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In early 2007, at the invitation of the Clinton Foundation and the Ministry of Health in Malawi, PIH (Abwenzi Pa Za Umoyo (APZU) in Chichewa, the national language of Malawi) began operating in Malawi to replicate the rural initiative programs that have proven so successful in delivering HIV treatment and comprehensive primary health care in Rwanda and Lesotho. The Malawi Ministry of Health directed PIH and CHDI to the impoverished rural area of Neno, and in early 2007, the partners began to implement an ambitious plan to combat the disease. Like PIH’s other projects, APZU combines treatment for HIV patients with comprehensive, community-based health care and programs to combat the conditions of extreme poverty in which disease takes root, including hunger and lack of access to clean water and decent housing, schools and livelihoods. From Neno and ten other rural health centers, APZU serves about 100,000 people spread over an impoverished rural area about half the size of Rhode Island.