With proper planning and commitment, malaria deaths in Africa could be cut by 75% in just three years. That's what the Bill & Melinda Gates Foundation is out to prove, and it has chosen Zambia as its battleground.

Many have been frustrated by the progress of international efforts, such as the UN-led Roll Back Malaria partnership, which in 1998 pledged to halve malaria deaths worldwide by 2010. It is nowhere near meeting its goal, and the Gates Foundation believes that planning is the missing factor.

Zambia has already declared that it will get insecticide-treated bednets to 90% of its households. It also aims to treat 60% of malaria patients with artemisinin drugs within 24 hours of diagnosis.

“The Zambian people and their leaders have shown tremendous resolve in their commitment to controlling and preventing malaria,” says Richard Feachem, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. The Global Fund has pledged $38 million to Zambia for malaria control over the next two years, and up to $83 million for the next five.

The Gates initiative aims to glue these efforts together with sophisticated data-management systems and extensive scientific trials to evaluate what works and what does not. This scientific support will be funded by a $35-million investment over the next nine years. The foundation announced the decision to aid Zambia at the World Health Assembly in Geneva on 19 May.

The world needs “a blockbuster success against malaria”, says Regina Rabinovich, director of the foundation's infectious-diseases programme. She hopes the project will “encourage both donor countries and developing countries to devote greater resources to fighting malaria”.

Called the Malaria Control and Evaluation Partnership in Africa (MACEPA), the project will be run by the Seattle-based non-profit organization PATH. It will partner Roll Back Malaria, the Global Fund and the World Bank.

Carlos Campbell, MACEPA programme director at PATH, says that its real-time data-management systems are “based on the best science available”. He adds that measuring the effectiveness of the efforts in Zambia is a priority, so the results can guide future large-scale efforts. Although funding for malaria control has been stuck for years at around $200 million annually, money is starting to flow, he says, so solid science is needed to ensure that the influx of resources is spent well.

MACEPA will also measure the economic impact of reducing malaria deaths. The World Bank estimates that the disease cuts the economic growth of African countries by at least 1.3% annually. Brian Chituwo, Zambia's health minister, says it was the social and economic impact of malaria, which is responsible for 40% of child deaths in the country, that drove his government to make malaria control a priority. (See Box).

Campbell hopes that the project will prove that investment in malaria control pays for itself through economic growth, encouraging other African countries to follow in Zambia's footsteps.