Equatorial Guinea's innovative malaria programs in the early 21st century achieved success in reducing malaria infection, disease, and mortality. Their program consists of twice-yearly indoor residual spraying (IRS), the introduction of artemisinin combination treatment (ACTs), the use of intermittent preventive treatment in pregnant women (IPTp), and the introduction of very high coverage with long-lasting insecticide-treated mosquito nets (LLINs). Their efforts resulted in a reduction in all-cause under-five mortality from 152 to 55 deaths per 1,000 live births (down 64%), a sharp drop that coincided with the launch of the program.