Journal of Poverty Alleviation and International Development, 6(2) ©2015 The Author. Published by the Institute for Poverty Alleviation and International Development under open access license CC BY-NC-ND 3.0. jpaid.yonsei.ac.kr State-led Malaria Control Efforts in the Developing World* Natasha M. EZROW** Abstract : The state can play a critical role in combating disease. However, international approaches in the most vulnerable countries have tended to undermine state building to the detriment of effective disease management. Though well intentioned, vertical programs executed by international agencies and NGOs can create islands of excellence that leave a tremendous void once they exit their target country. Ministries of health devote considerable resources to dealing with vertical programs, and, public healthcare institutions are weakened because other health issues are neglected. Moreover, external agencies have great difficulty adequately meeting local needs when projects circumvent the public healthcare system. Finally, tackling disease requires a response from the state that goes beyond the public health care system to confront the challenges of prevention, detection and treatment, both at the national and local levels. This paper explores the impact that the state can have in mitigating the spread of one particular disease, malaria, and critically examines the role of vertical programs. Vietnam is presented as a case study. Keywords : Malaria, Vietnam, Public healthcare, State building, Vertical programs * This is an open-access article distributed under the terms of the Creative Commons license Attribution-Noncommercial-NoDerivs 3.0 Unported. Distribution and reproduction are permitted, provided that the original author and JPAID as the source are credited. ** Dr. Natasha M. Ezrow is Senior Lecturer in the Department of Government at the University of Essex in the UK. Email: nezrow@essex.ac.uk