A Success Story: Madagascar in Remission

After months of treating patients and enacting public health measures, it appears that the WHO and the government of Madagascar have successfully battled the plague into remission on the African island nation.

The plague, the same disease that killed 50 million in Europe during the Middle Ages, is a regular occurrence in Madagascar, with the plague season lasting from September to April. Yet this year’s outbreak was particularly severe, with around 1800 suspected cases and 127 deaths by the end of October.

Though the rapid spread of the disease was cause for worry in itself, even more alarming was that the disease was spreading in the form of the rare pneumonic plague. Pneumonic plague is much more deadly than the bubonic plague that Madagascar is accustomed to — the infected typically succumb to the disease within 24 hours unless treated with antibiotics. Pneumonic plague, which is transmitted through droplets released when coughing, can also spread more easily than the bubonic form, which requires being bitten by a flea.

The outbreak seemed poised to be a major health crisis, as the disease spread to coastal cities and the capital city of Antananarivo. The nature of the pneumonic plague makes these urban areas suitable for the spread of the disease. Plague outbreaks in Madagascar usually only occur in rural settings, meaning that cities were unprepared for the disease. Thankfully, the WHO, having learned from the public’s scathing criticism for getting involved too late in the Ebola crisis, intervened and has helped the government get the outbreak under control.


The WHO provided 1.2 million doses of antibiotics and nearly $1.5 million in emergency funds in order to combat the spread of the disease. The organization has also been providing disinfectant materials, personal protective equipment, and training for public health workers in Madagascar to effectively identify the disease and care for the infected. Health officials identified over 7,000 cases of potential patients and helped 95% of them follow a 7 day antibiotic regimen. The speed and efficiency with which the WHO acted showcased the organization’s work at its finest.

Thanks to the work of the WHO and Madagascar Ministry of Health’s diligence, the disease now appears to be in remission. Multiple weeks have passed without any new confirmed cases of plague, with the last confirmed case of bubonic plague on October 28 and the last confirmed case of pneumonic plague on October 29. According to the WHO, “the number of new cases and hospitalizations of patients due to plague is declining in Madagascar.”

Yet, the WHO is still proceeding with caution. It will only take one new untreated case to pop up for a renewed spread of the disease to take place. And though the disease has not spread to neighboring countries, the WHO has still identified Comoros, Ethiopia, Kenya, Mauritius, Mozambique, La Réunion (France), Seychelles, South Africa, and Tanzania as at risk of receiving the disease from Madagascar. Stringent screening has been taking place in the airports of Madagascar in order to limit the spread of the disease.

All in all, this success story should encourage the international community to continue to support such organizations and disprove those who are cynical about the usefulness of such organizations.

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