Led in southeastern Madagascar, the Fagnimbogna project is showing encouraging results. This initiative, carried out by Médecins Sans Frontières, Health in Harmony – Fahasalamana Mirindra and Ny Tanintsika, aims to "simultaneously address health, environmental and socio-economic challenges in the isolated Ikongo district." In a region marked by poverty, climate change and limited access to healthcare, more than 23,000 children have already received medical treatment, while 4,000 pregnant women have received appropriate follow-up care. The project also supports three health centers, 15 community posts and a nutritional unit, strengthening local healthcare provision. FAGNIMBOGNA also addresses the root causes of vulnerability. Nearly 18,000 hectares of forest are now protected and essential infrastructure, including 26 boreholes, have been built or rehabilitated. Education is also a priority, with over 10,000 students supported. Based on extensive local consultation, the project relies on listening to thousands of residents to adapt solutions. Despite these advances, needs remain enormous in this difficult-to-access territory, where logistical and climate challenges continue to hinder sustainable development.