Madagascar Faces Dual Crisis of Malaria and Malnutrition

Antananarivo, Madagascar – Madagascar is grappling with a severe dual health crisis as the number of malaria cases for 2023 has surged past the national epidemic threshold, with reports from the Ministry of Public Health indicating a staggering 2.8 million cases and 400 deaths.

This marks a significant increase from the 1.7 million cases reported in 2022, highlighting a troubling escalation in the disease's spread.

In Ikongo district, Médecins Sans Frontières (MSF) is on the front lines, providing essential health and nutritional care to combat both malaria and malnutrition, particularly in children under five who are at high risk of complications.

According to USAID, around 7.5% of children under five in Madagascar are affected by malaria.

The peak of malaria season coincides with the cyclone and rainy season, running from October to May. During this period, access to healthcare becomes critically impaired.

Dr. Nantenaina from the Intensive Therapeutic Feeding Centre (ITFC) operated by MSF in Ikongo explains, "When the rain is heavy, providing care for children becomes difficult.

The roads become muddy, flooded, and unusable, complicating both patient access to health centers and our ability to provide care."

For many in remote areas like Ikongo, reaching a health facility is a formidable challenge. Soanary, a mother whose four-year-old son suffers from malnutrition and malaria, shared her ordeal: "After seeing my son's condition deteriorate, I had to walk for four hours and cross through water to get to the nearest health centre."

Climate change exacerbates these health crises. Madagascar, severely threatened by climate changes, faces extreme weather events that disrupt access to healthcare and aggravate the state of health and nutrition.

The World Health Organization notes that malaria cases and deaths rose by 25% to 55% from 2015 to 2022, with a more than 100% increase since 2000.

The behavior and survival of the Anopheles mosquito, responsible for transmitting malaria, are influenced by changes in temperature and rainfall, as well as by significant heat waves and floods, leading to increased disease transmission.

Evelyne, a nurse at the Ikongo primary health centre, noted, "During the rainy season, our health centres receive a lot of cases of malaria.

" Dr. Nantenaina added, "We have at least one new case of a malnourished child who also suffers from severe malaria every week during this season."

MSF has intensified its efforts in response to the escalating food insecurity driven by climatic phenomena and cyclones, particularly in the southern part of the country, which is most affected.

Since its deployment in Ikongo in 2022, MSF, in cooperation with Malagasy health authorities, has diagnosed and treated over 2,200 children suffering from both malnutrition and malaria, including 256 cases this year alone.

This crisis underscores the urgent need for continued support and innovative solutions to health care delivery in regions like Ikongo, where geographic and climatic challenges persistently hinder access to essential medical services.