The BOHEMIA project is a Unitaid-funded initiative that aims at reducing malaria transmission using a unique approach, mass distribution of a drug that kills malaria vectors feeding upon treated humans or livestock. The backbone of the project are two, large cluster-randomized trials in which close to 30,000 subjects and their livestock will be randomized to receive either ivermectin or albendazole as non-mosquito killing control. The first trial is currently ongoing in Mopeia, a rural district in northern Mozambique. The local malaria prevalence in children under 5 is 60-75% and the incidence is close to 5 infections per child, per year, in spite of high coverage of bednets and IRS. BOHEMIA will assess the incremental impact of this potential new tool against malaria. Along with determining the efficacy and safety of the drug, the project has strong components addressing health economics, social science, environmental impact and entomology.