Age takes its toll. After serving the population for nearly a century and a half (135 years), Cenhosoa, formerly the Military Hospital, Soavinandriana Hospital, and Girard and Robic Hospital, visibly bears the scars of its longevity. It has endured the years without the building receiving occasional renovations, without service improvements—far from it. Worse, patients must bring buckets and basins, filling containers throughout the night. The hospital also suffers from power cuts due to lack of backup generators. Cenhosoa perfectly illustrates the situation in public hospitals and basic health centers. This stems from health not being among the priorities of successive governments. The 2026 budget law allocates 856.1 billion ariary compared to 920.9 billion ariary in 2025—a 7% cut. Globally, Madagascar ranks 164th out of 192 countries in this domain. This reduction will have negative impacts on health conditions. Health's share of GDP is 6%, while the Abuja Declaration, which Madagascar has signed, sets a minimum of 15% of GDP for health. Public health spending per capita is even more alarming at 5 dollars (25,000 ariary), compared to 538 dollars (2,528,600 ariary) in Seychelles, 273 dollars (1,283,100 ariary) in Mauritius, and 13 dollars (61,100 ariary) in Comoros. The WHO sets a minimum threshold of 249 dollars (1,170,000 ariary). Health costs, however modest, remain the burden of households at 35-40%, due to lack of a genuine social security or insurance system. The universal health coverage index reflects this: it stands at only 28%, compared to 44% in sub-Saharan Africa. Many households have access to neither care nor medicines, whose prices sometimes represent five to ten times the individual daily income, estimated at 2 dollars (10,000 ariary). Weary, they prefer to trust providence or turn to devotion. There, at least, they are assured of the State's consideration and attention. It must be said that fifty thousand faithful gathered in a stadium are more impressive than three million patients visiting hospitals throughout the year. If hospitals are what they are today, one can understand why. Health spending is largely ensured by international aid and donors. There is no alternative with a tax pressure rate of 10-12%: the State cannot fulfill its duties. Tax evasion and a clearly deficient trade balance complicate matters. It was believed the State was determined to limit imports by imposing a 20% tax on imported luxury rice, as the budget law had set, but this hope was dashed with the tax suspension. As State revenues remain insufficient, the health budget will remain derisory. There will be no means to accommodate six thousand doctors (0.18 doctors per thousand inhabitants), far below WHO standards. Whether in a wealthy country or a poor nation, health is worth more than ever. Alas, health is a reality only in dreams—forbidden dreams at that, due to lack of sleep and means to afford sleeping pills and forget worries for a time. Even the night no longer brings counsel. Sylvain Ranjalahy