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How to explain Madagascar’s low HIV/AIDS rate?
Madagascar stands apart from sub-Saharan African nations with regard to HIV/AIDS rates. At below 0.3%, Madagascar has the same proportion of adults living with HIV as the United Kingdom [UNAIDS]. This is the lowest prevalence rate in Sub-Saharan Africa [CIA World Factbook] (see figure) and the main reason why life expectancy at birth in Madagascar (at 65 years) is 7 years longer than the sub-Saharan African average [World Bank]
A significant reason for this is Madagascar’s geography as an island, which greatly reduces the cross-border transfer of people, especially traders, truck drivers and migrant workers, that has contributed to the rapid spread of HIV across southern Africa. This geographic isolation has also shielded Madagascar from some other infectious diseases that are widespread in southern Africa, in particular human trypanosomiasis (sleeping sickness).
Figure 1: HIV/AIDS prevalence in Africa. Madagascar's geography and timely action by the government and aid agencies have helped the country to escape the worst of the pandemic so far (Source: UNAIDS).
Other factors reducing the spread of HIV in Madagascar are the relatively low level of urbanisation and movement of people within the country and the fact that Madagascar has not suffered any civil or foreign wars since independence. However, the high rates of other sexually transmitted diseases such as gonorrhoea and syphilis suggest that if HIV/AIDS were ever to gain a foothold in Madagascar, it could spread rapidly, especially in urban areas.
Due to Madagascar’s geography, the country largely escaped the first wave of HIV/AIDS that swept southern Africa in the 1980s. This created a window of opportunity for prevention programmes to be established in Madagascar before the disease became widespread. The National AIDS prevention plan carried out by the government prior to the political crisis of 2009 and the actions of international aid agencies and NGOs have been invaluable in raising awareness of HIV and preventive measures to contain the epidemic.
Yet Madagascar remains at high risk of HIV spreading further. Antiretrovirals have transformed the way we fight the pandemic by reducing infectivity and dramatically improving the life expectancy of infected people. In the last few years, these drugs have become available to millions of people across Africa and are no longer the preserve of the rich. But in Madagascar only two per cent of people living with HIV/AIDS are currently receiving antiretroviral treatment - the lowest rate in the world [World Bank].
Many of the containment efforts and education campaigns that have kept the disease at bay so far have faltered during the political crisis and the associated loss of most foreign development assistance. Rebuilding and extending these programmes to enhance awareness, diagnosis and treatment of HIV/AIDS are crucial tasks for the new Madagascan government and its partners in the years to come.
PROJECTS
17.03.2016
80% of Madagascans live in extreme poverty. As there is no universal health insurance, Doctors for Madagascar covers the medical costs for patients who otherwise could not afford medical care.
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17.11.2015
Doctors for Madagascar organises regular aid missions with volunteer doctors and medical staff from Europe. These volunteers treat patients directly and also provide training for local staff.
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01.10.2015
Southern Madagascar urgently needs qualified medical personnel. Our project "Skills to Save Lives" provides medical training for doctors, nurses and technical staff in one of the poorest areas of the country.
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01.09.2015
Pregnant women with severe labour complications often only reach a clinic after traveling for hours on an oxcart – with serious consequences for them and their child. Most have no access to pre-natal care. Doctors for Madagascar is working to improve care for pregnant women and newborns.
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17.08.2015
In Madagascar, patients are generally fed and cared for by their families. So that food shortages don't get in the way of treatment, Doctors for Madagascar covers the subsistence costs of all in-patients in our partner hospitals.
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17.07.2015
Many hospital buildings and health centres in Madagascar are in a desperate state, with no money for even the simplest repairs. Doctors for Madagascar supports hospitals and health centres to build and renovate essential facilities.
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17.06.2015
Kept in good condition, hospital equipment saves lives. But extreme climates, inconsistent electricity and inadequate maintenance in Africa wear out medical equipment much faster than in the UK. We provide not only medical equipment, but also training on maintenance and care.
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CLOSE UP
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FUNDRAISING EVENTS
Since 2012, Doctors for Madagascar has been an NGO partner at Praxis Update, a continuing medical education conference for GPs.
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PATIENT STORIES
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BEYOND MEDICINE
For a long time, relatives cooked meals for patients on traditional open fires in the wasteland outside the hospital site.
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PATIENT STORIES
April 2012: Sweaty and shivering with exertion, two oxen drag a heavily laden cart the last few metres to Fotadrevo hospital. The passenger, Tiana, has a 40°C fever and is nine months pregnant.
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MISSION REPORTS
Financing an aid mission yourself? Yes, it’s possible - Johannes Häußermann is the proof, with his crowdfunding drive "An Engineer for Madagascar".
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BACKGROUND
Developing countries have seen dramatic improvements in many areas over the last 15 years.
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BACKGROUND
Madagascar stands apart from sub-Saharan African nations with regard to HIV/AIDS rates. Why?
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PATIENT STORIES
The sun burns hot on 7th December 2012. One of Médecins Sans Frontières’ white 4x4s pulls into the gate of the hospital in Fotadrevo, carrying three women from the town of Bekily, 60 km away.
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ON THE GROUND
Nine hours’ worth of parched land pass by our 4x4 as we travel from Toliara to Fotadrevo. Cacti, shrubs, scant trees and now and then a village of mud huts. Sand and dust reach as far as the eye can see, in shades of red, brown and grey.
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