A major focus of the ARM initiative is malaria.  Malaria causes the death of 2–3 million people, mostly children, per year worldwide. More than 90% of these deaths are preventable.  For those who survive, malaria cripples economic potential as much as any disease on earth.  While there are major efforts to incorporate malaria control measures into health and development policies and to strengthen the skills and services of health care providers, there is less attention on strengthening the knowledge, skills and resources of health care consumers, the women and families threatened by malaria.  Yet, without health care consumers’ knowledgeable use of proven preventions such as insecticide-treated nets (ITNs) and treatments such as artemisinin combination therapies (ACT), this epidemic cannot be effectively stemmed. 

Freedom from Hunger is responding to this challenge through our ARM initiative, with an initial focus on malaria, the goals of which include improving health care consumers’

• awareness of the cause of malaria;

• prevention using ITNs, especially for children under 5 and pregnant women;

• early detection and treatment-seeking behavior, especially for vulnerable populations; and

• demand for and access to better malaria prevention and treatment supplies and services.

ARM leverages the platform of microfinance clients as sales agents or social entrepreneurs.  Implementing organizations offer these clients: access to financial services such as special savings accounts to purchase mosquito nets; loans to sell health protection products to others in the community; and health education to motivate personal use of the products.

Launched in 2002 with a major grant from GlaxoSmithKline, the initiative has completed an initial pilot and is moving into its next phase of innovation and expansion.  The initiative includes three critical components:

• Lifeskills Training.  During the first phase of the initiative, Freedom from Hunger applied its expertise in adult learning to develop a malaria education module that teaches clients how to avoid malaria, how to recognize and manage the disease when it strikes, and how to use locally available drug therapies appropriately to avoid drug resistance.  As we move forward, innovations will include the following:
• Additions to the Lifeskills Training series that specifically address the use of ACT and other health promotion products.
• Broader application of Lifeskills Training for use by any regularly gathering group, such as women’s self-help groups, agriculture production cooperatives, savings groups, church congregations and youth groups. 

• Distribution of ITNs and other health protection products.  During the first phase of the initiative, Freedom from Hunger brokered the distribution of ITNs to participating communities to support clients’ prevention efforts.  Moving forward, the initiative will explore permanent linkages with health protection product providers to make them more readily accessible to rural populations. 

• Linkages to health services.  In the first phase of the Initiative, Freedom from Hunger explored means to link clients to health care services for appropriate and reliable anti-malaria drugs.  Moving forward, Freedom from Hunger plans to partner with National Malaria Control Programs to assure coordination of drug treatment messages with drug availability.  

While the initiative is already under way in five West African countries, a sixth country will be added by June 2007. By that date, we plan to reach more than 180,000 women who will in turn pass benefits onto their family members—in aggregate, nearly 1 million people.  By the end of 2008, Freedom from Hunger will expand the initiative even further.  In Ghana, we will extend delivery of malaria education and linkages to affordable ITNs to 80% of rural Ghanaian communities.  Beyond Ghana, we will use our Reach network to distribute the basic materials, adaptation protocol, linkage process and network-building functions developed in the initial phase to many more organizations throughout West Africa.