A mission So. San was held from 7 to 27 May 2010. In Madagascar live about 25 million inhabitants, with a density of 43 ab./km². The population is almost quintupled in the last half century even if the country remains economically among the poorest and the quality of life remains low for the majority of the population. Despite the presence of different hospitals, the health system is not generally able to support emergencies that involve delicate and complex interventions. The supply of medicinal products generally does not present particular problems in Antananarivo, the capital of the fourth largest island in the world, while it can be difficult in the rest of the country. In autumn 2017, an epidemic of bubonic and pulmonary plague struck numerous districts. The situation, although improved, continues to be closely monitored by the local authorities and the WHO. Sporadic cases of cholera and rabies, transmitted by stray dogs, have also been recorded. Malaria is endemic especially in coastal areas. The plague and leprosy are endemic in some extremely backward areas. have been recorded in the past, cases of Rift Valley fever and cases of transmission of the polio virus.