R a 1.0M P eo p

4% f peo p

m r 5 yrs yrs yrs yrs yrs yrs yrs yrs yrs yrs

400,000 e 0 2 4 7 0 2 1 3 5 6 8 1 3 9 4 o x a

Figure 7. Blood slides examined, RDTs examined, Sli d Figure 8. Number of malaria cases and those treated 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 1

s) 2.5M 0.5M l e n First-line treatments and SPR0 in Nicaragua, 2000-2014 0% * First linumbe r e treatwithment d first-lineata is unavaila btreatmentle for 2001-200 in4. Nicaragua, 2000-2014

s) 2.5M N illi o 3 4 6 7 0 4 1 0 1 2 5 8 9 2 3 2.0M 0.n 0M

200,000 2% P o sitivity R a First-line treatments

P eo p Confirmed Cases m 600,000 6% e 0 2 4 7 0 2 1 3 5 6 8 1 3 9 4 illi o 20 0 20 0 20 0 20 0 20 1 20 1 20 1 20 0 20 0 20 0 20 0 20 0 20 0 20 1 20 1

i n 2.0M Confirmed Cases m s) 1.560M 0,000 6% Sli d 2.5M 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 1 l e ( n RDTs Examined Blood Slides Examined SPR (%) i n First-line treatments SPR) d ( e 1.5M illi o 0 0% * Firstl e ( line tre2a.t0meM nt data is unavailable for 2001-2004. t e i n SPR) 4.0M Confirmed Cases 1.d 0M m 3 4 6 7 0 4 1 0 1 2 5 8 9 2 3

f peo p 6% 4% 600,000 ( m

400,000 e i n o t e i n x a 1.0M f peo p 20 0 20 0 20 0 20 0 20 1 20 1 20 1 20 0 20 0 20 0 20 0 20 0 20 0 20 1 20 1 4% m 400,000 1.5M l e (

3.0M o s) 0.5M SPR) d l e x a n

1.5M ( RDTs Exae mined Blood Slides Examined SPR (%) umbe r s) t e i n People protected by IRS 0.5M N n illi o l e 1.0M

0.0M 4% f peo p m 200,000 2% P o sitivity R a 400,000 P eo p umbe r m e 0 2 4 7 0 2 1 3 5 6 8 1 3 9 4 illi o 2.0M 4.0M x a People protected by ITNs N i n 0.0M

200,000 2% P o sitivity R a P eo p m ( e Sli d 0 2 4 7 0 2 1 3 5 6 8 1 3 9 4 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 0 20 0 20 0 20 0 20 1 20 1 1.0M 20 0 20 1 0.5M i n l e ( umbe r o d US $

Sli d 3.0M s) 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 1 0 0% * First line treatment data is unavailable for 2001-2004. 1.0M N 1.5M n 0.0M

200,000 2% P o sitivity R a P eo p ct e 3 4 6 7 0 4 1 0 1 2 5 8 9 2 3 e s) 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4

t e 0 People protected b0y% IRS n

illi o * First line treatment data is unavailable for 2001-2004. 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 20 0 20 0 20 0 20 0 20 1 20 1 20 1 20 0 20 0 20 0 20 0 20 0 20 0 20 1 20 1 0.0MSli d m 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 1 20 1 20 1 20 1 0.5M 20 1 illi o People protected by ITNs 2.0M i n 2 4 0 3 7 2 1 4 5 6 8 3 9 0 1 l e pr o 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 1 20 1 20 1 20 1 20 1 m RDTs Examined Blood Slides Examined SPR (%) ( 1.0M 0 0% * First line treatment data is unavailable for 2001-2004. i n 20 0 20 0 20 1 20 0 20 0 20 0 20 1 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 1 3 4 6 7 0 4 1 0 1 2 5 8 9 2 3 ( RDTs Examined Blood Slides Examined SPR (%) P eo p d 4.0M US $ 0.0M *Funding 1in.f0ormM ation is not available for 2001-2005. 20 0 20 0 20 0 20 0 20 1 20 1 20 1 20 0 20 0 20 0 20 0 20 0 20 0 20 1 20 1 ct e 4.0M 6 8 1 2 4 7 9 1 4 0 3 5 0 2 3 t e 3.0M RDTs Examined Blood Slides Examined SPR (%) Government Global Fund USAID Others s) 0.0M 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 0 20 0 20 1 20 1 20 1

1.5M 0.n 5M 2 4 0 3 7 2 1 4 5 6 8 3 9 0 1 s)

l e pr o 3.0M People protected by IRS s) 4.0M n illi o

1.5M n s) 20 0 20 0 20 1 20 0 20 0 20 0 20 1 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 1 m illi o 2.0M People protected by IRS n

People protected by ITNs illi o i n P eo p m ( 3.0M m s)

1.0M 0.0Milli o *Fundin2.g0 Minformation is not available for 2001-2005. i n People protected by ITNs 1.5M n i n

( - 85 - m ( s) 6 8 1 2 4 7 9 1 4 0 3 5 0 2 3 d US $ People protected by IRS

1.0M n illi o 1i n .0M Government Global Fund USAID Others ( ct e m d US $ 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 0 20 0 20 1 20 1 20 1 illi o People protected by ITNs 2.0M t e

1.0M i n m ( 0ct e .0M 1.0M 0.5M i n t e ( 2 4 0 3 7 2 1 4 5 6 8 3 9 0 1 l e pr o d 0.5M 0.0M US $ 1.0M ct e 2 4 0 3 7 2 1 4 5 6 8 3 9 0 1 20 0 20 0 20 1 20 0 20 0 20 0 20 1 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 1 l e pr o t e P eo p 20 0 20 0 20 1 20 0 20 0 20 0 20 1 20 0 20 0 20 0 20 0 20 1 20 1 0.0M *Funding inform0.5aMtion is not available for 2001-2005. 0.0M 20 0 20 1 P eo p 2 4 0 3 7 2 1 4 5 6 8 3 9 0 1 6 8 1 2 4 7 9 1 4 0 3 5 0 2 3 G0o.v0ernmeM l e pr o nt Global Fund USAID Others *Funding information is not available for 2001-2005. 20 0 20 0 20 1 20 0 20 0 20 0 20 1 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 1 6 8 1 2 4 7 9 1 4 0 3 5 0 2 3 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 0 20 0 20 1 20 1 20 1

P eo p Government Global Fund USAID Others 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 1 20 1 0.020 0 M 20 0 20 0 20 1 20 1 20 1 *Funding information is not available for 2001-2005. 6 8 1 2 4 7 9 1 4 0 3 5 0 2 3 Government Global Fund USAID Others 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 0 20 0 20 1 20 1 20 1 on the Situation of Malaria in the Americas, 2000-2014 (DRAFT V.3)

Stratum 1 on the Situation of Malaria9 0in the Americas,Age groups 2000-2014 (DRAFT V.3) Stratum 2 56 50+ 45-49 years Stratum 3 7 Female 40-44 years Male 0 20 40 60 80 100 Stratum 1 90 35-3Ag9e yeagroupsrs Number of municipalities Stratum 2 56 30-34 years 50+ *Stratum 1: No autochthonous malaria case in 2012-2014; 25-245-49 yea9 ryeas rs Stratum 3 7 Stratum 2: <1 case per 1,000 inhabitants in 2012-2014; Female 40-44 years Stratum 3: >1 case per 1,000 inhabitants in 2012-2014. 20-24 years Male 0 20 40 60 80 100 15-135-39 yea9 ryeas rs Number of municipalities 10-130-34 yea4 ryeas rs *Stratum 1: No autochthonous malaria case in 2012-2014; 5-25-29 yea9 ryeas rs Stratum 2: <1 case per 1,000 inhabitants in 2012-2014; Stratum 3: >1 case per 1,000 inhabitants in 2012-2014. Und20-2e4r yea5 rs Un15-1known9 years 0 0 0 0 0 5 5 5 10-14 years 5 0 5 5 0 7 2 2 7 1 5-9 years 1 Confirmed cases Under 5 Unknown 0 0 0 0 0 5 5 5 5 0 5 5 0 7 2 2 7 1 35 1 30 Confirmed cases Female 30 le Male 25 peo p 26

, 00 0 20 35 30 21 Female 30 10 0 15le Male 13

s pe r 25 10 peo p 11 s e 10 26 9 , 00 0 C a 20 8 5 21 0 10 0 15 13

s pe r Unde 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50+ 10 11 s e r 5 10 yrs yrs yrs yrs yrs yrs yrs yrs yrs yrs 9

C a 8 5 0 Unde 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50+ r 5 yrs yrs yrs yrs yrs yrs yrs yrs yrs yrs

s) 2.5M

n First-line treatments

illi o 2.0M Confirmed Cases

600,000 6% m i n 1.5M l e ( SPR) d ( s) 2.5M Vectore Control Funding n t e i n 1.0M First-line treatments

4% f peo p Nearlym 400 ,95,000000 people are estimated to be protected by Governmental funding for malaria at the national level illi o 2.0M o Confirmed Cases x a IRS in Nicaragua,600,000 which has decreased steadily since6% has m varied from one year to the other. In 2014, it was 0.5i n M l e 1.5M umbe r 2007 (Figure 9). Tests conducted in 2012-2014 found lessl e ( than that in 2013, but higher than any year during SPR) N d

( 0.0M P o sitivity R a 200e ,000 2% bothP eo p An. albimanus and An. pseudopunctipennis to be 2010-2012. The Global Fund has been the main e t e 0 2 4 7 0 2 1 3 5 6 8 1 3 9 4 i n 1.0M

4% f peo p susceptiblem 400,0 0to0 pyrethroids. More people are estimated contributor of external resources since 2006 through Sli d o 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 1 x a to be protected by ITNs that IRS in 2014, with ITNs national0.5M grants as well as providing resources through l e 0 0% * First line treatment data is unavailable for 2001-2004. umbe r 3 4 6 7 0 4 1 0 1 2 5 8 9 2 protecting 173,000 people. 3 the EMMIE initiative (Figure 10). Other external funders N 0.0M

200,000 2% P o sitivity R a P eo p 20 0 20 0 20 0 20 0 20 1 20 1 20 1 20 0 20 0 20 0 20 0 20 0 20 0 20 1 20 1 e 0 2 4 7 0 2 1 3 5 6 8 1 3 include USAID via the AMI/RAVREDA project9 and PAHO/ 4

RDTs Examined Blood Slides Examined SPR (%) Sli d 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 0 20 0 20 0 20 0 20 1 20 1 Figure 9. People protected by IRS and by ITNs in WHO. 20 0 20 1 Nicaragua, 2000-20140 0% *4 .Fi0Mrst line treatment data is unavailable for 2001-2004. 3 4 6 7 0 4 1 0 1 2 5 8 9 2 3 Figure 10. Funding for malaria control in 20 0 20 0 20 0 20 0 20 1 20 1 20 1 20 0 20 0 20 0 20 0 20 0 20 0 20 1 20 1 3.0M s) Nicaragua, 2000-2014

1.5M n RDTs Examined Blood Slides Examined SPR (%) s) People protected by IRS n illi o m illi o People protected by ITNs 2.0M4.0M i n m 1.0M ( i n

( 3.0M d US $ s)

1.5M 1.0n M ct e s) People protected by IRS n illi o t e m 0.5illi o M People protected by ITNs 0.0M2.0M i n m ( 2 4 0 3 7 2 1 4 5 6 8 3 9 0 1 l e pr o 1.0M i n ( 20 0 20 0 20 1 20 0 20 0 20 0 20 1 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 1 d US $

P eo p 1.0M

0.0ct e M *Funding information is not available for 2001-2005. t e 0 1 2 3 4 5 6 7 8 9 0 1 0.5M 2 3 4 Gov0ernme.0M nt Global Fund USAID Others 0 1 2 3 4 5 6 7 8 9 0 1 3 4 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 1 20 1 20 1 20 1 20 1 l e pr o 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 1 20 1 20 1 2 20 1 20 1 P eo p 0.0M *Funding information is not available for 2001-2005. 6 8 1 2 4 7 9 1 4 0 3 5 0 2 3 Government Global Fund USAID Others 20 0 20 0 20 0 20 0 20 0 20 0 20 0 20 1 20 1 20 0 20 0 20 0 20 1 20 1 20 1

- 86 -