Recently, the Drug Regulatory Authority of Pakistan (DRAP) intensified its nationwide efforts toward combating the illegal sale, manufacturing and distribution of contaminated and falsified medicines in the country. DRAP implemented increased surveillance, intelligence-led enforcement and stricter regulations to combat, in other words, the fake drug crisis in Pakistan.
Background
The Ministry of National Health Services reports that 85% of medicines in Pakistan are either counterfeit or substandard. According to DRAP, 50% of the medication samples tested were fake — including life-saving treatments for cancer, cardiovascular diseases, mental illnesses and infections.
The issue of counterfeit medicines has been harming the health of Pakistanis for decades. Contaminated drugs often include arbitrary dosages of certain ingredients and deadly additives that can cause fatal effects, such as respiratory paralysis or death. A victim of fake medicine would need additional treatment to cure the damage from these drugs, which takes a toll on both the individual already suffering from an illness and the Pakistani health care system. Even if a fake drug has no effect at all, it is still dangerous, as a patient could unknowingly be left untreated for a serious disease.
Fake Drugs Affect the Poor the Most
The fake drug crisis in Pakistan disproportionately affects the poor, who cannot afford branded medicines or, in some cases, receive certain drugs from pharmacies for free. In 2012, a public cardiology pharmacy in Lahore distributed a contaminated drug to the poor. As a result, 125 people died due to fatal bone-marrow suppression.
Counterfeit drugs are also most often found in rural areas, where drug regulation is less strict. For these reasons, people living in poverty often have to resort to cheaper, falsified drugs, according to Wolters Kluwer Health.
To combat this, Muhammad Omar Larik recommended that the Pakistani government establish pharmaceutical support programs for the poor, as mentioned in his study published in the Journal of the Pakistan Medical Association.
Raids, Seizures and Closures
In recent crackdown efforts on the fake drug crisis in Pakistan, DRAP raided several pharmacies and local medicine shops. If lab testing revealed that the store sold falsified drugs, DRAP would shut it down.
DRAP sealed multiple establishments across the country, including the Al-Waali Care Concepts medical supplies store in Lahore. There were more drug regulation violations behind each closure, such as operating without a valid drug license and unlawfully storing medical devices. When officials raided Al-Waali Care Concepts, they brought legal action against the owner and started a formal investigation into the store.
In a surprise raid, a federal drug inspector shut down a pharmaceutical factory in Nooriabad for its illegal production of unregistered high-dose tramadol tablets. The production of this opioid is illegal nationwide due to smuggling concerns, public safety risks and especially its abuse abroad. DRAP suspects the factory produced the tablets with the intention of shipping them to foreign drug markets.
DRAP lab-tested several pharmaceutical products and consequently banned three newly-found counterfeit medicines: batch 251986 of Duphalac syrup, batch 091 of Taskeen Dard tablets and batch 01 of Pain-Nil tablets. The authority seized the identified batches of the medicines, removed them from the markets and tracked down the suppliers.
In Karachi, officials seized a large quantity of medicine that was sold across the city. In Lahore, DRAP caught individuals selling Urografin, an iodine-containing injection, and a dealer selling unregistered infertility medication, Lipiodol Ultra Liquid, beside a hospital, Dawn reported.
Provincial drug control officials also confiscated several batches of medicines meant to treat allergies, anxiety disorders, kidneys, fevers, body pain, bacterial infections and ulcers. Lab testing revealed that these medications were fake and completely ineffective. According to DRAP, these drugs were illegally produced and falsely labelled under well-known pharmaceutical brands.
Identifying Fake Drugs
A significant lack of public awareness also feeds into the fake drug crisis in Pakistan, as the public is not aware of the severity of the issue and unsure how to differentiate counterfeit medicines from real, safe medication.
As one solution, Dvago, a reputable pharmacy and medical store in Pakistan, outlined several warning signs to look for when identifying counterfeit drugs. These include packaging irregularities, missing or fake security seals, inconsistencies in the medicine’s appearance, an incorrect batch number or expiry date, extremely low prices and a lack of a proper leaflet or labels.
When purchasing medication, the store urges the public to only buy from licensed pharmacies, consult a pharmacist beforehand, verify the drug manufacturer, use track and trace systems with unique codes and most importantly, report suspicious medicines.
Increasing the Quality of Health and Life in Pakistan
Overall, the DRAP crackdown on illegal pharmaceutical drugs is a significant step toward increasing the quality of health and life for Pakistanis, especially for those living in poverty. Unfortunately, the fake drug crisis in Pakistan persists due to inadequate legislation, ineffective law enforcement and drug regulators’ failure to effectively interpret and implement the law.
Nevertheless, with consistent drug surveillance, more pharmacists, stronger law enforcement, trained drug regulators and a solid infrastructure for drug control, Pakistan can achieve its goals.
– Umaymah Suhail
Umaymah is based in Karachi, Pakistan and focuses on Good News and Global Health for The Borgen Project.
Photo: Flickr
Elimination of Leprosy in Chile
Background
Leprosy is a chronic, bacterial infection caused by the ingestion of a specific type of bacteria “Mycobacterium leprae.” Once the virus enters its host’s body, it quickly gets to work infecting the body’s skin and nerves, causing immense physical pain and discomfort to its victims. While the infection is not believed to be fatal, leprosy disease can cause various uncomfortable conditions, including severe itching, muscle fatigue, nerve weakness, and, without adequate recognition and treatment, serious disabilities. While treatment for leprosy eradication is available to those who seek it, it is challenging for victims to pursue a cure, as leprosy disease is difficult to properly identify, and symptoms don’t typically show themselves until years after the infection.
Hope is Still There
While leprosy is a dangerous disease that can leave potentially life-altering side effects, thankfully, hope is still there as there are a handful of treatments that can help with leprosy eradication in the body.
As of early March, both the World Health Organization (WHO) and the Pan American Health Organization (PAHO) have officially verified that Chile has not recorded leprosy for as long as 30 years. While this landmark accomplishment deserves celebration, it’s important to consider that leprosy eradication in Chile not only luck, but rather a set of principles Chile has taken to reduce the spread of leprosy.
A common example includes increased surveillance around the country, intended to closely monitor and detect sicknesses as soon as they come up and treat them accordingly, rather than choosing to wait and risk harmful side effects. Those who are found infected are treated and followed up on for the disease immediately. WHO has implemented a strategic system in place which ensures that anyone who is diagnosed with leprosy receives continuous, long-term health benefits to help aid the recovery process.
Multidrug Therapy
Another important discovery that has led to complete leprosy reduction in Chile is the expanded access that patients now have to multidrug therapy (MDT), a combination of medications used to thoroughly treat leprosy. Both PAHO and WHO have cooperated to pledge their support for the implementation of the MDT method within the Americas, completely free of charge to all of its members. The frequent generosity of donors around the world has made it possible to more effectively identify the disease before it negatively impacts its respective hosts and then cure the disease, effectively reducing leprosy before it takes control.
Chile’s new methods of disease recognition have been successful in allowing for Leprosy eradication within the entire country’s border. Efforts by the WHO and PAHO organizations have paved the way for more positive treatment for disease, including increased surveillance systems to track and monitor viruses and the MDT program, which have been consistently successful as shown by the grand milestone.
The decades of time and effort spent into eradicating the leprosy virus in Chile have finally paid off, and it goes to demonstrate that threatening diseases that may at first seem impossible to truly erase are actually quite easy when governments commit to certain health strategies, as cooperation is essential for not only the elimination of viruses within certain countries, but also as a way to maintain their absence in the following years.
– Will Mancuso
Photo: Flickr
Ambitious Plans: Poverty Reduction in Indonesia
Indonesia’s Economic Landscape
Composed of more than 17,000 islands, Indonesia is the most populous country in Southeast Asia and the fourth most populous in the world. Indonesia has maintained a stable economy over the years, known for its role in managing imports. However, approximately 24.8 million people, or 8.7% of the population, were considered poor as of early 2025. Indonesia aims to target extreme poverty, planning to reduce the percentage to 7% by 2026 and 4.5% by 2029. Indonesia also plans for economic growth to increase by 5.4% to 6% over the next year to support poverty reduction in Indonesia.
Tracking Poverty Through Data
To ensure that these changes hold, Indonesia has launched the National Socio-Economic Single Data System (DTSEN), a method used to identify citizens who live below the poverty line and need social support so that assistance can be provided. The database allows for the distribution of resources to those who need them. The DTSEN provides access to food aid, health insurance and services to those who are struggling. This effort, which involves cooperation from the government as well as various social groups, seeks to benefit citizens’ well-being and increase poverty reduction in Indonesia.
Expanding Access to Education
One of the most notable parts of Indonesia’s plan is the construction of more than 70,000 school units over the course of 2026. Education is a strong focus within Indonesia’s goal to reduce regional poverty through the Indonesia Bright Program (PIP), which offers funding for hundreds of thousands of young students. The program intends not only to raise educational opportunities for young students but also to ensure that the units being built meet high-quality standards, addressing issues such as poor building structures, leaky roofs and a lack of sanitation within schools.
Budgetary Reform and Land Allocation
To make these changes work, leaders met in December 2025 to propose a new strategic framework that allows citizens to access more equal opportunities and provides those who are struggling with the resources they need. Indonesia also plans to allocate state-owned land to more than 1 million poor families in another effort to reduce poverty in the country.
Looking Ahead
Indonesia’s plan to reduce poverty by the end of 2026 is ambitious but has shown early progress. By investing in social assistance, education and economic reform, poverty reduction in Indonesia can move from a goal to a measurable outcome.
– Will Mancuso
Photo: Flickr
Facts About Statistics Regarding Foreign Aid to Tuvalu
Taken at face value, the level of foreign aid to Tuvalu appears encouraging, certainly at a time where humanitarian aid efforts are drastically reducing across the globe. Increasing aid amounts can indicate the existence of significant global commitment. However, Tuvalu’s foreign aid statistics tell several painful stories.
The Sobering Reality
Aid is rising – not due to global commitment – but rather on account of the fact that Tuvalu faces a genuine existential risk. With an average elevation of less than 2 meters above sea level, Tuvalu is one of the most climate vulnerable nations in the world and faces the very real possibility of complete land submergence due to rising sea levels and saltwater intrusion.
Pacific island nations like Tuvalu, Palau and the Marshall Islands bear a negligible responsibility for the consequences of changing weather patterns yet face enormous costs. As of 2024, Tuvalu contributes 0.00003% of global CO2 emissions, but is becoming increasingly uninhabitable due to the consequences of changing weather that it did not create.
As the nation lacks the economic ability to combat rising tides, their unusual dependence on foreign aid and external grants as sources of income demonstrates a growing vulnerability, not global commitment. Climate hazard assessments for 2025 identified more intense cyclones and storm systems that extensively damaged infrastructure and essential services across sectors such as water, health and coastal development. Freshwater availability, agriculture and public health are areas that have all suffered, despite rising amounts of aid. This puts a direct stress on people’s livelihoods, income and wellbeing.
What This Means in the Context of Global Poverty
Due to the nation’s climate vulnerability, a large share of foreign aid to Tuvalu has to be tied to specific climate and infrastructure projects. Tuvalu cannot spend it on health systems, education or long-term economic diversification, due to the extent of climate risk the nation faces. The state has little discretionary fiscal space, even though the headline figures may look large. In a country that already has 26% of its population living below the poverty line, the inability to use foreign aid to help families going through hardship contributes directly to increasing poverty statistics.
As the main focus of foreign aid to Tuvalu is therefore focused on combatting climate risk first, funds that would be used to improve the economic and social wellbeing of Tuvalu’s population are stretched thin. The country’s economy depends heavily on natural resources such as fisheries, small-scale agriculture and coastal land, meaning that environmental changes can quickly translate into economic hardship.
Many homes and community buildings are located near the shoreline because the islands are extremely narrow. As the ocean encroaches inland, families lose land used for housing and farming. As Tuvalu relies largely on subsistence agriculture, where families grow crops such as pulaka (a traditional swamp taro) for their own consumption, land loss directly damages food and economic security.
Changing weather has also increased the salinity of soils and groundwater, as saltwater infiltrates farmland, damaging crops and reducing harvests. As a result, many households must rely more on imported foods, which are expensive due to transport costs. This creates additional financial pressure for families and is increasing food insecurity.
Solutions
However, it is not all doom and gloom for the small island nation. The Tuvalu Coastal Adaptation Project (TCAP) is perhaps one of Tuvalu’s most notable responses to the issues it is facing. Funded by the Green Climate Fund, the United Nations Development Program and the governments of Australia, New Zealand and the U.S. (~$36 million), the project aimed at helping the most vulnerable communities experiencing climate risk. The TCAP successfully reclaimed 8 hectares of land, and is estimated to have helped 60% of Tuvalu’s population suffering further climate driven poverty, offering a model for other small island developing states to “rise above the waves.” By reducing the risk of flooding and erosion, coastal protection projects help preserve livelihoods and reduce the economic losses that often push households into poverty.
Alongside land reclamation, the TCAP has also invested directly in young Tuvaluans, funding scholarships in climate science, coastal engineering and environmental studies. A focus on educating their nation will soon directly help safeguard homes and protect both public infrastructure and agricultural land.
International organizations have also introduced programs to help farmers adapt to changing environmental conditions, such as developing salt-tolerant crops, improving soil management techniques and promoting small-scale home gardens. Such programs help communities maintain food production despite rising salinity and environmental stress.
Concluding Thoughts
While the amount of foreign aid to Tuvalu appears significant, its use is severely hindered by fiscal limitations. Figures showing rising amounts of aid can therefore be misleading, as these correspond to rising climate threats and a growing existential risk, rather than increasing humanitarian aims. In truth, the real problem that Tuvalu faces, is not really a “lack of foreign aid,” but rather a lack of concrete climate change commitments and more accountable Nationally Determined Commitments (NDCs) that COP should make. Indeed, after the disappointment of COP30 last year, Tuvalu’s Minister of Climate Change, Maina Talia, claimed the conference was a “festival for the oil producing countries” who “bury our voice as small developing countries.”
Tuvalu’s experience highlights how changing weather patterns can intensify poverty in vulnerable nations by threatening livelihoods, food security and infrastructure. While foreign aid and international climate adaptation projects have helped strengthen resilience and protect communities, long-term solutions will depend on continued global cooperation and stronger action to address changing weather.
– Max Kenway
Photo: Unsplash
Renewable Energy in Antigua and Barbuda
Now, a different future is being sketched across these islands. It is common for government plans and regional forums to center on renewable energies projects. Rather than being treated as a distant ideal, green energy is increasingly being framed as a matter of survival — economically, environmentally and socially.
Antigua and Barbuda, as many small island developing states, is seeing the transition away from fossil fuels as the pathway to keeping the coasts protected and the economy afloat. Here is more information about the promotion of renewable energy in Antigua and Barbuda.
Antigua and Barbuda
Nestled in the eastern Caribbean’s Leeward chain, Antigua and Barbuda is a twin-islands nation that squeezes a population of nearly 95,000 onto 440 square kilometers of low coral atolls and limestone ridges — Antigua’s volcanic hills peak at just 405 meters, while Barbuda’s pancake-flat expanse is waterless and boasts pink sands.
When it comes to demography, a peculiar distribution characterizes Antigua and Barbuda: nearly all residents — 98% — crowd onto Antigua, with 60% living in St. John Parish and another 26% crammed into the capital and port city of St. John’s.
Having been a check point for the slave trade routes in the 17th century, most islanders (87% of the total) are of African descent navigate a youthful, female-skewed demographic with life expectancy hovering near 79 years.
Green Energy Targets
Antigua and Barbuda is aiming at one of the most ambitious targets in renewable energy among Small Island Developing States (SIDS), targeting 86% of electricity from local renewables by 2030 and 100% for water management essentials like desalination. This vaults it into the ninth spot among the best SIDS for expected MW capacity by 2030 — eyeing 483 MW — despite a population of less than 100,000, far outpacing per capita efforts by giants like Fiji or Cuba, home to millions of inhabitants. This green energy strategy crosses three main sectors: geothermal, wind and solar power, not all equally viable and the current share of renewable energy is only at 7%.
Although a country of very small size, geothermal power could leverage the nation’s perch on the Caribbean Plate. A 2018 pact with Polaris Energy scouts baseload potential on the territory and the government has recently expressed the intention of entering the geothermal market of St. Kitts and Nevis, a neighbor small island country, to strengthen regional energy cooperation.
At an initial look wind may seem like a source perfectly suiting an oceanic nation. However, this power proved to be a double-edged sword: trade winds whip reliably, but 2017’s Hurricane Irma — obliterating 95% of Barbuda — canceled the efforts of erecting resilient turbines, stalling ambitious sites.
It is solar power that steals the spotlight as the most reliable source of green energy, dominating almost 100% of current renewables. Bathing in year-round Caribbean sun, Antigua and Barbuda benefits from more than 4,300 hours of sunlight, making it the perfect spot for accumulating solar energy. A key feature of the sector is the shift from rooftop systems to off-grid systems. Projects like the hurricane‑resistant solar and battery plant on Barbuda are designed not just to generate clean power, but to keep the lights on after storms and also attract foreign capitals.
Changing Weather Patterns
Poverty remains a persistent challenge in Antigua and Barbuda, worsening under the strain of changing weather patterns. Those already on the margins face increasing threats from extreme weather, disrupted livelihoods and limited access to essential services such as health, transport and communications. The combined effects of hurricanes and the lingering fallout from COVID‑19 continue to erode social and economic stability.
Women are disproportionately affected, forming the majority in tourism and public sectors while shouldering household leadership. A UN Women and IISD survey urged retraining of public employees and stronger integration of gender concerns into climate policies. Many women rely on microfinance after disasters, while health risks — from waterborne diseases to mental stress — intensify vulnerabilities.
Expanding renewable energy in Antigua and Barbuda is vital to reversing these trends. Clean energy projects can lower costs, create stable jobs and strengthen climate resilience, ensuring that development benefits vulnerable groups more equitably. For instance, the International Renewable Energy Agency estimated that in a scenario where Antigua and Barbuda make it to 100% renewable energy, including the use of hydrogen and the proliferation of electric vehicles as variables, the cost of energy would decrease from USD 0.15 kWh to USD 0.09.
Why Are SIDS Obsessed With the Green Transition?
SIDS like Antigua and Barbuda, Mauritius, Nauru and others champion the green transition despite contributing a minuscule slice of global GHG emissions — less than 1% collectively, for 39 countries falling into this category.
Changing weather patterns hit them first before any other country in the world: sea-level rise erodes shorelines, hurricanes wreck homes and economies, coral die-offs cripple tourism and fish stocks.
Climate-resilient infrastructure and innovation are advancing at the national level among all SIDS. For instance, the Maldives and Tuvalu are experimenting with adaptive urban designs such as floating cities and artificial islands, adapting to rising sea levels. Collectively, SIDS are speaking out through the Alliance of Small Island States, urging stricter emissions targets and fair financial mechanisms for climate impact mitigation at the international level.
– Riccardo Chiaraluce
Photo: Flickr
The Role China Is Playing In Alleviating Poverty in Cambodia
Background
Over the past 40 years, China has lifted 800 million people out of extreme poverty, classified by the World Bank as living on less than $1.90 per day. This achievement was driven by a model which blends rapid economic growth with tangible improvements to well-being, targeted to each local community. As a result, China announced at the end of 2020 that it had already met the poverty targets of the U.N. 2030 Agenda for Sustainable Development ahead of schedule.
Learning from its own experience, China has trained more than 400,000 professionals from more than 180 countries and regions in poverty alleviation methods. It has launched village-by-village pilot projects designed to promote its experience in poverty reduction strategy overseas.
One such initiative is the Cambodia-China Friendship Village for Poverty Alleviation project in Tanorn, in the southern province of Takeo, Cambodia. Implemented by Cambodia’s Civil Society Alliance Forum (CSAF), with funding from the China Foundation for Peace and Development, the project began in 2021 and developed programs in infrastructure, education and health care sectors.
The Impact: Poverty in Cambodia
Before its implementation, the remote village had poor quality roads that made it difficult for farmers, who comprise 70% of the population, to sell their products. This isolation created extreme economic insecurity. Following road improvements, brokers are now able to drive trucks to purchase crops directly from farms, increasing market access and income stability.
For residents such as Sokhim, mother of four children who lives in the village and used to depend on rice farming, these changes have been transformative. With improved infrastructure and economic conditions, she now runs a grocery store and says that the project has improved livelihoods across the village.
Tanorn’s experience reflects a broader national trend: poverty in Cambodia has declined significantly in recent years, with the number of people living in poverty falling from 5.6 million to 2.8 million over approximately seven and a half years.
Strategy
However, despite development assistance from China having positive impacts on villages like Tanorn, its intervention in Cambodia has been closely intertwined with foreign policy goals and investment strategy.
In recent years, financial support from China has been used to establish a strategic and comprehensive production network in Cambodia. The Cambodian People’s Party (CPP), which has been in power continuously since 1979, has welcomed and protected Chinese investment. This relationship has allowed the creation of an autonomous and profitable ecosystem for Chinese companies operating in the country, deepening economic interdependence.
China’s influence extends beyond infrastructure and commerce. Through the opening of cultural centres promoting Chinese language and culture, university partnerships and funding of research centres and think-tanks, China has strengthened its soft power footprint. These tactics contribute to regime legitimacy in Cambodia, reinforcing political stability that is conducive to China’s long-term strategic interests.
Moreover, Chinese financial and material aid has had notable political implications. The CPP has welcomed China’s support as Beijing has overtly backed the party’s continued rule and opposed the actions of opposition parties. This reciprocal relationship has led to the adoption of governance practices resembling aspects of China’s authoritarian model, such as internet regulation, media control and censorship, and opacity in trade and business.
The Future
At a time when the World Bank’s 2024 Poverty, Prosperity and Planet report notes that global poverty reduction has slowed to a near standstill, China’s development interventions are creating positive change. However, the Cambodian case suggests that while poverty alleviation is delivering tangible improvements, it is also playing a role in reinforcing China’s political and strategic control abroad.
– Jenna O’Flynn
Photo: Flickr
Extreme Heat and The Lady Health Workers of Pakistan
Intensifying Heatwaves in Pakistan
Pakistan is highly vulnerable to extreme heat, with heatwaves becoming more frequent, prolonged and intense in recent decades. Pre-monsoon months often see dangerously high temperatures in combination with high population densities, as seen in cities such as Karachi and Lahore. Several severe events in recent years have emphasized the scale of this risk, including the 2015 heatwave that devastated the southeastern Sindh province and ultimately claimed more than 1,000 lives. In more recent years, Pakistan experienced a heatwave in June 2025, during which temperatures in many parts of the country exceeded 113°F.
Prolonged periods of extreme heat place significant strain on urban and rural communities alike, affecting infrastructure and health systems. Climate change is expected to intensify these trends, increasing the likelihood of longer and more severe heatwaves and expanding the geographic areas affected. For populations with limited access to cooling, reliable electricity or adequate health care, these conditions create public health risks and highlight the need for stronger heat-health preparedness measures.
Extreme Heat and Maternal Health Risks
Extreme heat poses significant risks during pregnancy due to the body’s changes in temperature regulation and fluid balance. During pregnancy, fetal development increases fluid requirements, making it more difficult for the body to dissipate heat. This increases susceptibility to dehydration and heat stress. High temperatures may disrupt hormonal regulation and impair the function of the placenta, potentially reducing oxygen and nutrient delivery to the fetus.
Evidence also links exposure to extreme heat with several adverse pregnancy outcomes, including gestational diabetes, preterm birth and stillbirth in some cases. Heat exposure can also increase the likelihood of infections and complicate care during labor. Because public health care systems in Pakistan are often described as overwhelmed, these risks may increase further. As temperatures continue to rise with climate change, these issues underscore the importance of recognizing pregnancy as a period of heightened vulnerability to extreme heat and ensuring appropriate support for pregnant populations.
Omission of Pregnancy in Heat-Health Action Plans
The National Heatwaves Guidelines released by the Pakistani government do not make direct reference to pregnancy during extreme heat events. The guidelines recommend that “individuals should check on neighbors, especially the elderly, children and those with chronic illnesses,” but they do not mention people in the perinatal period. The report encourages community care for “vulnerable residents,” but it does not define which groups fall into this category.
This highlights an ongoing issue within Heat-Health Action Plans (HHAPs) across the globe. As extreme heat events occur more frequently, many countries have implemented national HHAPs, as urged by the World Health Organization (WHO). However, while WHO guidelines outline strategies to protect pregnant individuals from extreme heat, a recent review found that of 83 eligible HHAPs from 24 countries, only 52% recognized the need to protect this population during heatwaves. Furthermore, none of the HHAPs comprehensively addressed the risks heatwaves pose to maternal, newborn and child health.
The Lady Health Workers of Pakistan
Pakistan’s Lady Health Worker (LHW) Program, established in 1994, plays a critical role in delivering maternal health services to communities across the country, particularly in rural areas and urban informal settlements. The program deploys more than 100,000 trained female community health workers who live within the communities they serve, each covering roughly 1,000 people. Although they are not physicians, they provide services that health professionals may not be able to deliver consistently at the household level. This includes conducting regular household visits to provide health education, basic preventive care and referrals to formal health facilities.
LHWs focus heavily on maternal and newborn health. They counsel pregnant individuals on the importance of antenatal care while monitoring pregnancies and linking families with clinics or midwives when complications arise. They are trusted members of their communities and provide care directly at the household level. As a result, LHWs often serve as the first point of contact for pregnant populations during environmental or health crises.
LHWs guide hydration, rest and heat-related illness. They also monitor vulnerable pregnancies and facilitate timely referrals to health facilities, helping ensure continuity of maternal care even when extreme heat and strained hospitals make access to services more difficult.
– Charlotte Bunn
Photo: Flickr
DRAP cracks down on the fake drug crisis in Pakistan
Background
The Ministry of National Health Services reports that 85% of medicines in Pakistan are either counterfeit or substandard. According to DRAP, 50% of the medication samples tested were fake — including life-saving treatments for cancer, cardiovascular diseases, mental illnesses and infections.
The issue of counterfeit medicines has been harming the health of Pakistanis for decades. Contaminated drugs often include arbitrary dosages of certain ingredients and deadly additives that can cause fatal effects, such as respiratory paralysis or death. A victim of fake medicine would need additional treatment to cure the damage from these drugs, which takes a toll on both the individual already suffering from an illness and the Pakistani health care system. Even if a fake drug has no effect at all, it is still dangerous, as a patient could unknowingly be left untreated for a serious disease.
Fake Drugs Affect the Poor the Most
The fake drug crisis in Pakistan disproportionately affects the poor, who cannot afford branded medicines or, in some cases, receive certain drugs from pharmacies for free. In 2012, a public cardiology pharmacy in Lahore distributed a contaminated drug to the poor. As a result, 125 people died due to fatal bone-marrow suppression.
Counterfeit drugs are also most often found in rural areas, where drug regulation is less strict. For these reasons, people living in poverty often have to resort to cheaper, falsified drugs, according to Wolters Kluwer Health.
To combat this, Muhammad Omar Larik recommended that the Pakistani government establish pharmaceutical support programs for the poor, as mentioned in his study published in the Journal of the Pakistan Medical Association.
Raids, Seizures and Closures
In recent crackdown efforts on the fake drug crisis in Pakistan, DRAP raided several pharmacies and local medicine shops. If lab testing revealed that the store sold falsified drugs, DRAP would shut it down.
DRAP sealed multiple establishments across the country, including the Al-Waali Care Concepts medical supplies store in Lahore. There were more drug regulation violations behind each closure, such as operating without a valid drug license and unlawfully storing medical devices. When officials raided Al-Waali Care Concepts, they brought legal action against the owner and started a formal investigation into the store.
In a surprise raid, a federal drug inspector shut down a pharmaceutical factory in Nooriabad for its illegal production of unregistered high-dose tramadol tablets. The production of this opioid is illegal nationwide due to smuggling concerns, public safety risks and especially its abuse abroad. DRAP suspects the factory produced the tablets with the intention of shipping them to foreign drug markets.
DRAP lab-tested several pharmaceutical products and consequently banned three newly-found counterfeit medicines: batch 251986 of Duphalac syrup, batch 091 of Taskeen Dard tablets and batch 01 of Pain-Nil tablets. The authority seized the identified batches of the medicines, removed them from the markets and tracked down the suppliers.
In Karachi, officials seized a large quantity of medicine that was sold across the city. In Lahore, DRAP caught individuals selling Urografin, an iodine-containing injection, and a dealer selling unregistered infertility medication, Lipiodol Ultra Liquid, beside a hospital, Dawn reported.
Provincial drug control officials also confiscated several batches of medicines meant to treat allergies, anxiety disorders, kidneys, fevers, body pain, bacterial infections and ulcers. Lab testing revealed that these medications were fake and completely ineffective. According to DRAP, these drugs were illegally produced and falsely labelled under well-known pharmaceutical brands.
Identifying Fake Drugs
A significant lack of public awareness also feeds into the fake drug crisis in Pakistan, as the public is not aware of the severity of the issue and unsure how to differentiate counterfeit medicines from real, safe medication.
As one solution, Dvago, a reputable pharmacy and medical store in Pakistan, outlined several warning signs to look for when identifying counterfeit drugs. These include packaging irregularities, missing or fake security seals, inconsistencies in the medicine’s appearance, an incorrect batch number or expiry date, extremely low prices and a lack of a proper leaflet or labels.
When purchasing medication, the store urges the public to only buy from licensed pharmacies, consult a pharmacist beforehand, verify the drug manufacturer, use track and trace systems with unique codes and most importantly, report suspicious medicines.
Increasing the Quality of Health and Life in Pakistan
Overall, the DRAP crackdown on illegal pharmaceutical drugs is a significant step toward increasing the quality of health and life for Pakistanis, especially for those living in poverty. Unfortunately, the fake drug crisis in Pakistan persists due to inadequate legislation, ineffective law enforcement and drug regulators’ failure to effectively interpret and implement the law.
Nevertheless, with consistent drug surveillance, more pharmacists, stronger law enforcement, trained drug regulators and a solid infrastructure for drug control, Pakistan can achieve its goals.
– Umaymah Suhail
Photo: Flickr
Gender Equality in Nigeria: Fighting For Female Safety
Gendered Issues in Nigeria
Gender equality in Nigeria remains an ongoing struggle. According to Girls Not Brides, 12% of girls marry before the age of 15 and 30% before 18. These statistics are influenced by poverty and education rates, with 71% of women with no formal education reporting having married before the age of 18. According to the United Nations Population Fund (UNFPA), one in three women experiences physical violence by the age of 15, often related to domestic circumstances.
Poverty is a driving factor, as 46% of the population lives below the poverty line. Economic pressures can lead families to arrange early marriages, which perpetuates unequal gender norms and limits women’s educational and professional opportunities.
Women for Women International
Women for Women International (WFWI) is a nonprofit organization established in 1993 that works to support women across 17 countries affected by conflict or injustice. Since 2000, WFWI Nigeria has reached more than 84,306 women. Its flagship program, Stronger Women Stronger Nations (SWSN), promotes gender equality in Nigeria through vocational and financial skills training, academic education, health education and support networks for vulnerable women.
WFWI has also taken action to address the root causes of gender inequality by engaging men. Given the data on domestic abuse, forced marriage and gender-based violence (GBV), WFWI identified that creating allies within the male population in Nigeria is integral to resolving gender inequality.
According to a study published in the Pan African Medical Journal in 2022, the highest prevalence of physical or sexual intimate partner violence was reported in Sub-Saharan Africa, at 65.64%. In Nigeria, information from the 2018 National Demographic Health Survey shows that 33% of women between 15 and 49 experience physical or sexual violence. The prevalence rate of GBV is 74.4% among survivors under 18, further reinforcing the risks for girls in early marriages.
WFWI’s men’s engagement program launched in Nigeria in 2002 with the aim of educating men on women’s health, the social and economic issues women face, and how men can offer support. The program creates focus groups and targets men in the community with religious, military or civil society backgrounds, creating a pathway for these men to advocate for women’s rights and gender equality in Nigeria.
Results of SWSN and Men’s Engagement
SWSN has had a measurable impact on gender equality in Nigeria since its launch in 2000. Change agents, women who received SWSN training and spread it through the community, have navigated the challenge of educational equality by establishing a mixed-gender primary school in the state of Bauchi. These agents were responsible for bringing nearly half of the 92 students to this school.
The program has reached more than 92,000 Nigerian women, with more than 5,000 graduating from SWSN in 2024. WFWI reports that graduates doubled their monthly earnings through newly acquired business skills, and 83% of graduates reported feeling actively involved in their public and private lives, compared with 36% at enrollment. Women’s knowledge of their political and national rights increased from 55% to 92%.
In the men’s focus groups, results have also been positive. WFWI acknowledges that women’s empowerment is not only achieved by reducing men’s power but that gender equity also benefits men’s health, household environments, financial matters and communities. Nearly 53,000 men have been reached since 2002, with more than 17,000 joining the project in Nigeria. One man, Murhula, has claimed that “my life has really changed” from his participation. His realization that “We thought that certain jobs are just for men […], but today I can say that the work a man can do, a woman also can do it.”
Looking Ahead
With the continuation of SWSN and the men’s engagement program, progress toward gender equality in Nigeria extends beyond policy into education, homes and communities. WFWI’s model demonstrates that addressing gender inequality requires engaging both women and men.
– Jaya Noonan
Photo: Unsplash
Managing Maternal Hypertensive Disorders in Venezuela
This alarming reality demands immediate intervention. Organizations including UNICEF are already responding, deploying strategies to expand healthcare access and strengthen training in obstetric neonatal and pediatric emergency care. Here is more information about maternal hypertensive disorders in Venezuela and how they are being addressed.
The Government
To understand Venezuela’s healthcare emergency, one must first understand its economic catastrophe. For decades, oil revenues financed nearly two-thirds of the government budget. In 2014, when oil prices collapsed and the central bank responded by printing more money, the country entered one of the worst hyperinflation periods in modern history. Ordinary Venezuelans have felt these impacts the most as political turmoil has been further exacerbated by exchange rate volatility and the recent capture of Nicolas Maduro.
Due to this, more than one quarter of the population need humanitarian assistance. Significantly, the most severe impacts befall the health systems from this economic collapse. Domestic general government health expenditure under Maduro was merely 3.6%, with out-of-pocket spending accounting up to 30% of health expenditure. For Venezuelans where the official minimum wages remain below $2/month, this basic healthcare need remains inaccessible. Furthermore, known as the ‘brain drain’ roughly half of the country’s doctors have emigrated, leaving hospitals understaffed and unable to perform basic tasks such as routine obstetric check-ups. For pregnant women and children, especially in indigenous communities, this has had detrimental effects.
Hypertensive Disorders
Hypertensive disorders affect 1.4 billion people globally. However, prevalence is skewed toward low- and middle- income countries. Such disorders are huge risk factors for developing heart disease, stroke and, in pregnant individuals, pre-eclampsia. These disorders are frequently and easily missed as key symptoms presenting as vision loss and headaches. Tests for such disorders require equipment which is inaccessible in rural areas of Venezuela and when untreated, leads to seizures and hemorrhage.
In Venezuela, hypertensive disorders cause roughly 20% of maternal deaths with other confounding causes being maternal hemorrhage. This had evident effects as shown by the growing ratios of maternal mortality. This impacts 226.7 individuals per 100,000 live births and worsening by +25% points since 2019. Simple low-cost training to help healthcare workers identify early warning signs of hypertensive diseases combined with targeted education campaigns for pregnant women, could meaningfully improve outcomes and empower women to advocate for their own care.
Who Is Helping?
Despite the fact that many organizations have received just 17% of the >$600 million that Venezuela’s humanitarian response plan requires, many organizations, governmental and non-governmental alike are implementing strategies to ameliorate the maternal health crisis. These strategies are offering hope for the future. Many individuals must walk miles to reach a suitable healthcare facilities, however pregnant women with hypertensive disorders cannot afford this time.
At Project HOPE, local health partners are receiving training and increasing accessibility to maternal healthcare at the Venezuela-Columbia border. Alongside initiatives provided by the International Medical Corps, hope is in sight for these vulnerable Venezuelan’s. Since its implementation, the International Medical Corps (IMC) has provided more than $1.8 million in equipment, medical supplies and facilities.
Medical units mobilized by this organization aid in improving maternal outcomes for those in remote areas, specifically indigenous communities. Furthermore, continuous efforts from UNICEF demonstrate significant advancements for access to healthcare with 129,871 children and 31,273 women accessing their implemented facilities in the first half of 2025. Increased training in partnership with the ministry of health resulted in 29,788 safe deliveries, 3,289 of which were from indigenous communities. If efforts like this continue to prevail, much needed relief may be provided to the mothers to be of Venezuela when aiming to reduce mortality due to hypertensive disorders.
Conclusion
While maternal hypertensive disorders are manageable themselves when early detection and low-cost diagnostic equipment is available, this is not available in many areas of Venezuela. This cannot be divorced from the broader poverty issue which lies within this country. Thus, Venezuela’s maternal health crisis is a story about compounding vulnerabilities. Economic collapse has gutted public health funding and hyperinflation pushing basic care out of reach. Sustained funding, continued education of local health workers and community level education for pregnant women offers credible paths forward to address maternal hypertensive disorders in Venezuela.
– Juliette Dall’Aglio
Photo: Flickr
Community Midwife Training in Nepal
Programs focused on community midwife training in Nepal are helping address these challenges. They are preparing local health workers to provide safe delivery care and newborn support in remote communities.
Maternal and Newborn Health Challenges in Rural Nepal
Nepal has made substantial progress in maternal health over the past two decades. According to global maternal mortality estimates, Nepal’s maternal mortality ratio declined from 553 deaths per 100,000 live births in 2000 to 186 deaths per 100,000 live births in 2017. This represents a reduction of about 66%.
Newborn survival has also improved. The World Health Organization (WHO) finds that Nepal’s neonatal mortality rate declined from 40 deaths per 1,000 live births in 2000 to 16.6 deaths per 1,000 live births in 2023. Despite these gains, many families in rural areas still struggle to access skilled care during childbirth.
In mountainous regions of Nepal, reaching a hospital or birthing center may require several hours of travel, sometimes on foot. Shortages of trained health workers and limited medical infrastructure in remote communities also contribute to gaps in maternal and newborn care.
Expanding Skilled Care Through Community Training
Nepal’s maternal health strategy includes training skilled birth attendants such as nurses and auxiliary nurse midwives. These skilled birth attendants help manage labor, identify complications and provide essential newborn care. Because many trainees come from the communities they serve, they often understand local languages and cultural practices, making it easier to reach families who might otherwise avoid institutional care.
These efforts have contributed to significant improvements in access to skilled birth support. Data from the Nepal Demographic and Health Survey (NDHS) show that the share of births attended by a skilled health professional increased from about 13% in 2001 to roughly 80% in 2022. Expanding access to trained midwives has played a major role in improving maternal and newborn outcomes across the country.
Safer childbirth also helps reduce poverty by preventing costly medical emergencies and allowing mothers to recover and return to work more quickly. This reduces the economic strain that childbirth complications can place on low-income households.
Nonprofit Partnerships Strengthening Maternal Care
International nonprofit organizations also support community midwife training in Nepal through partnerships with the country’s public health system. One organization working in this area is One Heart Worldwide. The nonprofit collaborates with Nepal’s Ministry of Health and Population to strengthen maternal and newborn health services in rural districts.
The organization works directly with government health facilities to improve the quality of maternal care. It does this by training skilled birth attendants, upgrading rural birthing centers and providing ongoing mentorship for health workers. Its programs also strengthen referral systems so that complicated pregnancies can be transferred more quickly to higher-level hospitals.
Another program working to support maternal health by expanding access to skilled care in underserved communities is CARE Nepal. The organization works with local governments and community health volunteers to improve prenatal care, promote safe delivery practices and increase awareness of maternal health services. CARE programs also focus on training health workers, supporting community outreach and helping connect pregnant women with nearby health facilities where trained midwives can assist during childbirth.
The Impact of Skilled Midwives
The availability of trained midwives plays a crucial role in improving maternal and newborn health outcomes worldwide. According to the United Nations Population Fund (UNFPA), midwives trained to international standards could deliver about 90% of essential maternal health services. They could also provide essential newborn care.
In addition to assisting during childbirth, trained midwives help strengthen local health systems by linking pregnant women with antenatal services, organizing checkups and helping families navigate referrals to larger hospitals when necessary.
A Healthier Future for Mothers and Newborns in Nepal
Continued investment in community midwife training in Nepal remains essential for improving maternal and newborn health outcomes in rural areas. Expanding training programs, strengthening health facilities and supporting partnerships between government agencies and nonprofit organizations can help ensure that skilled professionals attend more births.
Nepal’s progress in maternal health demonstrates how expanding access to skilled care can transform outcomes for mothers and newborns. As community midwife training initiatives continue to grow, safer childbirth and stronger maternal care are becoming increasingly within reach for families across the country.
– Tom Basu
Photo: Flickr