Madagascar, a nation frequently vulnerable to natural disasters, has been grappling with a severe humanitarian crisis during the first quarter of 2026. A series of destructive weather events, culminating in two powerful cyclones, has left a trail of devastation, exacerbating existing challenges related to food security, public health, and general well-being. This complex emergency demands urgent attention and sustained support to help affected communities recover and rebuild. ## Cyclones Unleash Widespread Destruction The onset of 2026 brought a relentless barrage of natural calamities to Madagascar. Following a period of heavy rainfall in late 2025 that caused floods and resulted in 11 fatalities, the island nation was struck by two major cyclones in rapid succession. Tropical Cyclone Fytia made landfall on the west coast on January 31st, just ten days before Intense Tropical Cyclone Gezani slammed into the east coast on February 10th. These powerful storms brought not only torrential rains but also destructive winds, triggering widespread flooding and landslides across several regions. The human toll and infrastructural damage have been immense. The cyclones directly caused 71 deaths and displaced at least 66,000 people from their homes. Tens of thousands of houses were either completely destroyed (27,100) or partially damaged and flooded (95,000), leaving countless families without shelter. The impact on essential services was equally severe: 762 classrooms were completely destroyed and another 2,569 sustained damage, disrupting the education of over 160,000 children. Furthermore, 78 health centers suffered damage, crippling critical healthcare access for vulnerable populations. Vast tracts of rice fields, crucial for the nation's food supply, were submerged. In total, more than 681,000 people have been directly affected, with over 630,000 in dire need of immediate humanitarian assistance, particularly in the hard-hit Boeny and Atsinanana regions, as outlined in the 2026 Cyclone Flash Appeal. ## Deepening Food Insecurity and Malnutrition The destructive cyclones have severely compounded an already fragile food security situation in Madagascar. An alarming 1.6 million people are currently facing acute levels of food insecurity, meaning their ability to access adequate food is severely compromised. Among these, an estimated 109,000 individuals are experiencing emergency levels of food deprivation (classified as IPC Phase 4), signifying a critical shortage that could lead to widespread illness or death if not addressed immediately. This dire situation is projected to continue between February and April 2026. In the cyclone-affected eastern areas, the path to recovery for livelihoods remains painstakingly slow. Displacement, coupled with the high costs associated with repairing damaged homes and vital infrastructure, prevents many from returning to their normal lives. The extensive damage to rice fields and aquaculture, key sources of income and nutrition, has crippled local economies and agricultural output. The consequences are particularly severe for children. Mass screenings conducted in the first quarter of 2026 revealed that over 4,500 children in the Grand South and Grand South East regions are suffering from Severe Acute Malnutrition (SAM), a life-threatening condition. Four districts in the South — Bekily, Ampanihy, Beloha, and Tsihombe — are experiencing serious levels of Global Acute Malnutrition (GAM), with rates ranging between 10 to 15 percent, demanding an urgent, multi-faceted humanitarian response. While there was a slight decrease in SAM admissions in January 2026 compared to the previous year, the overall situation remains precarious, with 2025 seeing significantly higher admissions than 2024, and an worrying upward trend observed in Ikongo District since October 2025. ## The Looming Threat of Disease Outbreaks The humanitarian crisis has created fertile ground for the spread of various diseases, further endangering public health. The widespread flooding, damaged water and sanitation systems, and the inevitable overcrowding in temporary displacement shelters significantly elevate the risk of waterborne and vector-borne illnesses. Diseases like acute diarrheal diseases and malaria pose an immediate threat, with contaminated water sources and stagnant floodwaters becoming breeding grounds for disease-carrying mosquitoes. Limited access to safe drinking water and proper sanitation facilities, already a challenge in many parts of Madagascar, has been severely exacerbated by the disaster. This, combined with ongoing health crises, creates a complex public health emergency that puts vulnerable populations, particularly children and the elderly, at heightened risk. The disruption of health services due to damaged facilities further complicates efforts to monitor, prevent, and treat these illnesses. ## Mpox: A Growing Concern Amidst the Chaos Adding to the public health challenges is an ongoing outbreak of mpox, formerly known as monkeypox. As of March 31, 2026, a total of 749 confirmed cases and two deaths have been reported across 23 out of Madagascar's 24 regions since the outbreak began in December 2025. Mpox is a viral disease that can cause painful rashes, fever, and other flu-like symptoms. While often mild, it can be severe in some individuals, particularly those with compromised immune systems or young children. The virus typically spreads through close contact with an infected person or contaminated materials. The spread of mpox is particularly concerning in the current humanitarian context. Overcrowding in temporary shelters, where displaced individuals often live in close quarters, can facilitate person-to-person transmission. The damaged healthcare infrastructure and the focus on immediate disaster response may divert resources from mpox surveillance and treatment, making it harder to contain the outbreak. Humanitarian partners on the ground are actively ramping up their response interventions, including public awareness campaigns, improved hygiene promotion, and access to healthcare, but the scale of the challenge is substantial. ## Addressing the Crisis and Building Resilience The multi-faceted crisis in Madagascar necessitates a comprehensive and coordinated humanitarian response. Immediate priorities include providing emergency shelter, food assistance, safe drinking water, sanitation facilities, and essential medical supplies to the affected populations. Efforts to restore damaged infrastructure, particularly health centers and schools, are crucial for long-term recovery. Beyond emergency aid, there is a critical need for sustained interventions to address the root causes of vulnerability. This includes strengthening disaster preparedness and early warning systems, investing in climate-resilient agriculture, and improving basic health infrastructure across the island. Building the resilience of communities in Madagascar against future climatic shocks and public health threats is not just about recovery, but about ensuring a safer, healthier future for all its citizens. International support and collaboration remain paramount. Humanitarian organizations, local authorities, and global partners must work together to deliver timely aid, implement sustainable development programs, and empower Madagascan communities to withstand and recover from the increasing frequency and intensity of such crises.