Trustees of Indiana University

Overcoming Madagascar’s Number One Killer: Pollution Highly Ranked

Lead Organization

Trustees of Indiana University

Bloomington, Indiana, United States

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Project Summary

Contamination of air, soil, and water is the leading cause of death in Madagascar. While other risk factors such as malnutrition and communicable diseases are declining, the burden of pollution continues to rise. The will to address this problem is strong: government agencies have partnered with the Global Alliance on Health and Pollution to draft a Health and Pollution Action Plan that has the support of Malagasy grassroots organizations. However, as one of the world’s poorest countries, Madagascar lacks the resources and expertise to make the necessary changes. Our project closes the gap between the will and the way by joining local Malagasy communities and leaders in a multidisciplinary network of experts to address the technical, logistical, and social components of harm reduction. In five years, we will reduce pollution exposure for half the population and develop local capacity to bring pollution levels down to developed-country standards within 20 years.

Problem Statement

In Madagascar, a country known for its extraordinary biodiversity, pollution is so severe that it has become the leading cause of premature death. It’s the smoke in people’s homes, where wood and charcoal are the main fuel sources for cooking. It’s the haze in the air, from burning forests, crops, and trash including plastics, metals, and biomedical waste, and from the toxic exhaust of ancient vehicles running on the lowest-quality fuel. It’s contamination in the water and soil from open dumping of unknown and unquantified chemicals where people grow their food and draw their drinking water. As one of the world’s poorest countries, there is very little capacity for monitoring pollution and its health effects, yet the scarce information available indicates that pollution causes one out of every three premature deaths[1] -- almost certainly an underestimate. While rates of malnutrition and communicable diseases have fallen in Madagascar, largely thanks to funding from international aid agencies, the death toll from pollution continues to rise, with the poorest communities experiencing the most suffering. A vicious cycle ensues in which widespread disease and disability prevent the economic growth needed to lift people out of extreme poverty. At a national level, the health costs of pollution total 8.6% of Madagascar’s gross national income[1], which does not account for the additional costs borne by those caring for the sick and dying. This same pollution is destroying the country’s natural resources[20], which are essential assets for its sustainable economic development.

Solution Overview

The solution to reducing death and disease from pollution is clearly spelled out in Madagascar’s Health and Pollution Action Plan (HPAP)[1],* yet the country lacks the expertise and resources needed for execution. To fill this gap, we assembled the world’s leading experts in successfully implementing each component of the plan. Over five years, we will introduce clean fuels into 40% of households using the established process of the Global LPG Partnership[7]; set up an air monitoring network designed by experts from Indiana University (IU)[2] and the University of Birmingham (UoB)[3], determine the main sources of outdoor air pollution using the apportionment process validated by air quality specialists at the Global Alliance on Health and Pollution[6], and use proven interventions to address these sources; and identify and remediate at least 20 contaminated sites causing the most harm to Malagasy health, preventing the poisoning of an estimated 250,000 people using the demonstrated toxic site identification program (TSIP)[23] and remediation methods of Pure Earth[5] and the proven precision toxicology process developed by IU, UoB, and other members of the Environment Care Consortium[4]. We will ensure continued progress beyond the duration of the program by establishing an ongoing national pollution monitoring program, developing an education campaign and training centers focused on transparency and understanding of this knowledge, and working with stakeholders to pursue a long-term sustainable development agenda. *(The HPAP and our project exclude sanitation because it is already targeted in Madagascar through other funders including more than $37 million implemented by UNICEF.)

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Project Funders

  • Oak Foundation 2018 - 2020
  • Indiana University 2017 - 2020
  • European Commission 2017 - 2018

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