Abstracts
Abstract
In line with the work of a growing number of concerned researchers, this brief article draws attention to certain features of Madagascar’s looming HIV crisis. Reporting on the findings of a survey conducted with patients of a clinic that has recently hosted a large-scale screening program, we focus especially on what is and is not known about the transmission, effects, and treatment of HIV, and on why an elevated infection rate among the clientele of this clinic (many of whom are involved in artisanal mining) should be of special concern. Anticipating the return of long absent awareness-raising campaigns concerning HIV in Madagascar, we close with some cautious recommendations on what they might cover and how they might be carried out.
Keywords:
- Madagascar,
- HIV,
- AIDS,
- public health,
- artisanal mining,
- awareness raising
Résumé
Dans la continuité des travaux d’un nombre croissant de chercheurs impliqués, ce bref article attire l’attention sur certaines caractéristiques de la crise du VIH qui se prof;ile à l’horizon à Madagascar. En nous appuyant sur les données issues d’une enquête menée auprès des patients d’une clinique qui a récemment accueilli un programme de dépistage à grande échelle, nous mettons l’accent sur ce que l’on sait et ce que l’on ne sait pas sur la transmission, les effets et le traitement du VIH, ainsi que sur les raisons pour lesquelles un taux d’infection élevé parmi la clientèle de cette clinique (dont beaucoup est impliquée dans l’exploitation minière artisanale) devrait être une préoccupation majeure. En prévision du retour des campagnes de sensibilisation au VIH longtemps absentes à Madagascar, nous terminons par quelques recommandations prudentes sur ce qu’elles pourraient inclure et sur la manière dont elles pourraient être menées.
Mots-clés :
- Madagascar,
- HIV,
- SIDA,
- santé publique,
- exploitation minière artisanale,
- sensibilisation
Appendices
Bibliography
- Alonso, D. and X. Vallès. 2023. “A Potential Transition from a Concentrated to a Generalized HIV Epidemic: The Case of Madagascar.” Infectious Diseases of Poverty 12(1):112. https://doi.org/10.1186/s40249-023-01164-2.
- Andrianarimanana-Köcher D., R.A. Rakotoarivelo, M.J. de Dieu Randria, M. Raberahona, A. Ratefiharimanana, E.H. Andriamasy, X. Vallès, A.C. Benski, J.V. Emmrich, A. Walsh, K. Robinson, N. Muller. 2024. “Call for Action: Addressing the Alarming Surge of HIV in Madagascar.” BMJ Global Health 9: e015484. https://doi.org/10.1136/bmjgh-2024-015484.
- Betombo, S., T. MacIntosh, M.S. Raharivelo. 2015. “Community Development and Health Care. Fampandrosoana ny Fiharahamonina sy ny Fahasalamana.” Unpublished bilingual poster, presented at a student conference in Antsiranana.
- Fassin, D. 2021. “Of Plots and Men: The Heuristics of Conspiracy Theories.” Current Anthropology 62(2): 128–137. https://doi.org/10.1086/713829.
- Ferguson A.G., C.N. Morris. 2007. “Mapping Transactional Sex on the Northern Corridor Highway in Kenya.” Health Place 13(2): 504–519. https://doi.org/10.1016/j.healthplace.2006.05.009.
- Geoffroy, A., L. Samison, F. Randriatsarafara, H. Randriantsara, Z.A. Randriamanantany, C. Vanhecke. 2024. “Madagascar urgently needs a 2024 National Prevalence Survey of HIV.” The Lancet HIV 8(11): e504. https://doi.org/10.1016/S2352-3018(24)00153-X.
- Hilson G., J. McQuilken. 2014. “Four Decades of Support for Artisanal and Small-Scale Mining in Sub-Saharan Africa: A Critical Review.” The Extractive Industries and Society. 1(1): 104–118. https://doi.org/10.1016/j.exis.2014.01.002
- INSTAT et ICF. 2022. “Enquête Démographique et de Santé à Madagascar, 2021.” Antananarivo, Madagascar and Rockville, Maryland, USA: INSTAT et ICF.
- Ndagano P, N. Schneck. 2021. “Madagascar Artisanal and Small-Scale Mining Sector; Country Profile.” Delve. https://delvedatabase.org/uploads/resources/Madagascar-Country-Profile.pdf.
- Raberahona, M., F. Monge, R.H. Andrianiaina, M.J. de Dieu Randria, A. Ratefiharimanana, R.A. Rakatoarivelo, L. Randrianary, E. Randriamilahatra, L. Rakotobe, C. Mattern, and V. Andriananja. 2021. “Is Madagascar at the Edge of a Generalised HIV Epidemic? Situational Analysis.” Sexually Transmitted Infections 97(1): 27–32. https://doi.org/10.1136/sextrans-2019-054254.
- Ratsiazo, L. 2015. “Le Sida, dangereux ou non à Madagascar?” Madagascar Tribune, 30 November. https://www.madagascar-tribune.com/Le-Sida-dangereux-ou-non-a,21664.html.
- Robinson, K.E., J.K. Long, M. Fardine, A.M. Stephano, A. Walsh, and E.P. Grewal. 2024. “Patterns of Rising HIV Positivity in Northern Madagascar: Evidence of an Urgent Public Health Concern.” Tropical Medicine and Infectious Disease, 9(1): 19. https://doi.org/10.3390/tropicalmed9010019.
- Stoudmann, N., L.M. Reibelt, A.G. Rakotomalala, O. Randriamanjakahasina, .A. Garcia, and P.O. Waeber. 2021. “A Double—edged Sword: Realities of Artisanal and Small—scale Mining for Rural People in the Alaotra Region of Madagascar.” Natural Resources Forum 45(1): 87–102. https://doi.org/10.1111/1477-8947.12215.
- Tiamgne, X.T., F.K. Kalaba, and V.R. Nyirenda. 2022. “Mining and Socio-ecological Systems: A Systematic Review of Sub-Saharan Africa.” Resources Policy 78: 102947. https://doi.org/10.1016/j.resourpol.2022.102947
- Tétaud, Sarah. 2024. “Madagascar: inquiétude face à une recrudescence du VIH.” RFI, 1 October. https://www.rfi.fr/fr/afrique/20240110-madagascar-inquiétude-face-à-une-recrudescence-du-vih.
- The Global Fund. 2022. Audit Report: Global Fund Grants in the Republic of Madagascar. https://www.theglobalfund.org/media/12456/oig_gf-oig-22-018_report_en.pdf.
- Walsh, A. 2012. Made in Madagascar: Sapphires, Ecotourism, and the Global Bazaar. North York: University of Toronto Press.
- Zhang, M. 2021. “Writing against ‘Mask Culture’ Orientalism and COVID-19 Responses in the West.” Anthropologica 63(1): 1–4. https://doi.org/10.18357/anthropologica6312021327
- Zhu, A.L. and B. Klein. 2024. “The Rise of Flexible Extraction: Boom-chasing and Subject-making in Northern Madagascar.” Geoforum 148 (103593). https://doi.org/10.1016/j.geoforum.2022.06.005.
- Zvarivadza, T. and A.S. Nhleko. 2018. “Resolving Artisanal and Small-scale Mining Challenges: Moving from Conflict to Cooperation for Sustainability in Mine Planning.” Resources Policy 56: 78–86. https://doi.org/10.1016/j.resourpol.2017.12.003.