State of Health Emergency extended
First case: 20 March 2020
Total cases: 13,397 (as of 13 August 2020)
Total deaths: 156
Schools: Closed in the capital Atananarivo, the rest of the country opened since 22 April.
Borders/Flights: The Government of Madagascar announced a suspension of all international air travel starting 20 March.
Containment measures: 14-day quarantine mandatory for individuals who have had possible exposure to COVID-19; restrictions on movements on the most affected regions of the country, including the capital Antananarivo (partial containment since 10 August); inter-region movements banned across the country.
In Madagascar, the total number of people who contracted COVID-19 has more than tripled from nearly 3,500 as of 7 July to more than 13,397 as of 13 August. The Government has extended the State of Health Emergency for another 15 additional days effective 8 August, following a deterioration of the COVID-19 pandemic in six regions: Boeny, Itasy, Bongolava, Matsiatra ambony, Bestiboka and Atsimo Andrefana. Out of 22 regions, 21 have reported outbreaks, with the capital reporting 79 per cent of the conﬁrmed cases. The Presidency has further announced plans to ease the full ccontainment measures that have been in place since 5 July for the capital Antananarivo and Moramanga District. Business operations in the two areas will be allowed to operate until 5 p.m., while in Fenerive Est and Toamasina I and II districts are back to normal operating hours subject to respect of the COVID-19 measures, including gatherings limited to 50 people. International ﬂights, except humanitarian, repatriation and cargo ﬂights, remain suspended. President Rajoelina on 26 July opened the ﬁfth coronavirus treatment centre, the Mahamasina Treatment Centre, in the capital Antananarivo, with capacity of 250 COVID-19 patients with severe symptoms, following an increase in infections and an overwhelmed health sector. Protection partners have reported an increase in GBV cases since the COVID-19 pandemic. According to a survey jointly conducted by Ministry of Population and UNFPA, at least 2,053 GBV claims were received in July, including physical violence, psychological violence, economic violence and sexual violence.
Meanwhile, health authorities have continued to use Covid-Organics, a herbal product made with Artemisia annua and launched on 20 April by the President, as a cure and prevention for the virus and is being distributed in schools and communities across the country. On 3 May, WHO published a press release welcoming innovations around the world, including traditional medicines, as part of the search for potential treatments for COVID-19, and warning about the risks of using products that have not been robustly investigated. The document specifically highlights that the use of medicinal plants such as Artemisia annua as treatment for COVID-19 should be tested for efficacy and adverse side effects. The Deputy Chairperson of the African Union Commission, Kwesi Quartey, in a tweet published on 13 May informed that the Madagascar's Health Ministry had agreed to collaborate with the Africa Centre for Disease Control (Africa CDC) to investigate the remedy.
Madagascar has the fourth highest rate of chronic malnutrition among children under age 5 in the world, and has been buffeted by floods and drought in recent months. Across the country, more than 567,700 children are no longer receiving vital school feeding, according to WFP.
Key measures include: (i) increased spending on epidemic prevention and control; (ii) cash-transfers and in-kind necessities to the poorest and those unemployed; and (iii) tax relief, suspension of government fees and waived social contributions.
The Government has adjusted the response strategy by decentralizing the case management in all the basic health centres where drugs and doctors will be made available, allowing patients to be treated immediately without having the results of their test. Only patients presenting severe form will be asked to join the referral centres.
The Government has delivered medicine and PPE to several regions by air, while the German and French embassies have donated respirators to health facilities and the Government of China has donated 14 tons of medical items.In addition, at least 563 units of oxygen concentrators and oxygen nasal cannula imported by the Government were received in the country on 9 August and will be delivered to the most affected regions, including the Capital.
The Presidency has launched an additional $20 million Social Protection Program in the capital, Antananarivo, targeting 200,000 households (about 1 million people). Food for peace allocated $US5 million to WFP to support the social protection programme. In addition, WHO, UNDP, UNFPA, and Madagascar Red Cross have jointly donated in kind-assistance worth $759,000 in medical equipment to the Government, to support the health centers in charge of COVID-19 treatment in several regions of the country. The country’s health facilities are currently overwhelmed with health centres serving mainly severe cases due to lack of capacity.
On 12 March 2020, the World Bank provided a grant of US$3.7 million to strengthen prevention against the COVID-19 pandemic, purchase materials and equipment, and train health workers. On 2 April, the World Bank approved $100 million Development Policy Operation for budget support to improve the human capital. On 3 April 2020, the IMF approved a disbursement under the Rapid Credit Facility, equivalent to US$165.9 million, to meet the external financing gaps arising from COVID-19 and in late July, a second disbursement of US$171.9 million was allocated.
The United Nations and partners have launched a three-month Emergency Appeal calling for $82.3 million to rapidly contain COVID-19 in the country and support millions of people affected by the humanitarian consequences of the pandemic. The Appeal includes support to the country’s weak health system to respond to the outbreak and maintain other basic health services, as well as rapid interventions to provide life-saving and life-sustaining assistance and protection to those most at-risk during the COVID-19 pandemic.