Climate Exchange

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ealth

Rift Valley fever

Rift Valley fever is a viral anthropozoonosis transmit-

ted by mosquitoes. Not much is known about the

virus reservoir and the impact on it of climate or envi-

ronmental changes. The presence of the RVF virus in

Madagascar was demonstrated in 1979 by isolations

from mosquitoes captured in the Moramanga district

rain forest 130 km east of Antananarivo. Since then,

epidemics of RFV have been linked to climate changes

and ecological perturbations caused by humans, favour-

ing the population dynamic of the mosquito vectors and

the transmission of the virus. Its impact is socially and

economically important because it affects both cattle

and human populations.

A workshop to launch the pilot project in October

2008 resulted in the signature of a memorandum of

understanding (MOU) for partnership in climate and

health by ministers and the appointment of two project

coordinators: one specialist and an expert in climate. It

also led to the establishment of the Madagascar Climate

and Health Working Group (CHWG) and the definition

of the terms of reference and formal appointment of the

members (Ministry of Health, Ministry in Charge of the

NMHS, Institut Pasteur de Madagascar, World Health

Organization, Roll Back Malaria, USAID, and Institut

National de Santé Publique et Communautaire).

The CHWG aims to identify the information and

service needs of the health sector, including gaps in

current data, information and service delivery, and

to provide recommendations for filling these gaps.

Strategies include institutional data sharing and target-

ing of research, education and training needs across

the sectors. Access to climate and weather tools for

in 2003 when the malaria unit of the Ministry of Health met

NMHS representatives following an outbreak. The aim was to

establish a close collaboration between the unit and the Applied

Research Service of the NMHS for malaria monitoring, prevention

and response. This collaboration was strengthened by partici-

pation of malaria unit staff in the United States International

Research Institute for Climate and Society (IRI) summer institute

and of Applied Research Service staff in the Southern African

Development Community (SADC) Climate Expert Meeting and

the Southern African Regional Outlook Forum (SARCOF) in

2005. The Epidemiological Surveillance Service, the Institut

Pasteur de Madagascar and international organizations working

in the health sector such as UNICEF and the President’s Malaria

Initiative/United States Agency for International Development

were also included.

This existing cooperation was one of the criteria used by the World

Meteorological Organization (WMO) in the selection of Madagascar as

the first country for the implementation in 2008 of a Learning Through

Doing pilot project focusing on the use of climate information in

support of the health sector. The project objectives were:

• To help Madagascar’s National Weather Service to meet the

specific needs of the health sector in terms of climate data and

information

• To adopt new working methods in the health sector with regard

to the effective and efficient use of climate data and information

for the prevention of epidemics.

The key outcomes expected from the project were:

• Improved service delivery

• Enhanced capacity in the NMHS

• Better use of weather and climate services in the health sector.

Within the framework of the project, three diseases were considered:

malaria, plague and Rift Valley fever (RVF). However, the outcomes

could be extended to all climate-sensitive diseases.

Malaria

Malaria remains the primary public health problem in Madagascar.

In sub-arid regions like the southern part of the country, malaria is

influenced by climate, as rainfall is very important to development

of mosquito breeding sites. Malaria prevails mainly during the wet

season in all districts of the island. The Central Highlands area has

a marked seasonality with an almost total absence of malaria during

the winter period. Fever surveillance has taken place since 2007 in

thirteen sites across Madagascar and climate variability information

will be helpful for understanding the distribution of malaria cases.

Plague

From 1957 to 2001, 20,900 suspected cases of plague were notified

in Madagascar, including 4,473 confirmed or probable bacterio-

logical (21.4 per cent). There have been two important increases

in plague incidence: between 1985 and 1990, partly due to the

socioeconomic difficulties of the country, and from 1994 to 1997,

following improvements to the epidemiological monitoring system

and the reappearance of the plague in the port of Mahajanga.

Endemic plague is prevalent from September to March (hot and wet

season) and July to November (dry season) respectively in the high-

lands and Mahajanga. This confirms the importance of the climate

component in plague surveillance.

From right, the project coordinator and co-chair of the CHWG, the

focal point for the Rift Valley Fever, with staff and patient

Image: Madagascar Met Services