HIV is on the rise, even though the disease has not yet reached alarming levels compared to other countries on the continent. The infection rate remains low, at less than 0.5% of the population. However, the number of Malagasy people living with HIV has tripled over the past decade, and the mortality rate has increased fivefold during the same period.
UNAIDS estimates that nearly 70,000 people are living with HIV/AIDS in Madagascar, a figure steadily increasing, according to Dr. Haja Randriantsara, the executive secretary of the National Committee against STDs and AIDS.
“In 2023, we observed an increase in new HIV cases, especially among young people and key populations, such as sex workers, men who have sex with men, injectable drug users, and pregnant women. This is truly alarming, as it poses a time bomb for our country. The challenge we face is that a significant portion of the population believes that AIDS does not exist in Madagascar. This is because, in 2016, public awareness and prevention campaigns through mainstream media were discontinued.”
According to a model developed by two epidemiologists and published in a scientific journal in December 2023, the epidemic’s peak could be reached by 2033, with an infection rate ranging between 9% and 24%, if no significant action is taken.
The government has already drafted a new five-year strategic response plan. The goal is to reinvigorate public awareness through mainstream media and reactivate prevention efforts in various sectors such as tourism, education, and the armed forces.
However, Dr. Hery Zo Andriamahenina, the medical coordinator at Doctors of the World, where numerous activities are conducted among sex workers, warns, “The fight against HIV/AIDS relies on testing. Unfortunately, in Madagascar today, we are sorely lacking in rapid diagnostic tests. Medications, specifically antiretrovirals to treat patients, are available and accessible for free, which is commendable. However, without these testing tools, the disease could spread uncontrollably.”
This deficiency is expected to be addressed through the new national strategic plan, provided that the necessary funds are gathered for its implementation.