Rotary and partners scale up by going local, deploying health workers to confront malaria and more
When the Partners for a Malaria-Free Zambia program began five years ago, Rotarian Bill Feldt offered a forecast of what success would look like in 2026:
“I would hope we’d see a dramatic reduction in malaria incidence,” he told Rotary magazine in 2021. “We’d want to see a self-sustaining health system that is fully utilizing community health workers, where they are diagnosing 60 to 70 percent of whatever small number of cases of malaria there are. ... We’ll see that turnover for community health workers is low ... They will represent the last kilometer of a health system that’s very successful.”
Rotary members launched the initiative in 2021 to reach more than 1.2 million people with malaria prevention information, testing, and treatment. The effort was supported by The Rotary Foundation’s first $2 million Programs of Scale grant, which was matched by the Gates Foundation and World Vision to create a $6 million project.
Implemented from 2021 to 2024, the program trained community health workers to test and treat malaria closer to people’s homes so they wouldn’t have to travel to clinics. Easier access means more frequent detection and early treatment, and therefore fewer severe cases and deaths.
The initiative grew out of a smaller partnership between Rotary members in Zambia and Feldt’s home state of Washington to distribute bed nets, and it continues to scale across Africa through an expanded initiative, the Rotary Healthy Communities Challenge.
A 2025 annual report details the successes, lessons learned, and what’s next — and finds that Feldt’s forecast was not off the mark.
Community health workers
Most community health workers learned to provide services beyond malaria, including care for pneumonia and diarrhea. This freed up health facilities to deal with more urgent cases.
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2,500
Community health workers trained
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1.25 million
People with improved access to malaria testing and treatment
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94%
Retention rate for community health workers
Malaria testing
One lesson learned is that the effort to eliminate malaria isn’t a straight line; better testing and more reliable data uncovered more cases.
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747,000
Malaria tests conducted by the program in 2024
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60%
Cases of malaria detected in the 10 target districts by community health workers — cases that would have been missed or else found at a more severe stage
Severe cases
While community health workers can treat most malaria cases in the field, under national protocols they must refer children under 2 months old, pregnant women, and people with severe symptoms to health facilities.
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1%
Malaria cases detected by community health workers that they referred to health facilities
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6,498
People admitted to health facilities for severe malaria in the target districts
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75
Deaths from malaria in those districts in 2024, marking a drop in most districts
What’s next: Rotary Healthy Communities Challenge
The success of Partners for a Malaria-Free Zambia led Rotary, the Gates Foundation, and World Vision to scale the project even further. The result was the Rotary Healthy Communities Challenge, which is expanding the proven community health worker model to reduce severe disease and death from not only malaria but also pneumonia and diarrhea, among the top killers worldwide of children under 5.
With Rotary members leading the work, the program is being implemented in 2024-27 in the Democratic Republic of Congo, Mozambique, Nigeria, and Zambia. Here’s a look at what’s been accomplished so far.
Democratic Republic of Congo
Despite an Ebola outbreak, supply delays, and insecurity that forced the program’s target areas to decrease from three provinces to one, the program was able to deploy health workers to areas that had never seen health care before.
1,097 community health workers trained
Mozambique
In the program’s first year, Mozambique faced postelection instability and heavy rains, making some communities difficult to access. Still, program leaders began tapping into existing training structures and engaging with communities to create demand.
122 community health workers and 2,852 community health volunteers trained
Nigeria
Program leaders helped support the government’s new community health worker strategy and worked to strengthen government partnership.
706 community health workers trained
Zambia
The program’s work in Zambia will focus on some of the final locations in need of community health workers. In the first year, program leaders worked to refine data collection systems to incorporate pneumonia and diarrhea in addition to malaria.
1,462 community health workers trained
*all figures as of February 2026
This story originally appeared in the April 2026 issue of Rotary magazine.