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 Wednesday 16 June 2010
 
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Country Profile: Madagascar
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AIDS Programmes

National Strategic Framework: 2007-2012; see also 2001-2006

Epidemiological Assessment:
National coordination is the responsibility of the National AIDS Control Committee, attached to the Office of the President of the Republic, which has an executive secretariat to coordinate the overall control effort. The Committee includes governmental partners, civil society and the private sector.

As part of decentralization of the HIV-control effort, regional control committees have been set up and regional coordinators appointed in each of the 22 regions. The activities of the regional committees are an integral part of the regional development plan. There are also local AIDS-control committees in 745 of the 1557 communes. Under the leadership of the Executive Secretariat for AIDS Control, the partners' forum provides a platform for coordinating and providing support for partners. CCM also helps ensure coordination, with the support of partners and donors. CCM is chaired by the Minister of Health, and its Vice President is the Executive Secretary.

Good coordination exists between the Committee and the Ministry of Health, which is responsible for technical activities within the health sector.

The following changes were noted:
 the President of the Republic takes the opportunity offered by each formal event (summit of Indian Ocean Commission (IOC) Heads of State, inauguration of public buildings etc.) more vigorously to stress the importance of HIV; and
 more and more testimonies are being made by people living with HIV in Madagascar.

In Madagascar as elsewhere in the world, much of the work performed by women is unrecognized and unappreciated. In addition, their participation in economic activity has not been matched by a sharing of domestic chores. Women are an increasingly important part of the labour force. Nonetheless, there are still barriers to their entry, and the unemployment rate is higher among women than among men. The 2003 Gender and Human Development report on Madagascar showed that women suffer from problems of access to all areas of social and political life. In Madagascar, young people become sexually active at an early age, between 15 and 19 years (34%, source EDS 2003-2004). Casual sexual relations are also common and 10% of women aged 15–19 years have unprotected casual relations, making them particularly vulnerable to sexually transmitted infections/HIV.

Despite the existence of a law protecting vulnerable persons from stigmatization and discrimination, which helps to establish a favourable environment for AIDS control, there are still certain population groups, especially among women and young people, who are poor and vulnerable on whom the national programme is focusing attention.

Challenges for the future include:
 better resource coordination;
 improving human resources in terms of both quality and quantity;
 marshalling additional funds;
 increasing capacity to absorb resource;
 problems of accessibility;
 strong encouragement for the participation of young people;
 ensuring high quality services are available to all who need them; and
 the main challenge is still universal access to prevention, treatment, care and support for all who need them (greater attention needs to be devoted to marginalized, poor and vulnerable populations).

HIV/AIDS Organisations

  Ministry of Health
Contact person: Dr Andrianjaranasolo Felix, HIV/AIDS Programme Tel: +261 032 40 496 76
Location: +261 20 222 3697
  Email:
  Web:
What we do:

  Comite National de Lutte contre le SIDA (CNLS)
Contact person: Fenosoa Ratsimanetrimanana , executive secretary Tel: +261 32 023 2101
Location: Fax:
  Email:
 
What we do:

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

 Population Services International (PSI)
Contact person: Douglas Call Tel: +261 20 22 629 84
Location: Immeuble- FIARO
Rue Jules RANAIVO
ESCALIER-D, 2eme Etage
BP 7748
Antananarivo 101, Madagascar
Fax: +261 20 22 361 89
  Email:
  Web:  
What we do: Behavior change communications and social marketing for reproductive health (family planning, HIV/STI prevention, VCT) and maternal child health (diarrheal disease and malaria prevention).

 UNICEF
Contact person: Bruno Maes Tel:
Location: Fax:
  Email:
  Web:
What we do:

 WHO
Contact person: Dr Léonard Tapsoba (representative to Madagascar and Réunion) Tel: +47 241 36500 (GPN)
+261 20 233 5555
Location: Rue du Dr Rasseta Andraharo Enceinte
Galaxy Plaza B.P. 362
Antananarivo 101, Madagascar
Mobile: +261 32 0330 300
  Fax: +261 20 2335 554
  Email:
What we do:

 UNAIDS Country Co-ordinator (covering Comoros, Madagascar, Mauritius and Seychelles)
Contact person: Ms Setou Kaba Tel: +261 20 22 366 32
Location: Fax: +261 20 22 641 84
  Email:
  Web: www.unaids.org
What we do: 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.

 UN Theme Group on HIV/AIDS, Chair
Contact person: Mme Barbara Bentein, UNICEF Tel: +261 20 22 206 38 (direct line)
Location: 5, Rue Robert Ducrocq, Behoririka
B. P. 732
Antananarivo 101, Madagascar
+261 20 22 626 46
  Fax: +261 20 22 628 45
  Email:
What we do:

Sources: - The Presidents Emergency Plan for AIDS Relief (PEPFAR)
- The World Bank
- World Health Organization
- United Nations Educational, Scientific and Cultural Organization (UNESCO) Country Profiles
- United Nations Population Division, Department of Economic and Social Affairs. 2005. “World Population Prospects: The 2004 Revision.” New York.
- The Joint United Nations Programme on HIV/AIDS (UNAIDS)

Treatment Map

Adult HIV Prevalence Rate (%) (2003): .95%
No. Of People living with HIV/AIDS: 49,000
No. Of HIV Testing & Counseling Sites: n/a
No. Of People in need of ART: 13, 286 adults 15-49 years ; 3,240 children 0-14 years
No. Of People On ART (UNAIDS June 2007): 89
No. Of Sites Reportedly Distributing ARV (UNAIDS, June 2007): 18, 16 public vs 2 private
No. Of People on ART Public Sector: 89
No. Of People on ART Private Sector: n/a
No. Of People on ART in Non-Governmental Programmes: n/a
No. Of People Expected to be on ART (2006 End): 300
Front Line Drug Regimen: stavudine + lamivudine + nevirapine, also known as triomune
*PMTCT Regimen: Mothers begin taking front line regime at 28 weeks. At onset of labour, a dose of zidovudine and lamivudine is administered and infants are prescribed the same regimen.

HIV/AIDS Fund Disbursements:
Total Funds Disbursed By The Global Fund as of Sept. 2006: US$44,249,362
Total Funds Disbursed By The World Bank Multi-Country HIV/AIDS Programme (MAP) as of Sept. 2006: US$50 million
Total Funds Disbursed By PEPFAR During 2005 Fiscal Year: nil

Source: Laboratoire National de Reference (LNR), UNAIDS

Indicators

Demographics (United Nations Population Fund):
Population:
Population aged 15-59:
Urban population:

Under 5 mortality per 1000 births:
Male life expectancy:
Female life expectancy:
Combined average life expectancy:
Combined average life expectancy 1975-1980:

Education (UNESCO, 2004):
Males with secondary education as percentage of secondary school-age youths:
Females with secondary education as percentage of secondary school-age youths:

Literacy rates (UNESCO, 2004):
Percentage of literate males aged 15 or older:
Percentage of literate females aged 15 or older:
Combined literacy rate for aged 15 or older:
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