This call will select proposals that complement and / or support Global Fund investments, contributing to building or strengthening a health system at community or national level that is sustainable, resilient, gender-sensitive and enables equal access to quality services for populations, particularly in the response to the three pandemics. Projects must be catalytic - i.e. they should be capable of changing practices and / or policies. Projects that anticipate the potential for scale up as well as the sustainable integration of evidence-based good project practices into national and regional public health policies will be considered favorably. L'Initiative is a donor that encourages innovative and pilot approaches.

This call for proposals aims to select projects complementary to and/or supporting the Global Fund to strengthen the role of key and vulnerable populations in improving their health and environment. L'Initiative encourages applications that focus on: 1) Implementing adapted, gender-sensitive advocacy and empowerment approaches with a view to promoting human rights and improving access to health services. 2) Improving the quality of health services and access to them by and for key and vulnerable populations, through adapted, gender-sensitive and community-integrated approaches. Projects must be catalytic - i.e. they should be capable of changing practices and / or policies. Consideration of the potential for scale-up* will be viewed favorably. L'Initiative is a donor that encourages innovative and pilot approaches. *Scale up is understood as a change process in a project. Taking an open and evolving approach, scale up projects can be considered those that: - Rework activities using Global Fund financing - And/or replicate and adapt their activities to reach other beneficiaries and/or other countries or within the same country to expand to other regions/districts/cities. Whatever the scalable method is, the objective is to maximize the effect or impact of the project and to meet increasing needs, which have either been only partially met or not met at all.

Over the past 20 years, increasing access to malaria prevention tools and strategies recommended by WHO has had a major impact on reducing the global burden of malaria morbidity. It involves a "combination prevention" approach combining different tools in line with the epidemiological and socio-economic contexts, the capacity of the health system, and target groups and areas. These tools include: - Chemoprevention, which involves the use of drugs, or a combination of drugs, to prevent malaria infection and the consequence this has. This includes intermittent preventive treatment (IPT) for infants and pregnant women, seasonal malaria chemoprevention (SMC) and the mass administration of drugs. - Vector control, which is highly effective in preventing infection and reducing transmission, is based on two main interventions, namely the use of insecticide-treated nets and indoor residual spraying. Use of these tools is currently threatened by the emergence of insecticide resistance among anopheles. According to the latest World Malaria Report , 78 countries reported mosquito resistance to at least one of the four commonly used classes of insecticide during the period 2010-2019. Resistance to all major classes of insecticides was reported in 29 countries. - Vaccination: Since October 2021, WHO has also recommended widespread use of the malaria vaccine RTS, S/AS01 in children in areas with moderate to high transmission of P. falciparum malaria. This is the first vaccine recommended by international regulatory bodies against malaria, which nevertheless raises questions about its limited effectiveness and restrictions around its implementation on the ground (see L’Initiative's Policy Brief on this subject). A second R21/Matrix-M vaccine candidate showed 77% efficacy (above the WHO target of 75% over a one-year period), according to an initial phase II study conducted in Burkina Faso, in children aged 5 -17 months. The data is preliminary, and therefore has not yet produced recommendations, but this vaccine candidate opens the door for new prophylactic options. Combined malaria prevention is one of the cornerstones of the fight against malaria. Coverage of this needs to be strengthened and its potential for impact broadened in order to achieve the goal of reducing malaria-related mortality by 90% by 2030 . It is in this context that this call for proposals sets out to support operational research projects to test and/or validate innovative approaches to improve the access, quality and efficiency of malaria prevention services.