A spotlight on Madagascar on World NTD Day

Health workers, Berthine and Prisca, are walking to households, collecting information and giving Mebendazole and Praziquantel to children from five years old to fifteen in Maromitety Vatomandry, Madagascar. Credit: Viviane Rakotoarivony/The End Fund/SCI Foundation.

This World NTD Day, we shine a light on one of our long-standing partners, Madagascar, to better understand the challenges they face and listen to their guidance on what is needed to achieve health equity.

As a community committed to beating neglected tropical diseases (NTDs), it’s important we act collectively to drive country ownership if we are to reach the ambitious goals of disease control and elimination that have been laid out in the 2021-30 road map.

Q&A with Dr Clara Fabienne Rasoamanamihaja and Lovasoa Thierry Randriatahina

Q: Why is World NTD Day relevant for your country?

A: NTDs continue to be a major public health issue in Madagascar but unfortunately, they have not received much attention. It is therefore important to increase awareness of NTDs among the entire population, as well as leaders at all levels, including political, administrative and social. In addition, it is critical to encourage better adoption of the global strategy recommended by WHO in the implementation of disease control activities.

Q: How do NTDs affect the people of Madagascar, particularly schistosomiasis and soil-transmitted helminths?

A: There are 114 districts in Madagascar; 106 are endemic for schistosomiasis (SCH) and 111 are endemic for soil-transmitted helminths (STH). To give you a better picture, demographically 92% of the total population are at risk of SCH, and over 95% at risk of STH.

Q: How is your country working to tackle SCH and/or STH?

A: The NTD Programme in Madagascar follows the guidelines recommended by WHO, which focuses on monitoring and implementation through preventive chemotherapy (i.e., mass drug administrations, MDAs) to combat these diseases.

Q: What are the main challenges preventing the achievement of health equity?

A: There are several barriers to health equity in Madagascar, such as high socio-economic inequality among the population; difficulties concerning the geographic and economic accessibility to healthcare; entrenched customs and traditions; and a lack of social mobilisation and information.

Q: What has SCI Foundation’s support meant to your NTD Programme?

A: The support of SCI Foundation has enabled us to move forward in the fight against NTDs, especially for SCH. Our partnership has strengthened public awareness, and the buy-in and trust of local leaders in NTD activities. It has facilitated the national programme to improve operational skills with regards to business planning and implementation and has improved the country’s global visibility of our progress in the fight against NTDs. Lastly, we have been able to engage other technical and financial partners to join, expand and support SCH programme activities at both national and international levels.

Q: What more needs to be done on a national, but also a global level, to combat NTDs and reach health equity?

A: It is critical that we increase the awareness and mobilisation of technical and financial partners to solidify their involvement in the fight against NTDs; this also applies to national leaders. We also need to expand the target population for MDA processing and complement and improve NTD control strategies to address NTDs at both a national and global level. Finally, it is important to continue developing the technical skills of programme staff.