This report outlines the U.S. Government’s (USG’s) contributions to a dramatic scale-up of malaria prevention and treatment measures across 15 President’s Malaria Initiative (PMI)-supported countries over the past four years. Many of these countries have reported significant reductions in under-five mortality, and there is strong and growing evidence that malaria prevention and treatment efforts are a major factor in these reductions. Throughout this report, we highlight the USG’s role in the scale-up of malaria interventions,training of health workers, support for services and commodities, and health systems strengthening. Progress in malaria control is a result of the collective actions of African governments; international donors, including the USG, The Global Fund to Fight AIDS,Tuberculosis and Malaria (Global Fund), and World Bank; and nongovernmental organizations.