AGP Executive Report

Polio Update: WHO says poliovirus type 2 transmission has been interrupted in five African countries—Burundi, Ghana, Guinea-Bissau, Republic of Congo, and Uganda—after assessments and targeted vaccination plus stronger surveillance. Health Workforce Crisis: A Lancet Public Health study estimates the world still needs 34.4 million more health workers (doctors, nurses, midwives, dentists, pharmacists) to reach moderate universal health coverage; it highlights very low nurse density in places like Chad and Madagascar. Nurses Under Attack: On World Humanitarian Day, the International Council of Nurses launches the #NursesforPeace bulletin, urging an urgent end to attacks on health professionals and calling for enforcement of international humanitarian law, with examples including support for emergency care in Madagascar. Water, Sanitation, Hygiene: WHO and UNICEF research finds nearly one billion people rely on healthcare facilities without water, leaving patients and health workers without basic conditions for safe care. Regional Health & Security: At the SADC summit in Durban, leaders discussed regional priorities that include health financing and cross-border cooperation, alongside broader industrialisation and security goals.

World Humanitarian Day: The International Council of Nurses (ICN) launched a new #NursesforPeace bulletin, urging an urgent end to attacks on health workers, patients, and facilities in conflict and disaster zones, including support efforts linked to Madagascar. Health Workforce Crisis: A Lancet Public Health study warns that the world still needs 34.4 million more doctors, nurses, midwives, dentists, and pharmacists to reach moderate universal health coverage, with nurse density in Madagascar reported at just 3.3 per 10,000. Clean Care Basics: WHO and UNICEF research says nearly 1 billion people used healthcare facilities without clean water in 2025, a major safety risk for patients and staff. SADC Summit and Health: Southern African leaders meeting in Durban backed regional priorities that include healthcare financing alongside industrialisation, infrastructure, and agriculture—key for long-term service delivery. Rubella Vaccination Gap: Global reporting highlights that rubella vaccine coverage is improving but remains uneven, with many countries still lacking routine programmes, raising risks for pregnancy-related birth defects.

Health Workforce Crisis: A new Lancet Public Health study warns that global shortages remain severe, estimating an extra 34.4 million doctors, nurses, midwives, dentists, and pharmacists are needed to reach moderate universal health coverage—highlighting especially low nurse density in sub-Saharan Africa, including Madagascar at about 3.3 per 10,000. Clean Water in Care: WHO and UNICEF research says nearly 1 billion people still use healthcare facilities without clean water, with 936 million treated where sanitation is lacking and 652 million facing poor hygiene—an urgent patient-safety issue for the region. Gender and Staffing Gaps: Another Lancet Public Health analysis finds women drive most health workforce growth (about 71% of the increase) yet major shortages persist, leaving many communities without reliable access to essential services. Regional Health and Security at SADC: At the 46th SADC summit in Durban, leaders backed a regional push on infrastructure, agriculture, critical minerals, and also discussed peace and health priorities, including support for responding to Ebola and dialogue in Madagascar. Rubella Vaccination Progress: CDC analysis notes rubella-related birth defect syndrome cases have dropped about 73% since 2012, but Africa still carries most of the remaining burden, underscoring the need to strengthen immunization coverage.

Clean Water & Care Access: New WHO/UNICEF research says nearly one billion people used healthcare facilities without clean water in 2025, leaving patients and health workers without a basic requirement for safe care. Regional Health & Peace Talks: At the 46th SADC summit in Durban, leaders reviewed security situations affecting Madagascar and reaffirmed commitments to dialogue and peaceful solutions, while also discussing health priorities alongside industrialisation. SADC Integration Agenda: The summit backed economic corridors, regional value chains, agricultural trade, and critical minerals transformation—plus moves like a regional tourism visa and a regional development fund that could shape future public services. Madagascar Conservation Boost: Madagascar’s Golden-crowned Sifaka was named among 100 species targeted for recovery under the $200m Phoenix Species Project, highlighting community-led conservation in northern dry forests. Connectivity for Remote Areas: Airtel and Starlink launched satellite-to-phone service in the DRC, a reminder that better connectivity can support health communication in places with weak network coverage.

SADC Summit Health & Migration: South Africa’s Ramaphosa took over the SADC chair as leaders met in Durban, with the bloc urging a coordinated regional dialogue on migration drivers amid ongoing deportations and xenophobic tensions; the summit also reiterated solidarity with the DRC and urged dialogue in Madagascar. SADC Chair Next Stop (Zambia): The 47th SADC Summit will be hosted in Zambia, with Lusaka set to take the incoming chair role after Durban’s 46th meeting. Rubella Vaccination Gap: A global rubella review reports modeled cases down ~73% since 2012, but Africa carries most of the remaining burden; rubella vaccination still isn’t in routine schedules in 15 countries, raising pregnancy-related birth-defect risks. Madagascar Care Spotlight: Reconstructive surgeon Dr. Sr. Marlene Long—who has delivered cataract and leprosy care in Madagascar for decades—was featured in a Q&A highlighting life-changing surgical work. Connectivity for Health Access: Airtel and Starlink launched Africa’s first satellite-to-phone service in the DRC, expanding reach where mobile coverage is missing—relevant for remote health communication. Biodiversity & Health Links: Madagascar’s Golden-crowned Sifaka was named among 100 species selected for recovery, underscoring conservation efforts tied to healthier ecosystems.

Rubella & maternal health: A CDC review shows modeled rubella birth-defect cases fell about 73% since 2012, but the burden remains heavily concentrated—Africa accounted for 89% of estimated cases in 2024—highlighting why pregnant women and immunisation gaps still matter. SADC summit & regional priorities: Southern African leaders are meeting in Durban for the 46th SADC Heads of State summit, with food security, development financing, and regional integration on the agenda under a theme focused on infrastructure, agriculture, and critical minerals transformation. Critical minerals push (jobs, not raw exports): SADC’s Elias Magosi urged countries to stop exporting critical minerals in raw form and move toward beneficiation and manufacturing to create jobs and improve living standards. Migration tensions & health access risks: Security has been stepped up around Durban as anti-immigrant groups plan a march tied to migration policy—an issue that can quickly affect community safety and access to services. Madagascar conservation win: Madagascar’s golden-crowned sifaka was named among 100 species selected for recovery by the Phoenix Species Project, backed by major philanthropic funding, spotlighting community-led forest protection in northern dry forests. Connectivity & health logistics: Airtel and Starlink launched Africa’s first satellite-to-phone service in the DRC, extending messaging and light data where mobile coverage is weak—useful for emergency communication and health outreach.

Mpox Vaccine Shortage in Madagascar: Madagascar is being forced to divide and share mpox vaccine as the epidemic takes off, raising urgent questions about supply, distribution, and how quickly health services can scale up. Rubella Immunisation Gap: A CDC analysis reports global rubella birth-defect cases have dropped about 73% since 2012, but the African Region still carries most of the burden, and 15 countries have no routine rubella vaccine program—an issue that matters for pregnancy safety and maternal-child health planning. SADC Summit in Durban (Health-linked priorities): Southern African leaders meet in Durban under a theme focused on infrastructure, agriculture, and critical minerals transformation; migration tensions are also on the agenda, which can affect public health access and disease prevention for mobile communities. Climate and Mangrove Risk Signals: New climate signals tied to El Niño and Indian Ocean Dipole are expected to stress mangroves through flooding, heat, and salinity—bad news for coastal protection, fisheries, and food security that communities rely on. Madagascar Conservation Spotlight: Madagascar’s golden-crowned sifaka has been selected for recovery under the Phoenix Species Project, highlighting biodiversity protection efforts in Loky-Manambato that also support healthier ecosystems. Deep-sea Mining Precaution Push: Madagascar is among African countries backing a precautionary pause on deep-seabed mining, a move that could protect marine ecosystems and the long-term health of ocean-dependent livelihoods.

Mpox Response in Madagascar: Madagascar health authorities are being forced to “fractionally dose” mpox vaccines—splitting each dose into fifths—to stretch limited supplies during the country’s largest-ever outbreak, with at least 4,000 cases reported and about one million people considered at risk from clade 1b; officials say initial shipments of 30,000 doses in May were followed by another 30,000 at end-July, but demand far outstrips availability, putting high-risk groups like sex workers, young children, people living with HIV, and medical workers at the center of the strategy. Regional Health & Resilience Context (SADC): As SADC leaders meet in Durban for the 46th summit, the agenda highlights regional resilience and development priorities—industrialisation, infrastructure, agriculture, and critical minerals—framing the broader conditions that shape health systems and access across member states including Madagascar. Madagascar Conservation With Health Links: Madagascar’s golden-crowned sifaka has been named among 100 species selected for recovery by the Phoenix Species Project, spotlighting Loky-Manambato forest protection efforts that support ecosystem stability and long-term community wellbeing.

Mpox Vaccine Shortage in Madagascar: Madagascar is being forced to “fractionally dose” mpox vaccines—splitting doses into fifths—to stretch limited supplies during its largest-ever outbreak, with at least 4,000 cases reported and about one million people considered at risk of clade 1b; high-risk groups include sex workers, young children, people living with HIV/AIDS, and medical workers. SADC Health-Relevant Regional Push: King Mswati III has left for the SADC summit in Durban, where leaders will focus on regional industrialisation, infrastructure, agriculture, and critical minerals—areas that shape health through jobs, services, and resilience. Madagascar Conservation Spotlight: Madagascar’s golden-crowned sifaka has been named among 100 species selected for recovery by the Phoenix Species Project, a $200m effort led by Re:wild and Bezos Earth Fund, highlighting local forest protection needs tied to long-term ecosystem health. Food Safety Standards: The Codex Alimentarius Commission (CAC49) adopted new and revised food hygiene and labelling texts, including guidance for water safety and allergen labelling—important for safer food systems across the region.

Mpox Response Under Strain: Madagascar is forced to “fractionally dose” mpox vaccines—splitting doses into fifths—to stretch limited supplies during its largest-ever outbreak, with at least 4,000 cases reported and about one million people considered at risk from clade 1b; high-risk groups include sex workers, young children, people living with HIV/Aids, and medical workers. Biodiversity Recovery Spotlight: Madagascar’s golden-crowned sifaka (Loky-Manambato) has been named among 100 critically endangered species selected for recovery under the $200 million Phoenix Species Project led by Re:wild and Bezos Earth Fund, highlighting local conservation work amid threats like deforestation and poaching. Regional Health & Resilience Context: SADC leaders are pushing for stronger regional integration and self-reliance as climate shocks and uneven support strain services, with energy and connectivity progress noted but electricity access still below targets. Food Safety Standards: The Codex Alimentarius Commission (CAC49) adopted new and revised food hygiene and labeling texts, including guidance for water safety and allergen labeling in emergencies—relevant for protecting public health through safer food systems.

Mpox Response in Madagascar: Madagascar is being forced to “fractionally dose” mpox vaccines—splitting doses into fifths—to stretch limited supplies during its largest-ever outbreak, with at least 4,000 cases reported and around one million people at risk of clade 1b; officials say the approach is authorized for emergencies by WHO but carries added risk. Disease Surveillance in the Region: A Cameroon study looks at how supervision and short message support can improve detection rates for diseases under surveillance, highlighting ongoing gaps in timely reporting and follow-up. Local Conservation with Health Links: Madagascar’s Golden-crowned Sifaka has been selected for recovery by the Phoenix Species Project, spotlighting Loky-Manambato and the dry-forest protection work tied to biodiversity and ecosystem health. Food Safety Standards: The Codex Alimentarius Commission’s 49th session adopted new and revised food hygiene and labeling texts, including guidance for water safety and handling allergens—important for safer food systems. Health & Equity via Breastfeeding: Burundi’s high exclusive breastfeeding rates are being used as a model for maternal and child health investment, emphasizing stronger health systems and workplace protections.

Mpox Vaccine Shortage: Madagascar is splitting mpox vaccines into fifths (“fractional dosing”) to reach more people during its largest-ever outbreak, with at least 4,000 cases reported and about one million people at risk of clade 1b; high-risk groups include sex workers, young children, people living with HIV/Aids, and medical workers. Regional Health & Resilience: SADC leaders meeting in Durban stress self-reliance and resilience as global uncertainty and climate shocks strain services, with progress noted in energy and digital connectivity but electricity access still below targets—an issue that can directly affect health facilities. Food Safety Standards: The Codex Alimentarius Commission (CAC49) adopted new and revised food hygiene and labelling texts, including rules for water safety, chicken meat standards for Campylobacter and Salmonella, and emergency food labelling guidance. Maternal Health Spotlight: Burundi’s high exclusive breastfeeding rates are being highlighted by WHO and UNICEF as proof that workplace protections and public investment can drive better maternal and child outcomes. Conservation & Health Link: Madagascar’s Golden-crowned Sifaka was named for recovery support, spotlighting Loky-Manambato forest protection—important for ecosystem health that underpins long-term community wellbeing.

Mpox Response in Madagascar: Madagascar health authorities are being forced to “fractionally dose” mpox vaccines—splitting doses into fifths—to stretch limited supplies during the country’s largest-ever outbreak, with at least 4,000 cases reported and around one million people considered at risk, including sex workers, young children, people living with HIV/Aids, and medical workers. Wildlife & Community Conservation: Madagascar’s Golden-crowned Sifaka (Propithecus tattersalli) has been named among 100 species selected for recovery by the Phoenix Species Project, spotlighting Loky-Manambato and locally led dry-forest protection efforts. Regional Health-Linked Trade & Industry: A Mauritius–Madagascar business forum opened in Antananarivo, bringing together companies across agriculture, agro-industry, energy, mining, logistics, and also healthcare and pharmaceuticals. Food Safety Standards: The Codex Alimentarius Commission (CAC49) adopted new and revised international food hygiene and labeling texts, including updates on water safety, Campylobacter and Salmonella in chicken meat, and allergen labeling guidance. SADC Integration Push: SADC leaders stressed stronger regional self-reliance and integration amid global uncertainty, highlighting progress in energy and digital connectivity while noting electricity access still lags targets.

Mpox Response: Madagascar is stretching scarce mpox vaccine supplies by using WHO-authorised fractional dosing, splitting doses into fifths to reach more than one million people as the outbreak grows (at least 4,000 cases reported, with clade 1b a fast-spreading concern). Regional Health & Resilience: SADC leaders are meeting in Durban as South Africa takes the chair, with a push for stronger regional integration and resilience amid climate shocks and uncertainty—an agenda that can shape health and social protection priorities across member states including Madagascar. Conservation & Community Health: Madagascar’s Golden-crowned Sifaka has been selected for recovery funding by the Phoenix Species Project, spotlighting Loky-Manambato forest protection efforts that support local livelihoods and ecosystem stability. Food Safety Standards: The Codex Alimentarius Commission (CAC49) adopted new and revised food hygiene and labelling texts, including guidance for water reuse and updates on allergen labelling—important for safer food systems in the region. Trade & Access to Services: A Mauritius–Madagascar business forum in Antananarivo brought together companies across sectors including healthcare and pharmaceuticals, pointing to potential partnerships that can improve access to medicines and health services.

Mpox Response: Madagascar is stretching a limited mpox vaccine supply by using WHO-authorised fractional dosing, splitting doses into fifths to protect more than one million people as the outbreak grows (at least 4,000 cases reported; clade 1b risk includes sex workers, young children, people living with HIV/Aids, and health workers). Food Safety & Nutrition Policy: The Codex Alimentarius Commission’s 49th session adopted new and revised international food standards, including hygiene texts and updates on Campylobacter and Salmonella in chicken meat, plus guidance on allergen labelling and emergency food labelling. Community Health & Prevention: A study on disease detection in Cameroon highlights how supervision and short message support can improve detection rates for diseases under surveillance in the Littoral Region. Health-Linked Environment: A new Madagascar almond nursery supply chain note (Terminalia mantaly) points to broader greening efforts that can support healthier ecosystems and livelihoods. Wildlife Health Link: Madagascar’s Golden-crowned Sifaka recovery spotlighted Loky-Manambato conservation work, underscoring how habitat protection supports ecosystem health.

Mpox Vaccination in Madagascar: Madagascar is being forced to “fractionally dose” mpox vaccines—splitting doses into fifths—because supply is too low for the fast-growing clade 1b outbreak, with at least 4,000 cases reported and over a million people considered at risk, including sex workers, young children, people living with HIV/Aids, and health workers. Disease Surveillance in Practice: A Cameroon health facility trial highlights how supervision and short message support can affect detection rates for diseases under surveillance, pointing to gaps that still slow outbreak reporting. Food Safety Standards: The Codex Alimentarius Commission’s 49th session advanced new and revised hygiene, allergen labelling, and water safety texts, including guidance for emergencies—relevant for safer food systems across the region. Maternal Health Spotlight: Burundi’s high exclusive breastfeeding rates are being used as a model for how health systems, workplace protections, and public investment can improve outcomes beyond awareness campaigns. Local Health Context: A report notes Madagascar’s Antananarivo cable car system sits unused after a costly launch—an indirect reminder that public spending and service delivery failures can shape everyday wellbeing.