Assessing and Building Capacities: Decentralised Structures of Madagascar's Public Health System


Madagascar is facing significant challenges in its health care system, due to the high prevalence of infectious diseases in the country, particularly neglected tropical diseases (NTDs). Many of these diseases occur simultaneously and have chronic manifestations, imposing a huge burden on the population. It is therefore vitally important to have a strong public health and laboratory system in place so that the country can respond to and deal with such public health emergencies and epidemics in a reliable and timely way. However, the current health care system is characterised by a high degree of centralisation and a shortage of qualified personnel, leading to inequities in health service delivery. The Madagascar Ministry of Health has officially requested the support of the RKI and the BNITM to strengthen diagnostic capacities for infectious diseases in the country, such as plague, NTDs and malaria, and to help improve the system at the central and local level. The overall goal is to improve service delivery in the fields of diagnostics, surveillance and research. The project will work closely with public health professionals and academics from Madagascar’s universities to systematically strengthen the resilience of the public health system.


Strengthening the decentralised public health and laboratory system in Madagascar.

In Cooperation with

  • University of Fianarantsoa, Madagascar
  • University of Mahajanga, Madagascar
  • University of Antananarivo, Madagascar
  • University of Toamasina, Madagascar
  • Centre d’Infectiologie Charles Mérieux (CICM), Madagascar
  • Robert Koch Institute (RKI), Germany

Thematic priorities

  • Clinical management
  • Infection prevention and control
  • Laboratory diagnostics
  • Marketing authorisation and safety of medicinal products
  • Resolutions and international agreements
  • Strengthening of public health systems
  • Surveillance and reporting



01.01.2023 - 31.12.2025


ca. 550,000 Euro

Partner Countries

  • Madagascar


Dr. Daniela Fusco
Organisation: Bernhard Nocht Institute for Tropical Medicine (BNITM)
Bernhard-Nocht-Straße 74,
20359 Hamburg, Germany


  • Training and competence development

    Strengthening human resources in four university hospitals through training programmes.

  • Research and provision of evidence

    Conducting a survey on the diagnostic and surveillance capacities of the public health system in peripheral areas, with a focus on NTDs; conducting a survey to further evaluate education and university training opportunities in the field of public and global health.

  • Capacity development

    Conducting workshops to develop recommendations and guidelines for strengthening the resilience of the public health system; supporting the development of a concept for the future establishment of a national disease control centre; implementing pilot projects in the areas of diagnostics and surveillance in peripheral regions.