Madagascar's Vaccine Cold Chain Faces Climate Challenges Amid Solar Innovations

Madagascar's vaccination efforts are increasingly tested by a volatile climate, with many health facilities relying on solar-powered cold chains to keep vaccines viable. These systems, critical for the country's immunization programs, are now grappling with the repercussions of extreme weather events, including prolonged droughts and severe cyclones. Recent reports indicate that southern Madagascar has faced devastating storms that have wreaked havoc on health infrastructure, which is already strained by limited resources and geographic isolation.

According to Ranaivo Soloherilala Andrianaina, head of the cold chain division at Madagascar's Expanded Programme on Immunization (EPI), recent cyclones have caused substantial damage to solar-powered vaccine storage systems. "Some buildings were completely flooded, with the solar fridges still inside. We’ve seen fridges buried under debris and panels swept away by the wind," Andrianaina stated in an interview on July 16, 2025. Such incidents have raised urgent concerns about the logistical resilience of the nation’s vaccination system, especially as nearly 97% of Madagascar’s primary health centers—approximately 2,880 facilities—are equipped with these solar-powered refrigerators.

Despite the inherent challenges, the reliance on solar energy is essential in a country where only 33% of the population had access to electricity as of 2023, significantly lower than the African average of 50.6%. The solar systems, supported by international partners, are designed to meet stringent standards, including compliance with the World Health Organization’s (WHO) Performance, Quality, and Safety norms. They are capable of maintaining the required vaccine temperatures for at least 72 hours during power outages. "In case of a problem, vaccines can be moved to the nearest distribution center," Andrianaina added, although he acknowledged the logistical difficulties posed by damaged roads and infrastructure.

To bolster the resilience of these systems, Madagascar has implemented training programs for health center staff and district technicians. These sessions emphasize critical practices such as mounting solar panels on robust metal poles, using smaller panels to reduce wind resistance, and ensuring optimal positioning for sunlight exposure. "Large panels don’t withstand strong winds very well," Andrianaina noted, advocating for the use of multiple smaller panels over single large installations. This approach has been particularly effective in regions like Sainte-Marie, where reinforced mounts and routine inspections have prevented damage.

However, the challenges are multifaceted. In addition to cyclones, southern Madagascar faces other environmental threats such as sandstorms, locally known as tiomena, which coat solar panels in dust and diminish their efficiency. Regular maintenance and cleaning have thus become vital components of the overall strategy.

In response to these mounting challenges, community-driven approaches have emerged as a critical element of Madagascar’s health strategy. Thomas Arsène Tomboravo, the mayor of Ambodibonara in the northwest, emphasized the importance of local solidarity in maintaining the health services. "We mobilize local resources. Business owners chip in to repair or replace the equipment. Everyone gets involved because we know it’s about saving lives," he explained, highlighting the collective effort to ensure the continuity of vaccination services in remote areas.

As Madagascar progresses towards building health centers that adhere to new climate-resilient standards, the integration of community engagement with technical enhancements is becoming increasingly apparent. The ongoing climate shocks have shifted the focus from mere energy access to the durability, maintenance, and governance of health systems. If Madagascar can successfully align its resources and collective will, it may lay the foundation for a more sustainable immunization framework amidst the ever-evolving climate crisis.