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www.thelancet.com/lancetgh 3 Published Online April 8, 2016 University of Washington, Seattle, WA, USA (M Birger BS, L Singh BA, A Chapin BA, J L Dieleman PhD) University of California, San Francisco, CA, USA (B Zelman MPH, R Shretta MPH) Correspondence to: Joseph L Dieleman; University of Washington; 2301 5th Avenue, Suite 600; Seattle, WA 98121 USA dieleman@u.washington.edu The tracking of government spending and development assistance for the elimination of malaria Maxwell Birger, Lavanya Singh, Brittney Zelman, Rima Shretta, Abigail Chapin, Joseph L Dieleman Abstract Background Substantial progress has been made in re ducing the incidence and prevalence of malaria. In 2016, 111 countries have eliminated malaria and another 35 countries, are making progress toward elimination of the disease. However, little is known about how much governments and donors spend on the prevention and treatment of malaria. Here, we aimed to estimate development assistance for health and government health expenditure for the prevention and treatment of malaria in 35 malaria-eliminating countries.Background Substantial progress has been made in re ducing the incidence and prevalence of malaria. In 2016, 111 countries have eliminated malaria and another 35 countries, are making progress toward elimination of the disease. However, little is known about how much governments and donors spend on the prevention and treatment of malaria. Here, we aimed to estimate development assistance for health and government health expenditure for the prevention and treatment of malaria in 35 malaria-eliminating countries. Methods To measure development assistance for health, we tracked resources from source, to channel, to recipient country or region, between 1990 and 2012, and disaggregated spending across a wide set of programme areas, using data from the Institute for Health Metrics and Evaluation’s Financing Global Health report. We then generated projections of malaria assistance from donors from 2013 to 2017. To measure government health expenditure, we used data from a diverse set of sources including the WHO Global Health Expenditure database and World Malaria Report, to estimate the share of domestic government health budgets spent on malaria from 2000 to 2013. Findings Across the 35 included countries, US$895·5 million was given by donors for the elimination of malaria between 2000 and 2012. The funds were channeled mainly through the Global Fund to Fight AIDS, Tuberculosis, and Malaria. Most of these resources were spent on the strengthening of health systems and on bednets. However, most resources for malaria elimination are provided by local governments. In 2010, the year that included countries received the most donor funding for malaria, government expenditure was still 4·6 times higher than that from foreign funding. Interpretation Analysis of trends in malaria expenditure shows which countries and donors are prioritising the elimination of malaria, as well as how funding for elimination has evolved over time. These data can inform the ongoing eff orts against malaria in the 35 elimination countries, and provide the basis for understanding how other countries can realistically move towards malaria elimination. Funding The University of California, San Francisco’s Malaria Elimination Initiative. Copyright © Birger et al. Open Access article distributed under the terms of CC BY. Declaration of interests We declare no competing interests.