Against the odds: Madagascar’s fragile polio victory

Madagascar faced an outbreak of polio between 2020 and 2023, leaving dozens of people paralyzed. In the face of this crisis, the government — alongside global health partners — launched seven sweeping vaccination campaigns across the country. In May, the outbreak was officially declared over.

The fight involved a symphony of people and organizations playing different roles — ranging from community health volunteers navigating remote terrain, to international agencies coordinating logistics and funding. They’ve faced enormous challenges, including hard-to-reach communities, vaccine misinformation, limited resources, frequent cyclones, and complicated data collection systems.

And the success remains fragile — with cuts to foreign aid threatening hard-won gains.

To understand what it took to fight polio in Madagascar — and what’s at stake if those efforts falter — Devex traveled across the island, visiting clinics, and speaking with health workers, volunteers, officials, and families working to protect the next generation.

“The idea of a child dying or being paralyzed by a vaccine-preventable disease is just tragic,” said Katy Clark, senior program manager at Gavi, the Vaccine Alliance. “It’s critical that children are given the same opportunities in Madagascar as they’re given in Manhattan.”

Keep reading: Join Devex on the ground as we trek across Madagascar to hear the stories of those who have worked to keep polio at bay. This story was supported by a U.N. Foundation press fellowship. Devex retains full editorial independence.