Objective:
To conduct a thematic review of regional malaria elimination in Southern Africa. The review aimed to develop and consider strategic and managerial options more than evaluating operational details and not to develop a new approach to malaria elimination in this region.

1. Conduct extensive consultations on the current approaches to financing, oversight and governance of malaria elimination in Southern Africa in order to elaborate strategic options for the Global Fund’s Catalytic Investment mandated by the Board that would be complementary to the ongoing or planned interventions in country grants, also considering how the limited country allocations are being prioritized in the relevant countries;
2. Review progress and evaluate strengths and weaknesses of the MOSASWA and E8 grant implementation by the two Principal Recipients (PRs) as well as coordination (including, but not limited to the Regional Coordination Mechanisms (RCM), MOSASWA and E8 activities, other coordination mechanisms such as SADC, national Country Coordinating Mechanisms (CCMs), as well as key partners); and
3. Recommend a best way forward based on prioritization of possible options within approaches elaborated through the consultations, considering technical and political feasibility of options, strengths and weaknesses of multi-country grants, governance and performance oversight options and the funding availability.

Content:
In Southern African countries, two regional structures have applied for Global Fund grants for the 2014-2016 allocation period: The Elimination 8 (E8), supported by eight Heads of State, is a sub-regional initiative with the objective to enable and accelerate to zero local transmission in the four ‘frontline’ countries (Botswana, Namibia, South Africa, and Swaziland) by 2020 through the provision of a platform for collaboration and joint strategic programming. The MOSASWA, consisting of Mozambique, South Africa, and Swaziland is a cross-border malaria initiative built on the E8 platform, which aims to create a regional buffer zone of IRS in Maputo province to reduce the importation of malaria from Mozambique to South Africa and Swaziland. For the 2017-2022 period, the Global Fund aims to address a limited number of key multi-country priorities, which are not easily addressed through country allocations alone but deemed critical to fulfil the aims of the Global Fund Strategy. The Board has allocated US$20 million during the 2017-2019 funding cycle as catalytic investment to address malaria elimination in Southern Africa, with the aim to support WHO’s Global Technical Strategy goal of eliminating malaria in at least 35 countries by 2030.