1) To facilitate empowerment of the Rusinga community through increased participation in local health and environment policy formulation and implementation. We will establish an interactive partnership linking this isolated community to relevant national and international partners. A programme of training, education, local policy development and technology transfer will be implemented through a novel institutional framework that connects local decision making and action to the most relevant and up-to-date information and skills in the national and international healthcare community. We will evaluate the effect of this program on local attitudes, priorities and policies and then compare and contrast these with current national and international norms. 2) To demonstrate the effectiveness of community-implemented malaria control by targeting larval stages of mosquitoes. We will harness the improved local decision-making and implementation capacity resulting from aim 1 activities to initiate and evaluate a novel malaria prevention programme through increased community awareness and active mosquito abatement. We will also collect baseline socioeconomic status data so that we can evaluate the longer term economic consequences of the control program. 3) To develop an institutional framework and strong national capacity for the consolidation and replication of local health coalitions and communal malaria control initiatives. We will augment institutional capacity both locally and nationally through career development of Kenyan investigators and the transfer of technology, skills and responsibility from the international collaborators. The results will be used as a basis for subsequent consolidation and expansion of these approaches more broadly across the District through the Suba Health Coalition. The results will also be disseminated to local, national and international policy makers so that this approach can be extended and expanded to other communities in Kenya and elsewhere in Africa.