At a Glance: Madagascar
Population (2012): 22.6 million
Population at risk of malaria
Estimated annual malaria deaths/100,000 population (2008): 8
Under-five mortality rate (2009): 72/1,000 live births, or approximately 1 in 14 children die before their fifth birthday4
Malaria is a major health problem in Madagascar, and while its epidemiology varies considerably in different regions of the country, the entire population is considered to be at risk for the disease. On the east coast, transmission is stable and perennial, and the west coast has one long, rainy transmission season and a brief dry season. Almost one-third of the Central Highlands is above 1,500 meters elevation, where malaria transmission rarely occurs.
Malaria cases and deaths reported through the national health management information system have declined over the period of 2003–2009, but malaria remains a leading cause of deaths for children under five. Following the political crisis and coup d’état in March 2009, all U.S. Government support to the current government, from the central Ministry of Health to the primary care health facility level, was suspended until a freely and fairly elected government is in place. The fiscal year (FY) 2012 Malaria Operational Plan was developed based on the assumption that U.S. Government suspensions will remain in place.
The President’s Malaria Initiative (PMI)
Madagascar is one of 19 focus countries benefiting from the President’s Malaria Initiative (PMI), which is led by the U.S. Agency for International Development and implemented together with the U.S. Centers for Disease Control and Prevention. PMI was launched in 2005 as a five-year (FY 2006–2010), $1.265 billion expansion of U.S. Government resources to reduce the burden of malaria and help relieve poverty on the African continent. The 2008 Lantos-Hyde Act authorized an extension of PMI funding through FY 2013. With congressional authorization and the subsequent launch of the U.S. Government’s Global Health Initiative, PMI’s goal was expanded to achieve Africa-wide impact by halving the burden of malaria in 70 percent of the at-risk populations on the continent (i.e., approximately 450 million residents), thereby removing malaria as a major public health problem and promoting development throughout the African region.
To reach its goal, PMI works with national malaria control programs and coordinates its activities with national and international partners, including the Roll Back Malaria Partnership; The Global Fund to Fight AIDS, Tuberculosis and Malaria; the World Health Organization (WHO); the World Bank; the U.K. Department for International Development; numerous nongovernmental organizations, including faith-based and community groups; and the private sector.