Air and water pollution are major environmental problems in Madagascar. According to the Health and Pollution Action Plan (HPAP), nearly one in three people in Madagascar die prematurely from exposure to pollution [1]. Exposures to contaminated air and water are the country's main risk factors contributing to death and disease [1]. In 2016, diseases resulting from exposures to pollution were responsible for 31.3% of all deaths nationwide. Among the pollution problems, indoor air pollution was responsible for 10.7% of all deaths, outdoor air 4.3%, unsafe water 8.1%, unhealthy sanitation for 7.4%, lead exposure for 0.5% and occupational exposure to carcinogens for 0.4%[1].

Contamination of water from floods and pollution of water resources during drought, combined with rising temperatures, increase the transmission of prevalent diseases in Madagascar. According to the 2019 government survey supported by UNICEF, bacterial water pollution, largely caused by open defecation, affects more than 86% of households in Madagascar. It is estimated that diseases resulting from pollution cost Madagascar between US $ 117 million and US $ 166 million in 2015 due to lost productivity, the equivalent of 1.2% to 1.7% of the country's GDP [1].In 2016 the solid waste generation rate in the country’s capital Antananarivo was approximately 1,100 tons per day and World Bank estimated it to reach 1,600 tons per day by 2020 due to population increase and changes in the mode of consumption. The waste collection rate in 2016 was approximately 75% but projections showed that the rate could drop below 50% if the means of waste collection and disposal remain flat [2]. Waste in the capital of Madagascar saturates the Andralanitra landfill, which is the only landfill of the Urban Community of Antananarivo, and causes threads to environment and human health. The waste from the landfill contaminates water and land, while the odours, toxic gases and outbreaks of insect pests make living conditions unpleasant for residents [3].


Contributors to environmental pollution in Madagascar include deforestation, transport emissions, unsustainable agriculture, and land use. The use of wood and charcoal for cooking is a major source of indoor air pollution and contributes to the high indoor pollution (PM10 and PM2.5) in Madagascar, while emissions from traffic, processing food, automobile manufacturing, the petroleum industry are sources of outdoor air pollution.

Floods, cyclones, agricultural activities, as well as poor land and wastewater management are the main polluters of water bodies and soil in the country. Madagascar has rapidly growing cities and rural towns that are prone to flooding, storms, drought and heat stress. Cyclones and floods regularly contaminate urban wells and increase the incidence of water-borne diseases in the country.

In Madagascar, open defecation and improvised latrines commonly pollute downstream water [4]. Uncollected solid wastes, disrupted and dispersed by heavy rains and high winds, cause additional pollution. Population growth and urbanization increase the pressures for waste management.  


Key policies and governance approach

Madagascar has ratified the Basel Convention, Rotterdam Convention and Stockholm Convention in 1999, 2004 and 2005 respectively. In addition, Madagascar has signed the Libreville Declaration, which represents a common framework for the implementation of priority actions in health and environment in African countries. Poor air quality, chemicals, new toxic substances, industrial and domestic hazards are among the factors are highlighted in the Declaration, providing the basic rationale for tackling these issues in the country. Madagascar has a Working Group on Health and the Environment which implements national actions under the Declaration. 

The Health and Pollution Action Plan (HPAP), a joint program between national ministries and the Global Alliance for Health and Pollution (GAHP), helps Madagascar to analyse pollution challenges and to advance concrete actions to reduce the impact of pollution on public health [1]. The priority pollution problems identified by the HPAP working group in Madagascar are to reduce the health impacts of household air pollution, to reduce the health impacts of outdoor ambient air pollution and to reduce the health impacts of contaminated sites and exposure to chemicals [1].


Successes and remaining challenges

The Ministry of Environment and Sustainable Development (MEDD) oversees environment pollution, air, and water quality monitoring, but in practice its capacity is limited. The lack of technical staff and financial means impedes efforts to improve efficiency and so little progress has been made [1]. For example, there is conflicting information on the existence of sources of air emission standards[1]. Thus, existing legislation and regulations do not seem to cover all environmental pollution.

Also, there is no formal mechanism for discussion or coordination around air pollution between ministries, only ad-hoc meetings can be organized when there are visible and serious pollution problems or accidents brought to attention by the media[1].

In addition, Madagascar has validated a national policy and a strategic plan to fight against non-communicable diseases, but pollution has not been included in its scope,  despite growing recognition of its contribution to noncommunicable disease mortality[1]. Thus, there is a need to mainstream pollution into related national strategies in Madagascar.


Initiatives and Development Plans

The government of Madagascar recognizes the pollution problems and has partnered with the World Bank in the Integrated Urban Development and Resilience Project for Greater Antananarivo (PRODUIR), which is being implemented until 2023. The objective of the PRODUIR project is to improve urban living conditions, flooding resilience and reduce pollution in low-income neighborhoods of Antananarivo [3].


Goals and Ambitions

Given the significant public health burden of environmental pollution in Madagascar air and water quality and improved sanitation should be essential elements in promoting public health in the country.



  • The government of Madagascar and policy makers must recognize and prioritize pollution challenges and integrate pollution control into national development plans, policies and programs.
  • The Health and Pollution Action Plan (HPAP) provides several recommendations for the government of Madagascar. The highest priority recommendations include the inclusion of pollution as a national priority in internal development plans, as well as in national development strategy documents created for international development partners and other aid donors.
  • Also, to give clear responsibility and the necessary resources to a specific body to monitor pollution problems, advise on actions and report on progress.