Malaria donor transitions

The MEI has developed a program of support on donor transitions and specializes in supporting country sustainability and transition by generating actionable analyses and facilitating strategic planning and implementation with partners at the global and country levels.

Donor transitions support

In partnership with the Global Fund, the MEI created SUSTAIN: A Sustainability and Transition Readiness Assessment Tool for Malaria, the first and only transitions assessment specific to malaria. The SUSTAIN tool is an assessment and planning tool for guiding national malaria programs through the process of preparing for a sustainable transition from donor support. The purpose of SUSTAIN is to support national malaria programs, as well as their funders and other partners, to identify and address needs as countries prepare for the end of donor support for malaria. It is intended to serve as a first step in the transition planning process, generating evidence to help inform a country’s sustainability and transition plan.

At the country level, the MEI helps malaria programs to:

  • Assess transition-related priorities, risks, and opportunities
  • Develop a plan of action to address sustainability and transition priorities
  • Implement the sustainability and transition plan, such as evidence-based guidelines to integrate vertical malaria programs into general health systems
  • Strengthen subnational management capacity and communication with the national-level malaria program to support coordination to address transition challenges
  • Build collaboration between stakeholders to facilitate transition and sustainability, including in the ministry of health, and with other ministries (e.g., finance, labor), implementing partners (e.g., civil society organizations and the private sector), technical advisors, and donor partners.
  • Engage in early and strategic planning to embed key malaria response functions currently supported by donor funding

Challenging context

As countries experience economic growth, reduce malaria burden, and/or achieve malaria elimination, they will experience declines in or the end of donor financing for malaria. Such donor transitions can pose a number of challenges for the sustainability of malaria response, including, among others, a decline in funding; changes and disruptions to health workforces, data and surveillance systems, supply chains, and program governance and management; and changes in the level of political will and attention to malaria. If mismanaged or poorly planned, donor transitions can result in program disruptions and undermine progress to date. Transition can also offer a critical opportunity to create more effective and efficient programs, integrate vertical malaria programs into country health systems, and build stronger domestic capacity to finance and manage essential health services.

Securing sustainable finance and navigating these program and health system changes may require new strategic plans, increased attention to advocacy, a renewed focus on targeting and efficiency, elevating the priority of the malaria program and services for vulnerable populations, and developing new management and communication capacities for subnational engagement and leadership.


The MEI has worked with national malaria programs in Guyana, the Philippines, Sri Lanka, and Thailand to conduct sustainability and transition assessments, facilitate sustainability and transition planning processes, and embed elements of the malaria response strategically within the health system. The MEI also serves as a technical partner to the Global Fund on sustainability, transition, and co-financing.