The Executive Director of UNAIDS Winnie Byanyima is calling for accelerated global solidarity to strengthen Madagascar’s response to HIV, including preventing new HIV infections and expanding access to treatment, to end AIDS as a public health threat. Ms Byanyima is visiting the country between 19–24 October to support its response to the HIV epidemic. Madagascar has seen dramatic increase in new HIV infections since 2010 and a 158% increase in AIDS-related deaths over the same period. UNAIDS is concerned about what appears to be a dramatic increase in new HIV infections. 

“Madagascar is experiencing a rapid increase in the number of new HIV infections in communities, in stark contrast to the regional trend where new HIV infections are declining,” said Ms Winnie Byanyima, Executive Director of UNAIDS. “Madagascar’s pandemic is driven by gaps in HIV prevention and glaring inequalities which must be urgently addressed.”

In 2023 there were an estimated 76 000 people living with HIV in Madagascar and around 3100 people died of AIDS-related illnesses.   Gaps in data gathering and weak surveillance systems make estimating the scale of the pandemic difficult. Stockouts of HIV testing kits and limited access to testing facilities further hinder accurate data collection in communities.

In addition, the majority of people living with HIV do not have access to treatment. Only 22% of the estimated 76 000 people living with HIV in Madagascar had access in 2023.

In northern Manakara HIV testing campaigns by the Ministry of Health have shown urban HIV prevalence rates ranging from 3% to 18% among the population.  There is a need to strengthen comprehensive data gathering to better inform the national HIV response to effectively tackle the pandemic.  

UNAIDS has been actively supporting Madagascar’s HIV response, especially in strengthening the surveillance systems to ensure more accurate and comprehensive data collection. UNAIDS has also been supporting the implementation of HIV testing and counselling services and helping to expand access to antiretroviral therapy.

Madagascar is one of the most unequal countries in the world, a factor which is driving new HIV infections. In 2023, the World Bank estimated the country’s poverty rates at 62.6%. Madagascar has been hit by cyclical natural disasters including drought in the south and cyclones, making it difficult for the country to recover and mount an effective response to HIV.

“Madagascar can scale up its response to HIV but urgently needs technical and financial support from the international community to ensure that HIV prevention commodities, including condoms, testing kits and antiretroviral treatment are available to everyone in need,” said Ms Byanyima.