Rwanda's health profile is dominated by communicable diseases, including malaria, pneumonia, and HIV/AIDS. Prevalence and mortality rates have sharply declined in the past decade but the short supply or unavailability of certain medicines continues to challenge disease management. Kagame's government is seeking to improve this situation as one of the Vision 2020 priorities. It has increased funding, with the health budget up from of national expenditure in 1996 to in 2008. It also set up training institutes, including the Kigali Health Institute (KHI), and in 2008 effected laws making health insurance mandatory for all individuals; by 2010, over of the population was covered. These policies have contributed to a steady increase in quality of healthcare and improvement in key indicators during Kagame's presidency. In 2010, 91 children died before their fifth birthday for every 1000 live births, down from 163 under five deaths for every 1000 live births in 1990. Prevalence of some diseases is declining, including the elimination of maternal and neonatal tetanus and a sharp reduction in malaria morbidity, mortality rate, and specific lethality. In response to shortages in qualified medical personnel, in 2011 the Rwandan government launched an eight-year US$151.8 million initiative to train medical professionals.