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  MADAGASCAR - Country Profile Updated: March 2005  

AIDS Programmes

National Strategic Framework Status

Finalised for 2000 - 2006. Adjusted in 2002 following first national seroprevalence survey in 2003.

National policies

National monitoring and evaluation plan has been developed Prevention of mother-to-child transmission policy Legal Framework for people living with HIV/AIDS has been established.

Ministry of Health:
Tel: +261 20 222 3697

Conseil National de Lutte contre le SIDA (CNLS)
Contact person: Fenosoa Ratsimanetrimanana - Executive Secretary
Tel: +261 32 023 2101
Email: /

HIV/AIDS Organisations:

  1. Catholic Relief Services (CRS)
    Contact person: Jennifer Overton
    Antananarivo (101) Batiment du Catholic Relief Services
    Route de l'Universite BP 6073
    Tel: +261 20 226 6565
    Email:
    Community awareness campaigns, support for people living with HIV/AIDS and food security projects.

  2. Population Services International (PSI)
    Contact person: Dr Jean Patrick Duconge
    Immeuble-FIARO
    Rue Jules RANAIVO
    ESCALIER-D, 2eme Etage
    BP 7748
    Antananarivo 101
    Tel: +261 20 226 2984
    Fax: +261 20 223 6189
    Condom distribution, HIV/AIDS awareness campaigns, STI treatment, family planning services.

  3. UN Theme Group on HIV/AIDS, Chair
    Contact person: Agniola Zinsou (going to change soon)
    Tel: +261 20 22 226 57
    Email: /

  4. UNAIDS Country Coordinator
    Contact person: Setou Kaba
    UNAIDS
    Tel: +261 20 22 36632
    Fax: +261 33 11 44176
    Email:
    Website: www.unaids.org
    Leads, strengthens and supports an expanded response aimed at preventing transmission of HIV, providing care and support, reducing the vulnerability of individuals and communities to HIV/AIDS.
Country Indicators
Demographic data Year Estimate Source
Total population (thousands) 2004 17,901 UN population division database
Female population aged 15-24 (thousands) 2004 1,722 UN population division database
Population aged 15-49 (thousands) 2004 8,226 UN population division database
Annual population growth rate (%) 1992-2002 2.9 UN population division database
% of population in urban areas 2003 26.5 UN population division database
Average annual growth rate of urban population 2000-2005 3.6 UN population division database
Crude birth rate (births per 1,000 pop.) 2004 40.9 UN population division database
Crude death rate (deaths per 1,000 pop.) 2004 12.8 UN population division database
Maternal mortality rate (per 100,000 live births) 2000 550 WHO (WHR2004)/UNICEF
Life expectancy at birth (years) 2002 56 World Health Report 2004, WHO
Total fertility rate 2002 5.7 World Health Report 2004, WHO
Infant mortality rate (per 1,000 live births) 2000 89 World Health Report 2004, WHO
Under 5 mortality rate (per 1,000 live births) 2000 139 World Health Report 2004, WHO
For consistency reasons the data used in the above table are taken from official UN publications
Socio-economic data Year Estimate Source
Gross national income, ppp, per capita (Int.$) 2002 720 World Bank
Gross domestic product, per capita % growth 2001-2002 -14.4 World Bank
Per capita total expenditure on health (Int.$) 2001 20 World Health Report 2004, WHO
General government expenditure on health as % of total expenditure on health 2001 65.9 World Health Report 2004, WHO
Total adult illiteracy rate 2000 33.5 UNESCO
Adult male illiteracy rate 2000 26.4 UNESCO
Adult female illiteracy rate 2000 40.3 UNESCO
Gross primary school enrolment ratio, male 2000/2001 105 UNESCO
Gross primary school enrolment ratio, female 2000/2001 101 UNESCO
Gross secondary school enrolment ratio, male 2000/2001 not available UNESCO
Gross secondary school enrolment ratio, female 2000/2001 not available UNESCO
For consistency reasons the data used in the above table are taken from official UN publications

Source: WHO/UNAIDS epidemiological fact sheets on HIV/AIDS and Sexually Transmitted Infections, 2004 Update.
Email:
Epidemiological Fact Sheet
Estimated number of adults and children living with HIV/AIDS, end of 2003
These estimates include all people with HIV infection, whether or not they have developed symptoms of AIDS, alive at the end of 2003:
Adults and children 140,000  
Adults (15-49) 130,000 Adult rate(%) 1.7
Women (15-49) 76,000  
Children (0-15) 8,600  
Estimated number of deaths due to AIDS
Estimated number of adults and children who died of AIDS during 2003:
Deaths in 2003 7,500  
Estimated number of orphans
Estimated number of children who have lost their mother or father or both parents to AIDS and who were alive and under age 17 at the end of 2003:
Current living orphans 30,000  

Assessment of the epidemiological situation (2004)

Recent information from Madagascar indicates that HIV prevalence has begun increasing among women attending antenatal clinics. Overall prevalence among antenatal clinic women is now 1.1 percent. Sentinel surveillance data are available from Antananarivo, the major urban area, since 1990 and through 1996. No evidence of HIV infection among antenatal clinic women was found at that time. In 2003, HIV prevalence among antenatal clinic women tested in Antananarivo was 0.3 percent. Outside of Antananarivo, HIV sentinel surveillance among antenatal clinic women was conducted since 1990. In 1994 and 1995, HIV infections among antenatal clinic women were detected in Morondava and Toamasina Provinces only. In 1996, 3 out of 10 sites reporting found evidence of HIV infection. In 2003, HIV prevalence among antenatal clinic women tested in Toamasina, Toliara and Fianarantsoa was 1 percent. In Antsiranana and Mahajanga, HIV prevalence was over 1 percent.

HIV infection among sex workers remains low, less than 1 percent of sex workers tested in 2001 in Antananarivo and Toamasina were HIV positive. HIV infection among sex workers in Antananarivo arose in 1995, after four years of no infections. However, less than 1 percent of sex workers tested in 1995 were HIV positive. In 1995 and 1996 outside of Antananarivo, evidence of HIV prevalence among sex workers was found in only 2 sites. In Antsiranana, 1 to 2 percent of sex workers tested HIV positive during that period. Again, in 1998, 1 percent of sex workers tested in Antsiranana were HIV positive. In Toamasina, less than one percent of sex workers tested were HIV positive in 1995.

In Antananarivo, less than 1 percent of STD clinic patients tested were HIV positive in 1995 and no evidence of HIV infection was found between 1996 and 1998. Outside of Antananarivo, 14 sentinel surveillance sites reported in 1995. HIV prevalence ranged from no evidence of infection to 7 percent in Antsiranana. Nine of the 14 sites found no evidence of HIV infection among STD clinic patients. In 1996, however, HIV prevalence ranged from no evidence of infection to only 0.7 percent from 12 reporting sites, with the majority of sites reporting no infections. In 1996, less than 0.5 percent of STD clinic patients tested in Antsiranana were HIV positive. In 1998, HIV prevalence information was available from three clinics. The only evidence of infection was found at the Antsiranana clinic, 2 percent.



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