Madagascar has remarkable biodiversity with 80% of its flora and fauna found nowhere else in the world. While its economy is highly reliant on natural resources, significant unmet health and economic needs drive unsustainable practices. In the face of growing uncertainty—Madagascar is extremely susceptible to climate change—we spoke to Madagascar PHE Network Coordinator Nantenaina Tahiry Andriamalala about how early population, health, and environment (PHE) successes have led to a rich network of organizations working to address health and conservation needs in tandem.