According to the WHO, in the African Region, about 473 000 children die from pneumonia, 300 000 from diarrhea, and a further 443 000 from malaria every year. Mortality in hospitalized cases of severe pediatric malaria is 9%-10%. Many efforts to prevention infection and improve nutrition so as to modulate the impact of infection are in place but when critically ill children present, correctly preparing staff and systems to prioritize effective care can make the difference. This session will discuss why children die from malaria, reading the signs and practical prioritization of care to reduce morbidity and mortality.