Responding to outbreaks of plague
MSF officially ended operations in Madagascar in 2016 but returned in October 2017 to respond to the outbreak of plague in (also known as Toamasina).
The island has suffered from outbreaks of bubonic plague almost annually since 1980. The disease returns with each hot rainy season (September to April). On average, between 300 and 600 cases of bubonic plague are recorded every year, mostly in the same rural areas, and authorities are typically equipped to contain and treat it.