For people suffering from kidney failure in Madagascar, staying alive can represent a considerable expense. A dialysis session currently costs at least approximately 240,000 ariary. For patients requiring multiple weekly sessions, the bill can reach nearly one million ariary per week including medications, not counting tests, transportation, and other medical follow-up costs. A burden difficult for many households to bear. It is in this context that the agreement signed yesterday at the State Palace of Ambohitsorohitra raises strong expectations. The Malagasy State and Lifenity International, an Indian company specializing in medical solutions and healthcare infrastructure, want to strengthen dialysis care capacity in the six provincial capitals. Public Health Minister Monira Managna signed the agreement in the presence of the head of state, Colonel Michaël Randrianirina. Beyond increasing capacity, the project aims above all to make care more financially and geographically accessible. The Public Health Ministry notably announces a significant reduction in dialysis rates. The challenge is also to enable patients living far from the capital to receive treatment without multiplying trips. The needs are significant. According to ministry figures, up to 3,000 patients would need dialysis in the country, while only five hospitals have a dedicated service. For affected families, the disease becomes both a medical ordeal and a genuine financial battle. Some must go into debt or sell their property to ensure treatment continuity. This distress has long mobilized civil society. The Tsarà association notably campaigns to help people suffering from kidney failure through donations of medicines and equipment. A few years ago, it also had dialysis equipment shipped in. But according to well-informed sources, materials were blocked at the port before disappearing, while medicines eventually deteriorated. A precedent that reminds us how important actual equipment availability remains as their acquisition. For patients eligible for transplantation, another difficulty persists. Transplant unit projects were launched under the previous administration, but their implementation remains suspended pending the adoption of legislation authorizing organ transplants. Meanwhile, medical evacuation abroad remains an option reserved for those with sufficient means or benefiting from coverage. The partnership with Lifenity International could therefore represent a major breakthrough, provided the announcements materialize. For patients and their families, the urgency is no longer simply having more centers: it is being able to sustainably access nearby dialysis at a truly affordable price.