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The launch of the Roll Back Malaria (RBM) programme in 1998 coincided with enormous changes in Zimbabwe’s political economy. The economy was in decline following the adoption of the Economic Structural Adjustment Programmes (ESAP) in the early 1990s. Inflation, simmering land grievances among former liberation fighters and the rise of a formidable opposition party, the Movement for Democratic Change (MDC) in 1999 among other reasons threatened the ruling party ZANU PF’s position. These developments brought more attention to the contentious and highly politicised land question and led to a violent and unsystematic acquisition of land from white farmers and its redistribution among the black majority as the ruling party sought to satisfy the electorate and hold on to power at turn of the 21st century. This paper examines the implementation of the Roll Back Malaria Control programme within the context of the Fast Track Land Reform programme and the subsequent Zimbabwean crisis. It shows how the prevailing economic challenges affected malaria control and led to Zimbabwe’s resolute stance on the continued use of IRS with DDT at a time when the chemical had been banned in most countries. Despite the RBM’s insistence on dropping IRS from the pool of interventions, the Zimbabwean government remained unwavering in its reliance on IRS as the primary method of malaria control.