Climate change: malaria is increasing and healthcare is out of reach

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Madagascar is one of the countries most affected by malaria. According to the Ministry of Health, the reported number of malaria cases exceeded the national epidemic threshold in 2023, with 2.8 million cases and 400 deaths recorded, compared to 1.7 million in 2022.

In Ikongo district, where MSF provides health and nutrition care, people face a dual crisis of malaria and malnutrition, exacerbated by geographical challenges. Children under the age of five are particularly at risk of complications. According to USAID, malaria affects approximately 7.5% of children under the age of five in the country.

Roads almost unusable

The peak malaria season coincides with the cyclone and rainy seasons, from October to May. During this time, it becomes extremely difficult for people to access health centers, further endangering the lives of malnourished children. Dr. Nantenaina, doctor at MSF’s Intensive Therapeutic Feeding Center (ITFC), explains:When it rains heavily, it becomes difficult to take care of children. The roads become muddy, flooded and unusable. It is a struggle for both healthcare workers and patients to get around, making it difficult for patients to access health centers or for us to send them back home.“

In hard-to-reach areas such as Ikongo, the distance between households and healthcare institutions is considerable. Soanary, the mother of a four-year-old boy suffering from malnutrition and malaria, describes her journey: “After seeing my son’s condition worsening, I decided to go to the nearest health center. To get here I had to walk four hours and cross the water, with my son on my back.“

Soanary is not the only one facing this situation. The lack of transportation resources and poor road conditions make it difficult for communities to access health centers, especially during the rainy and cyclone seasons. As a result, people only seek medical attention when their health has deteriorated to a critical state.

Climate change is at the heart of the crisis

Madagascar is one of the countries most threatened by climate change. The country has been hit hard by extreme weather events, which have hampered access to health services and undermined overall health and nutrition status. This situation has played an important role in the rise of malaria and malnutrition.

According to the World Health Organization, malaria cases and deaths from the disease have increased by 25% to 55% between 2015 and 2022. Furthermore, the World Malaria Report 2023 highlights that these figures increased by more than 100% between 2000 and 2023. 2022.

Changes in temperature and rainfall, as well as significant heat waves and flooding, can affect the behavior and survival of the Anopheles mosquito, leading to increased disease transmission within communities. In the Ikongo district, which already has a humid tropical climate, the consequences of climate change are particularly serious. People are being cut off from health care, exacerbating an already compromised nutritional situation.

Moreover, many villages in Ikongo are surrounded by swamps and rivers. Heavy rains cause flooding of plantations and rice fields, worsening the already precarious nutritional conditions in the area.

“During the rainy season, our health centers receive many cases of malaria,” explains Evelyne, a nurse at the Ikongo primary health centre. “We have at least one new case of a malnourished child who also suffers from severe malaria every week during the rainy season.” says Dr. Nantenaina, doctor at MSF’s Intensive Therapeutic Feeding Center.

Doctors Without Borders has been present in Ikongo since 2022. Between then and March 2024, MSF medical teams and Malgasy health authorities and health promoters diagnosed and treated 2,205 children suffering from both malnutrition and malaria, including 256 cases this year. In response to food insecurity, which is exacerbated by various climate phenomena and cyclones, MSF teams have increased their activities in the southern part of the country, which has been most affected. Currently, MSF supports seven primary health centers and two intensive nutrition clinics to diagnose and treat malnourished children in Ikongo district.

Distributed by APO Group on behalf of Doctors Without Borders (MSF).