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Madagascar, with a population of 24.4 million, faces several humanitarian challenges. The Grand Sud of Madagascar has consecutively been affected by locust attacks in 2013, drought in 2014 and a devastating El Niño induced drought in 2015. However, the government needs more support for the implementation of a preventative long-term locust control strategy and a long-term strategy to build community resilience on the cyclical drought in the southern part of the country.

In 2017, the El Niño phenomenon peaked during a critical time in the agricultural calendar of southern Madagascar, causing drought and failed harvests. As of the end of 2017, some 810,000 people in the south of Madagascar are severely food insecure (IPC phase 3), although this number is expected to improve if the expected maize and pulse harvests materialize in February 2018.

An average of 1.5 cyclones affect Madagascar yearly, the highest number in Africa, and each strong cyclone on average affects 700,000 people. It is predicted that the 2017/2018 cyclone season will have two to four more cyclones than average. The first cyclone of the season, Ava, hit Madagascar on 5 January 2018, causing heavy rains and strong winds, before leaving the island on 6 January as a tropical storm. By 11 January 2018, around 150,000 people had been affected, with a cumulative number of 47,984 people evacuated, 42 dead and 26 missing. The cyclone damaged infrastructure, including houses, schools, roads and government buildings.

Disease outbreaks, such as the bubonic and pneumonic plague, are recurrent in some remote parts of Madagascar. Plague outbreaks normally register around 400 cases (mainly bubonic plague) in rural areas over the period of September to April. In late 2017, an outbreak of pneumonic plague occurred and spread to the capital and other urban areas. Although the effects have largely subsided, the underlying causes have not been addressed and further outbreaks are possible.

Humanitarian needs are exacerbated by chronic poverty: about 9 out of 10 people in Madagascar live on less than $2 per day. Maternal mortality rates are among the highest in the world. More than 50 per cent of children under age 5 are chronically malnourished, and access to clean drinking water is ranked in the bottom four for Africa.