Long associated with the great pandemics of the Middle Ages, plague remains a health reality in certain regions of the world today. Among them, Madagascar continues to rank among the most affected zones, alongside the Democratic Republic of Congo and Uganda. According to the Robert Koch Institute (RKI), approximately 3,000 cases were recorded globally between 2010 and 2015, causing more than 500 deaths. While these figures may seem limited compared to major contemporary health crises, they nonetheless reflect a worrying persistence of the disease in certain endemic areas. Madagascar stands out particularly: each year, numerous cases are reported, with recurring epidemic episodes, the last major outbreak dating back to 2017. This situation contrasts sharply with the history of plague. Between 1346 and 1353, the disease decimated between 25 and 50 million people in Europe, representing up to half the continent's population. Today, although treatments exist, plague remains a public health concern in Madagascar, requiring constant vigilance, particularly regarding epidemiological surveillance and sanitary conditions.