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The Challenge

The Challenge

While the 21st century has witnessed unprecedented technological advances and once unimaginable economic growth, the world faces the critical challenge of persistent extreme poverty and disease in the context of environmental unsustainability.

Madagascar is recognized as a uniquely beautiful country, but it is also one of the poorest countries in the world, where most people lack access to basic life-saving healthcare.

The three biggest challenges we face in Madagascar:


A population of over 22 million • Amongst the 10 poorest countries in the world • 72% of people live on less than one dollar per day • Only 13% of households have access to safe drinking water • 54% have no toilet or latrine • Malaria, diarrheal diseases and respiratory infections are among deadliest threats • About half of children are chronically malnourished • 1 in 14 women die during childbirth over their reproductive lifespan • 16% of children die before their fifth birthday • Less than 60% of one-year-olds are fully vaccinated against preventable diseases.


Though we have knowledge & technology to address the leading killers, there is a debilitating deficiency of essential resources • Per capita spending on health in Madagascar is $19 (compared with $94 for Sub-Saharan Africa) • Health facilities lack medicines, supplies, trained staff, and basic infrastructure such as clean beds and water and waste management • Patients face often insurmountable financial and geographic barriers to carePatients must purchase, and even procure, all medicines and supplies before treatment • Over 70% of our catchment live at least 5km from the nearest health center.


Increased knowledge and research are needed to inform the efficacy of public health programs and produce data for replicating and scaling-up delivery modelsHuman health outcomes are a consequence of complex relationships between socioeconomic and environmental factors • We need a more holistic conception of health that incorporates a larger understanding of conservation and sustainable development.


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