Air Madagascar flies four times weekly between Île Sainte Marie and Tana (€227, one hour) and three times a week to Tamatave (€227, 30 minutes). Flights to Maroantsetra and destinations further north involve a stopover at Tamatave. Flights up the northeast coast are often full; in the vanilla season (June to October) book as far in advance as possible and reconfirm all bookings.
Madagasikara Airways has three to four weekly flights to Tana (€131, one hour) and a single weekly service to Tamatave (€101, 30 minutes).
Boats leave Ambodifotatra for Soanierana-Ivongo (€24 to €28) as early as daybreak. Cargo boats leave from a different port on Ilot Madame, the tiny island at the entrance to Baie des Forbans, sailing to Mananara, Maroantsetra and Tamatave. There are no set schedules for these; departures from Île Sainte Marie are often in the evening or at night, and you will likely have to wait several days for something to turn up.