Greater Mekong Subregion Elimination of Malaria through Surveillance

Countries in the Greater Mekong Subregion (GMS) are successfully reducing the burden of malaria. Since 2010, there has been a reported 86% decline in cases and 97% decline in deaths. Between 2019 and 2020 alone, the GMS region experienced a 47% decline in malaria cases. In the GMS 40-78% of the population first seek health care in the private sector, to achieve malaria elimination, we need sustained private sector engagement.

Illustration of a mosquito and the PSI logo

The Greater Mekong Subregion Elimination of Malaria through Surveillance (GEMS+) project supports national malaria programs in Cambodia, Lao PDR, Myanmar, and Vietnam to integrate the private sector into national malaria elimination strategies, surveillance systems, planning, and management structures.

In the initial phase of GEMS programming (2016 – 2019), PSI supported a diverse network of 25,000 private providers who tested over 3.5 million suspected cases and detected nearly 100,000 malaria cases. GEMS+, a 3-year follow-on to GEMS, represents an ambitious investment with the primary objective of transitioning private sector malaria programs to government oversight by 2023.


GEMS+ Private Sector Network Coverage

Country-Specific Initiatives


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How We Operate

The GEMS+ program provides a comprehensive package of support to private providers within its network. Key components of support include: 1) training, supervising, monitoring, and motivating providers; 2) routine support to providers to test, treat, and report malaria cases; 3) ensuring availability of sub-national staff (both internally and in government) to support collection of paper forms, supervise, and monitor quality and 4) provider assessment through regular data analysis.  Successful integration of the private sector into national malaria programs requires the development of national policies and strategies, allocation of resources by the government dedicated to the private sector program, and sustained engagement of transitioned providers. With private sector engagement in place, PSI supports national malaria programs to oversee and utilize the malaria testing and treatment services offered by the private sector as complementary to public facilities and community providers. 

Over time, PSI is gradually reducing direct support to providers as national malaria programs increasingly assume ownership and oversight.

Graph illustrating how we work

GEMS+ has identified six program components for transition to government oversight. 

  1. Provider Network Management
  2. Comprehensive Training
  3. Commodity Supply
  4. Quality of Care
  5. Supportive Supervision
  6. Case Surveillance


  • PSI co-developed the Malaria Case Surveillance (MCS) app to allow providers to easily report cases as soon as they find them in an easy-to-use interface. Utilizing this real-time data collection from providers in the field, PSI is able to make informed decisions. 
  • The Health Network Quality Improvement System (HNQIS) tablet-based app was created to enable PSI staff to score provider performance against global best practice benchmarks, in order to provide immediate and constructive feedback to continue improving provider quality. HNQIS also helps our team know which providers need more assistance and can plan their supervisory support visits accordingly.
  • PSI uses the District Health Network Information System (DHIS2) to house its electronic surveillance system, which allows for widespread access to data and user-friendly tools to visualize data in ways that facilitates decision making. 
  • PSI developed chatbots for popular messaging apps to allow doctors and pharmacists to report malaria cases, thus streaming critical health information from providers into national networks. 

Our Impact

In 2020, GEMS+ achieved the following impact:


malaria tests conducted


malaria cases detected, treated and reported


Private Outlets Transitioned

Frequently Asked Questions

In Southeast Asia, between 40-78% of the population first seek health care in the private sector, meaning that private providers potentially see most of the malaria cases in the region. It is therefore critical that private sector outlets are able to test for malaria, and are stocked with the right drugs in order to provide correct treatment.

PSI works with the private providers that at-risk communities trust most. This includes doctors working at registered private clinics and pharmacies, as well as community health volunteers and non-formal outlets that can be a significant source of drugs and advice in some areas. GEMS+ supports national malaria programs to use local evidence (including case data from the public and private sector, national stratification, supervision, and quality assessment scores) to identify a manageable number of high-performing providers in high burden areas who make a measurable contribution to the national caseload. 

Malaria elimination will fail without surveillance, and surveillance is incomplete without including data from the private sector. Without it, the government is not seeing the full picture.

PSI uses DHIS2, which is an open-source software allowing for greater access to data, and tools to help visualize data and automatically generate indicator calculations and reports. More information on DHIS2 can be found here.

annual reports

GEMS 2019 Annual Report

This report shares the results from the GEMS program’s fourth and final year, during which private provider networks consolidated in Cambodia, Lao PDR, Myanmar, and

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2018 GEMS Annual Report

PSI’s GEMS program strengthens private sector case management and surveillance to accelerate malaria elimination in Cambodia, Lao PDR, Myanmar, and Vietnam. This annual report shares

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GEMS 2017 Annual Report

PSI’s GEMS program strengthens private sector case management and surveillance to accelerate malaria elimination in Cambodia, Lao PDR, Myanmar, and Vietnam. This annual report shares

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From Strong Malaria Surveillance to a Strengthened PHEOC

By Kemi Tesfazghi, GEMS Program Director and Bram Piot, Senior Surveillance & Monitoring Officer, PSI Once established, a Public Health Emergency Operations Center (or PHEOC)

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Every Case Counts: Malaria Elimination through Private Sector Case Management

By Kemi Tesfazghi, GEMS Program Director, PSI Even as the world grapples with a pandemic, malaria presents a threat that cannot be ignored: increasing resistance

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Total Health System Malaria Surveillance

By M. James Eliades, PSI Asia Malaria Elimination Director 2017  -2019 Malaria has evolved. In countries where malaria is prevalent, overuse of the most common

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Adapting Private Sector Surveillance Strategies from the Greater Mekong Sub-Region to High Burden Settings

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Private Sector Engagement in Malaria Case Management Toolkit

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Community engagement to strengthen malaria elimination in 4 provinces in Vietnam

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Differential malaria prevention behaviors and care seeking practices between worksite migrant workers and villagers in the malaria-at-risk areas in Myanmar

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Insights on forest-goer health seeking journeys for febrile illness in Cambodia and Vietnam using respondent-driven sampling

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Readiness of formal private sector providers for malaria case management in malaria high burden areas of Myanmar

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Choice of health service providers among the forest goer population in Myanmar

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Impact of private health sector engagement interventions on provider quality of malaria case management in Cambodia, Lao PDR, Myanmar and Vietnam

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In the News

Malaria Wars

A disaster is looming in Cambodia and the rest of the Greater Mekong subregion: A deadly malaria parasite has become resistant to both drugs used

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