The outbreak, which began in 2020, posed a significant threat to public health—particularly among children under five, as well as unvaccinated adults. At its peak in 2023, the country reported 287 confirmed cases, including 45 cases of acute flaccid paralysis and two adult paralytic cases. Additionally, 198 positive detections were identified through environmental surveillance in wastewater across 30 districts in 13 regions.
In response, the Malagasy government—through the Emergencies Operations Centre and in partnership with the Global Polio Eradication Initiative (GPEI)—launched aggressive emergency vaccination campaigns. Backed by unwavering political support from President Andry Rajoelina and First Lady Mialy Rajoelina, the campaigns successfully reached over 19 million people.
“No new cases have been detected since September 2023,” health officials confirmed, meeting the critical benchmarks required for outbreak closure: at least 12 consecutive months without detection, high population immunity, and strong, consistent surveillance.
Key to the success was Madagascar’s intensified surveillance system, which allowed for early detection of the virus in both individuals and environmental samples. This was complemented by house-to-house immunization, community engagement, and a strategic expansion of vaccination efforts that achieved 95% national coverage.
“The progress made in recent years in the immunization and eradication of polio is a hopeful sign,” said First Lady Mialy Rajoelina. “Together, we have proved that it is possible to overcome limits and build lasting change.”
Madagascar’s success story reflects the power of coordinated action. Partners including WHO, UNICEF, Gavi, Rotary International, and the Bill & Melinda Gates Foundation played crucial roles in providing technical, financial, and logistical support. Frontline health workers, community volunteers, and local leaders were instrumental in reaching remote and underserved populations.
Dr. Chikwe Ihekweazu, Acting WHO Regional Director for Africa, emphasized the importance of sustaining momentum: “This success demonstrates that with political will, strong partnerships, and community involvement, polio outbreaks can be swiftly controlled. We must now sustain these efforts to prevent any future resurgence.”
UNICEF Regional Director Etleva Kadilli praised the tireless work of health workers and volunteers: “Madagascar offers a beacon of hope for polio eradication efforts across Africa. But we must remain vigilant to ensure no further outbreaks occur.”
Gavi’s Chief Country Delivery Officer, Thabani Maphosa, echoed the sentiment: “This achievement is a testament to what’s possible when we strengthen routine immunization and expand coverage. Reaching even the most marginalized ensures no child is left behind.”
Looking ahead, health authorities will continue working with global partners to fortify immunization systems, enhance surveillance, and maintain high preparedness levels to prevent future outbreaks—not just of polio, but of other vaccine-preventable diseases.
Haingo Ranoharisoa, Chair of Rotary’s National PolioPlus Committee in Madagascar, summed up the moment: “The closure of this outbreak represents the hard work of thousands of frontline workers, volunteers, and our national health teams who never gave up on protecting our children.”
As the world edges closer to eradicating polio entirely, Madagascar’s achievement stands as both a triumph and a reminder: progress is possible with unity, investment, and the will to act.