Information and news on advocacy.

, ,

Mobile health technology in Uganda

Mobile health UgandaFor years, many issues have plagued Uganda’s health care system. The vast majority of its population lives in rural areas with limited access to health care. Medical professionals are scarce, and their services are often extremely expensive. However, amid these challenges, a solution has emerged: mobile health technology. These innovative platforms connect users with essential healthcare services and provide access to incredible tools through personal devices. Mobile health technology in Uganda is laying a strong foundation for a more equitable future.

Struggles of the Past

The country has one of the worst doctor-to-patient ratios in the entire world. There is roughly one doctor for every 25,000 citizens. This falls drastically short of the World Health Organization’s (WHO) recommendation, which is to have one doctor for every 1,000 people.

Health care in Uganda is largely unaffordable. Brown University’s Kyoko Saito recently traveled to Uganda, where she noted that one night in the hospital costs around $20, a shocking figure when considering that the country’s average monthly income is $78. Furthermore, hospital staff determine whether or not patients are financially stable and turn them away if they cannot pay for treatment.

Ugandan health systems struggle to obtain and restock essential equipment, store reliable health information and ensure quality of overall service.

Put simply, the fundamental structure of the Ugandan health care system is broken. There are not enough resources and not enough medical professionals. Furthermore, to exacerbate the issue, health care is expensive and predominantly located in urban areas, alienating around 70% of the rural population.

What is Mobile Health Technology?

Mobile health technology, commonly referred to as mHealth, is an umbrella term for the use of mobile phones and other personal electronic devices in medical care. Potential uses for mHealth include:

  • Tracking medical data and storing digital records
  • Enhancing communication between doctors and patients with secure messaging channels
  • Offering virtual training programs for essential workers
  • Allowing doctors to evaluate, diagnose and treat patients remotely through video consultation, imaging reports, e-prescriptions, etc.
  • Managing chronic diseases through mobile apps
  • Implementing nutrition monitoring systems

Although mHealth has only been around for a few years, 83% of physicians in the U.S. already use it to provide care. Expanding mobile health technology in underdeveloped countries like Uganda will lead to further benefits.

mHealth in Uganda

Currently, almost 30% of Ugandans have access to the internet, and this figure grows rapidly each year. The increased dissemination of electronics in recent years has allowed for mobile health technology in Uganda to flourish, working to address the fundamental issues that plague its health care system. Here are a few examples of the uses of mobile health technology in Uganda:

  • EVA System: A “mobile, AI-ready colscope that expands expertise on point-of-care cervical cancer screenings and sexual assault forensic examination.”
  • Palliative Care: For patients with cancer who have limited access to in-person physicians, mHealth technology has shown incredible potential in providing necessary palliative care.
  • Smart Health App: Stores patient data, plans for virtual appointments, provides instructions for care relating to immunization, childhood disease, pregnancy and more.
  • Test Results: In southwestern Uganda, health workers utilized text messaging as a means of quickly transmitting results for HIV-positive citizens.
  • Mass Communication: In northern and eastern Uganda, public health officials used text messaging to raise awareness for malaria and to remind patients to take their medication.

Looking Towards the Future

Mobile health technology in Uganda presents an inspiring solution that provides accessible, affordable health care to its citizens. Indeed, with these advancements, individuals in rural areas can now connect with medical professionals. Furthermore, hospitals can spend less on equipment and doctors can become less burdened by the vast overflow of Ugandans that need care. While there are significant hurdles that remain (namely, improving access to technology in rural areas of the country), the results have been extremely promising so far.

Over the next five years, Uganda’s mission should be to provide mobile health technology to over half of its inhabitants. This could ensure that the population can stay healthier (especially those in underfunded, remote locations), working to break the decades-long cycle of poverty that has affected millions of Ugandan citizens.

– Josh Weinstein

Josh is based in Chester Springs, PA, USA and focuses on Technology and Solutions for The Borgen Project.

Photo: Flickr

, ,

Norovirus in India Pushes New Public Health Plan

Norovirus Impact in India Pushes New Public Health PlanNorovirus, a highly contagious virus causing acute gastroenteritis, has seen a notable increase in India in recent years. This virus primarily affects the gastrointestinal system, leading to symptoms such as vomiting, diarrhea and stomach cramps. In December 2024, the Indian government reported more than 1,000 cases of diarrhea-related diseases, coinciding with a global rise in gastrointestinal illnesses. Poor sanitation of food and water sources has significantly contributed to the spread of norovirus in India.

According to the Minnesota Department of Health, these symptoms can appear as early as 12 hours after exposure. Children under 5 and the elderly are particularly vulnerable. As pandemic-related restrictions have eased, increased person-to-person contact has led to higher transmission rates of various infectious diseases.

Norovirus Transmission and Prevention

Norovirus spreads through direct contact with an infected person, consuming contaminated food or water or touching contaminated surfaces and then touching the mouth. Unlike some other pathogens, norovirus is resistant to alcohol-based sanitizers. The Centers for Disease Control and Prevention (CDC) emphasize that proper handwashing with soap and water is more effective in preventing norovirus infection than using alcohol-based hand sanitizers. ​

Government Response: National Health Mission

In response to the rising burden of infectious diseases like norovirus, the Indian Ministry of Health and Family Welfare has launched initiatives to improve public health outcomes through the National Health Mission (NHM). The NHM outlines development strategies for improving sanitation, food and water safety and health infrastructure in both rural and urban areas. The mission uses a performance-based framework. States that meet health benchmarks receive increased funding, promoting both accountability and innovation. The 2018–2019 Health System Strengthening Conditionality Report details how these benchmarks are designed to reflect the diverse health needs of India’s states.

Guiding Indicators for Public Health Improvements

To monitor and encourage improvements in health outcomes, NITI Aayog, in collaboration with the Ministry of Health and Family Welfare and technical assistance from the World Bank, developed the State Health Index. This index assesses states and union territories based on health outcomes, governance and key inputs or processes. The index aims to nudge states toward transformative action in the health sector. ​The NHM uses various key indicators to evaluate state-level progress:

  • Incremental performance based on the NITI Aayog Health Index

  • Operationalization of health and wellness centers

  • Implementation of human resource information systems

  • Grading of district hospitals

  • Mental health service expansion

  • Screening of individuals aged 30 and older for noncommunicable diseases

  • Performance ratings of urban and rural primary health centers

These indicators aim to identify specific needs across states and tailor support accordingly. The goal is to encourage cooperation while allowing state governments to focus on the communities ’ most urgent health issues.

Looking Ahead

India’s public health efforts are being shaped by both long-term planning and immediate challenges. The recent increase in norovirus cases has highlighted existing gaps in sanitation and preventive care. Government-led initiatives such as the National Health Mission offer targeted approaches to address these ongoing issues while promoting systemic improvement. Continued implementation of state-specific strategies may help reduce disease incidence and improve health outcomes in vulnerable populations.

– Jonathan Joseph

Jonathan is based in Milwaukee, WI, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

, ,

Silent Killers: Neglected Tropical Diseases in South Sudan

Neglected Tropical Diseases south sudanSouth Sudan has suffered nearly a decade of conflict and is one of the countries most heavily affected by neglected tropical diseases in the world. The conflict caused almost irreparable damage to the nation’s social support structures that have only in recent years been improving with the help of external humanitarian organizations. Continent-wide diseases such as HIV/AIDS, malaria and pneumonia place a heavy burden on South Sudan. However, many neglected tropical diseases are also rife within the nation, acting as silent killers that hugely contribute to the country’s mortality rate yet garner far less attention and aid than is needed to combat the outbreaks.

Civil War and the Health Care System

The South-Sudanese Civil War occurred from 2013 to 2020 due to President Salva Kiir’s accusation towards Riek Machar, former deputy, and 10 others of attempting to start a coup d’etat. Conflict broke out between the Sudan People’s Liberation Movement (SPLM) and the Sudan People’s Liberation Movement-in-Opposition (SPLM-IO), devastating the country’s social structures, such as the democratic institutions, the weak economy and the fragile healthcare system. South Sudan currently ranks third in the world on the Fragile States Index.

The war catalyzed a vast humanitarian crisis that shook the very core of the nation, destabilizing the basic structures and needs for the population to survive. The inflation rate soared, reaching a peak of 835%, which made commodity prices exponentially rise and plummeted the value of the Sudanese Pound. Millions fled their homes during the conflict, leaving them displaced in a famine and relying on an already-overwhelmed health care system.

In 2020, essential health care coverage stood at 44% and critical care services such as child health care were at risk due to shrinking national fiscal space. Additionally, at the height of the COVID-19 pandemic in 2021, more than 8 million people out of the total 13 million population needed humanitarian aid.

Neglected Tropical Disease Outbreak

The World Health Organization (WHO) recognizes 20 neglected tropical diseases, 19 of which affect South Sudan. While South Sudan has been formulating plans and programs to combat neglected tropical diseases for decades, progress is slow and has only in recent years bolstered more support.

In 2008, the Ministry of Health identified the top neglected tropical diseases that affected South Sudan: visceral leishmaniasis (VL), human African trypanosomiasis (HAT), onchocerciasis, dracunculiasis (Guinea worm), lymphatic filariasis (LF), schistosomiasis, trachoma and soil transmitted helminths (STH).

The ministry recommended the use of integrated mass drug administration (MDA), however, it feared that “the existing financial resources and global political commitment are not sufficient to reach the goals of elimination or control by 2020 at the latest.”

Indeed, in the 2016-2020 South Sudan National Master Plan, it outlined that “the allocation of funds to states and countries through inadequate, lacks guidance on allocation of funds to specific programs areas such as NTD control.” In 2008, the Ministry of Health estimated that around 3.9 million people were at risk of trachoma in surveyed areas, and in 2024, South Sudan remained with the highest prevalence of active trachoma anywhere in the world, with up to 80% of children under 9 suffering from the condition.

The Good News

The story is not all bleak, however, as the continued efforts have been gradually paying off. The 2023-2027 South Sudan NTDs Master Plan details that increased attention has allowed for “significant strides globally in the control, eradication and elimination of NTDs.” These positive steps include 70-80% member states previously NTD-endemic in 2020 now declaring the elimination of at least one disease, 44 member states certified free of guinea-worm disease compared with 2020, and 44 states fully mapped for PCT-NTDs (preventative chemotherapy NTDs) compared with 2020.

With support from the WHO, since 2021, the country has managed to treat almost 17 million people for river blindness, elephantiasis, bilharzia, trachoma and soil-transmitted worms. Additionally, a treatment drive in 2023 traveled house-to-house, performing MDA against bilharzia. Increased awareness and education efforts are allowing isolated villages to receive more accessible treatment diseases; Dr Aja Kuol, the president of South Sudan’s Ophthalmologic Association and first South Sudanese female ophthalmologist has been travelling across the country with her team to perform sight-restoring operations to those suffering from sight-related diseases, reaching almost 4,700 people in 2023, The Telegraph reports.

Lastly, the Centers for Disease Control and Prevention (CDC) introduced Project ECHO, which aims to reduce clinical variations and improve the quality of care for patients. As of 2024, the project conducted nearly 200 sessions and 3,500 health care workers across the nation have received the training.

Closing Remarks

The civil war in South Sudan caused not only physical mass destruction and damage but also took a huge mental toll on the population. The efforts to combat neglected tropical diseases across the country have been slow and demoralizing at times, however, the effort has paid off. Now that the society is breaking initial barriers such as poor awareness and education, the country can expect improvement, with the most recent master plan facilitating “multi-sectoral collaboration” that can achieve the nation’s vision of a neglected tropical disease-free country.

– Helena Pryce

Helena is based in Nottingham, UK and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr

, ,

Cholera Outbreak in Sudan: How the Country is Fighting Back

sudan choleraAs an ongoing war continued to tear apart Sudan, millions went into extreme poverty and poor living conditions, which caused an outbreak of cholera starting in late 2024. The northeastern African country has struggled with cholera outbreaks for years. Once the civil war broke out in early 2023, it brought even more immense hardship to the country and another epidemic. Millions of civilians—more than half the country’s population—had to relocate to various camps, including one in the country’s White Nile State. It is here that poor conditions and limited access to clean drinking water have led to a cholera outbreak, with 50,000 cases recorded in January and more than 1,300 deaths.

Sudan’s History with Cholera

Throughout its history, Sudan has faced problems with cholera outbreaks, time and time again. The disease, which is transmitted through contaminated food and water sources, has left many underdeveloped communities vulnerable to epidemics. During these outbreaks, many have had concerns and criticized the government’s lack of acknowledgement and response to the epidemics. The government never formally acknowledged the 2017 epidemic, even though the National Epidemiological Corporation recorded over 23,000 cases and more than 800 deaths linked to the disease. In 2019, the Sudanese government, with assistance from the World Health Organization (WHO), made a greater effort to curb another outbreak, mobilizing treatment centers, cholera kits and enhancing disease surveillance.

The Ongoing Conflict’s Effect on the Cholera Outbreak

Millions of people had to forcefully leave their homes and move into overcrowded camps due to the country’s current civil war. As the fighting continues to affect more areas, an increasing number of health facilities stop operating. This widespread lack of health care is ultimately worsening the cholera outbreak in Sudan.

Communities fleeing from the war and attacks on hospitals and health care facilities are only exacerbating the health care crisis, as people have to rely on aid groups, which have limited resources.

The current outbreak takes place in the White Nile State, which struggled with attacks early in February. These attacks damaged a power plant in the area, leaving many without power and cutting off access to water pumps. Without access to clean drinking water, cases of Cholera in the area surged.

Looking Forward

Treating the cholera outbreak in Sudan and the broader health care crisis is extremely challenging, as access to essential resources such as clean water, food, vaccines, and sanitation facilities is limited. However, Sudan’s Federal Ministry of Health (FMoH), along with organizations such as the WHO and UNICEF, has launched several oral vaccination campaigns, accompanied by a ban on collecting water from local rivers.

The country is heavily reliant on outside help to establish facilities to fight the outbreak and help affected people. UNICEF-backed clinics help distribute rehydration solutions to people showing symptoms of cholera. In high-risk regions, UNICEF has also established areas for chlorinating water, which will help rid the cholera-causing bacteria from people’s drinking water. The power to stop this outbreak also lies within the communities and organizations working to educate people on how to prevent and treat cholera symptoms.

– Collier Simpson

Collier is based in Savannah, GA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

,

Lack of USAID and Tuberculosis in Kenya

kenya tuberculosisKenya is experiencing a resurgence in tuberculosis (TB). Thousands of Kenyans have lost access to public health care regarding Tuberculosis testing and treatments in the last month since the Trump administration eliminated foreign aid. The aid freeze went into effect on January 20, Inauguration Day. Many Kenyans have taken tuberculosis tests before the aid freeze but unfortunately have not received results due to the health program cuts. Tuberculosis is the deadliest infectious disease; in 2023 alone, 1.25 million died from TB. Half of the international donor funding for TB research and treatment came from the United States.

The U.S. personally funded TB Essentials for Kenya. With the loss of financing, public health programs have shut down, leaving many undiagnosed and suffering. Tuberculosis is fully treatable, yet with the lack of international funding, the entire program, including research, diagnostics and successful treatment, has been ceased.

Unaffordable Care

Many Kenyans live below the poverty line.  According to the UNDP report, 36% of them live below the national poverty line. This percentage is living off of less than $1 a day. This poverty rate prevents many Kenyans from obtaining basic necessities and creates many health issues. In the case of the resurgence in tuberculosis, this poverty rate is detrimental for many. A TB test can cost more than $80 and is highly inaccessible to Kenyans—the U.S.-funded testing for Kenyans and transportation for the movement of medical supplies and prescriptions, according to The New York Times. Most importantly, the U.S. paid for data management on the resurgence. TB treatments require long-term intense medication that often makes the infected feel dejected. Without constant care, it is most likely that TB patients will relapse.

In the neighborhood of Nairobi, the infected still live in their homes, spreading the disease to their families persistently. Community advocates are rallying together to protect their neighbors. TB survivor Doreen Kikuyu collects sputum samples for her neighbors and delivers them to one of the last standing labs herself. There is a lack of public health care workers to administer prescriptions to Kenyans who are not drug-resistant. TB drugs are intense; there are a dozen tests to be run on a patient to ensure their body is strong enough for life-saving treatment. A lot of Kenyans are drug-resistant and have been prescribed a rare drug concoction, according to The New York Times.

Since the foreign aid freeze,  prescriptions are not being re-stocked. TB patients must be consistent with treatment, and fall-off is a cause for a relapse in illness. It takes the average Kenyan family’s entire savings to treat TB and check those uninfected for the spread of the disease.

Survivor, Savior

The resurgence in tuberculosis resulted in almost 90,000 infections alone in Kenya in 2024. TB survivors are a trustworthy source of help for those struggling. Survivor Agnes Okose uses personal funds from her small business to fund visits to other villages to collect sputum samples and transport them to the remaining lab for testing. Twenty years ago, President George W. Bush established the Emergency Plan for AIDS Relief, setting up many clinics across Africa, The New York Times reports. These clinics have treated HIV and TB patients for the past two decades. These clinics are utterly separate from the nation’s primary medical systems. The foreign aid halt has affected this network of clinics.

African health officials claim that this has resulted in 40% more patients needing care in the primary medical systems throughout Africa, according to The New York Times. Due to the separation of the infectious disease clinics, clinicians in the primary medical systems are unaware of how to diagnose or treat HIV and TB. The resurgence in tuberculosis has left the Kenyan government grueling with no further details on how they will fix the loss of foreign funding.

Hope for surviving this resurgence and the world’s safety is that of the tuberculosis survivors in Kenya. It is unclear if foreign funding from the U.S. will return; what is constant is community care for each other and the desire to prevent tuberculosis from spreading. The Astellas Global Health Foundation works tirelessly with community health leaders to establish public health care access, specifically in Nyamaria County. Kenya’s resurgence in tuberculosis can quickly become another global pandemic with the lack of USAID. Kenyans are protecting their people, their nation, and the world.

– Mackenzie Inman

Mackenzie is based in Washington, DC, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

, ,

Mystery Illness Sparks Public Health Crisis in the DRC

Mystery Illness Sparks Public Health Crisis in the DRCA public health crisis is unfolding in the Democratic Republic of Congo (DRC) as health officials investigate a mystery illness that has claimed at least 60 lives and infected approximately 1,000 people. The disease first appeared in the village of Boloko in the Équateur Province on Jan. 21 and has since spread across the northwestern region. The illness presents hemorrhagic fever symptoms, including vomiting, nosebleeds and internal bleeding, resembling Ebola and yellow fever. However, the World Health Organization (WHO) ruled out these diseases after conducting initial tests on patient samples. Health officials are examining multiple potential causes, including malaria, waterborne pathogens and exposure to contaminated food sources.

Investigating the Source of the Outbreak

Dr. Michael Ryan, WHO’s director of emergencies, suggested the outbreak may be linked to poisoning, though investigations remain ongoing. The African Centres for Disease Control and Prevention (Africa CDC) has also considered malaria as a possible factor, given its high prevalence in the country. Researchers traced the first reported deaths to three young children who had consumed a bat carcass before falling ill. While zoonotic diseases—those transmitted from animals to humans—are common in the region, scientists have not confirmed a direct link. Health authorities are also assessing whether contaminated water sources or food poisoning contributed to the outbreak. The Congolese government has deployed health experts to affected areas to conduct research and assist local health care workers. However, limited resources and a fragile health care system pose challenges to an effective response.

Public Health Crisis: Food Insecurity and Disease Risk

Congo, the second-largest country in Africa by landmass, has a population of 105.8 million, with 73% of people living on less than $2.15 per day. The DRC ranks among the poorest in the world, with widespread food insecurity, displacement and malnutrition. More than 6.9 million people are displaced and 3.7 million children and women suffer from acute malnutrition.

Agriculture remains Congo’s largest economic sector, but it struggles to meet food demands due to climate change, conflict and underdeveloped infrastructure. Production growth slowed to 2.2% in 2023, further limiting access to food. Many rural communities rely on subsistence farming, but disruptions in crop yields and market access leave millions vulnerable to hunger. Deforestation and land degradation further impact food production, driving many Congolese to rely on bushmeat for survival.

Health experts warn that extreme poverty and food shortages create conditions where people turn to wild animals as a food source, increasing the risk of zoonotic disease transmission—infections that jump from animals to humans. Over the last decade, Africa has seen a 60% rise in rare disease outbreaks linked to wild animal consumption. Congo’s vast tropical forests harbor numerous pathogens, making human- wildlife interactions a continuous public health risk.

Dr. Gabriel Nsakala, a public health professor at Congo’s National Pedagogical University, emphasized that as long as poverty, deforestation and food insecurity persist, epidemics will continue to emerge and evolve. Poor sanitation, limited access to clean water and weak health care infrastructure further increase the likelihood of disease outbreaks spreading rapidly in vulnerable communities.

International Response and Humanitarian Assistance

Congo’s public health system lacks sufficient personnel and resources to contain large-scale outbreaks. Fewer than 10 employees work at the country’s national public health agency, making it heavily reliant on the WHO and other international partners.

The United States Agency for International Development (USAID) recently reduced funding for foreign health initiatives, limiting the resources available for emergency responses in the DRC. Without international aid, the country struggles to conduct laboratory testing, deploy medical personnel and provide essential treatments. Meanwhile, the World Food Programme (WFP) remains one of the largest humanitarian organizations operating in the DRC. The WFP provides nutrition assistance, cash transfers and food security programs, reaching more than 5.3 million people in 2023. The organization also funds long-term agricultural initiatives, literacy programs and infrastructure projects to improve economic stability.

Looking Ahead

The public health crisis in the DRC coincides with a worsening humanitarian crisis in the country, where ongoing conflict between the Congolese military and the M23 rebel group has displaced thousands. With limited health care infrastructure, high poverty rates and persistent violence, controlling disease outbreaks remains a significant challenge. As investigations continue, health officials emphasize the urgent need for increased funding, stronger health care infrastructure and international support to prevent future epidemics and strengthen public health responses in the region.

– Mackenzie Inman

Mackenzie is based in Washington, D.C., USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr

, ,

How USAID Cuts Impact Global Polio Eradication Efforts

How USAID Cuts Impact Global Polio Vaccination EffortsPolio, a highly infectious viral disease, has affected millions of people worldwide. The introduction of the polio vaccine in the 1950s led to an exponential decrease in infection rates. However, access to vaccines remains limited in some countries, keeping the disease circulation alive in certain regions. The Global Polio Eradication Initiative (GPEI) works to vaccinate populations in endemic countries, striving for complete eradication. Recent funding reductions from USAID, a historically significant donor, have raised concerns about the initiative’s progress.

Polio primarily affects children under 5, with about 0.5% of cases leading to paralysis. Though most common in children, unvaccinated individuals of any age remain vulnerable to infection. The disease, once present in more than 120 endemic countries, now persists in only two—Afghanistan and Pakistan. Despite this significant progress, outbreaks of wild poliovirus continue to surface in regions with political instability, such as Gaza, where vaccination campaigns face disruption due to ongoing conflict.

GPEI’s Efforts to Eradicate Polio

The Global Polio Eradication Initiative was launched in 1988 with the goal of eliminating polio worldwide. Since its inception, polio cases have declined by 99%, a testament to the effectiveness of vaccination programs. GPEI focuses on two primary goals: permanently stopping poliovirus transmission in endemic countries and preventing outbreaks in nonendemic regions. GPEI’s strategy includes mass vaccination efforts, political advocacy, community engagement and infection surveillance. By collaborating with governments and organizations such as WHO, CDC, UNICEF and the Gates Foundation, the initiative has successfully reduced polio cases. However, continued progress depends on sustained financial support.

USAID Funding Cuts and Its Impact

GPEI relies on funding from multiple government and nongovernment organizations. The United States (U.S.) has historically contributed $40 billion to the initiative, making USAID a key financial supporter. However, recent reductions in USAID funding have raised concerns about the program’s sustainability. In early 2025, the Trump administration significantly reduced USAID funding, including a $131 million grant for UNICEF and GPEI’s polio immunization efforts. This loss of funding has forced GPEI to extend its five-year strategy to 2029, pushing back its original goal of eradication by three years. While USAID’s funding cut presents challenges, it remains unclear whether the reduction will be permanent. GPEI continues to operate with financial backing from other sources, though long-term funding gaps could slow vaccination efforts.

New Funding Sources and the Future of Polio Eradication

Despite the loss of USAID funding, other nations and organizations have stepped up to support GPEI’s mission. Countries such as Saudi Arabia and the United Arab Emirates (UAE) have pledged $500 million toward polio eradication efforts. Additionally, organizations such as the WHO and the Gates Foundation continue to provide financial support, ensuring that vaccination programs remain operational. Alongside large-scale government contributions, GPEI also relies on small individual donations from supporters committed to eradicating polio within this generation. The organization remains focused on vaccination, public awareness and policy advocacy, working toward its revised goal of eradication by 2029.

Looking Ahead

While USAID’s funding reduction poses obstacles for GPEI, global support for polio eradication remains strong. Ongoing contributions from international donors and nongovernmental organizations continue to drive vaccination efforts, bringing the world closer to a polio-free future. Regardless of the status of USAID funding, GPEI continues its vaccination and eradication efforts with support from international donors and organizations.

– Lizzie Mazzola

Lizzie is based in Raleigh, NC, USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr

, ,

How big is the hole? Suspension of USAID in Ethiopia

ethiopia usaidEthiopia is the largest recipient of USAID in sub-Saharan Africa. After receiving the money for 2023, Ethiopia has seen a suspension in the $1 billion in aid it receives. The funding cut has left the country in a vulnerable position, disrupting critical aspects of its healthcare system, including data management, medicine procurement, delivery, and workforce training and retention

Where the Suspension Has Hit Hardest?

The suspension of USAID funding has severely disrupted Ethiopia’s fight against diseases like malaria, HIV and tuberculosis. Around 5,000 health care workers lost their jobs, affecting vital services such as vaccinations, patient care and disease surveillance. The funding cut also threatens Ethiopia’s global “95-95-95” HIV treatment goals, with 503,000 people receiving care across 1,400 health facilities. Additionally, 10,000 data clerks responsible for managing HIV treatment have lost their jobs, further hindering the delivery and monitoring of care.

This could cripple efforts to combat HIV in the short to medium term, leaving many patients vulnerable. This has worsened the strain on the health care system, leaving it unable to provide basic services and hindering disease eradication efforts, deepening health poverty. 

With USAID support, Ethiopia launched a five-year health sector plan (HSTP-II) from 2020-2025 to improve health care. The plan aims to ensure quality, accessible health care, strengthen governance and leverage technology for reliable health data. A key challenge is the severe shortage of health care workers, with less than 100,000 staff members, far below the 445,000 necessary for universal health coverage. The plan’s success is crucial to expanding services and addressing this workforce gap.

The suspension of USAID funding has severely impacted Ethiopia’s HSTP-II, halting training programs and delaying the expansion of the health care workforce. Many NGOs have been hit hard by the suspension, including the Tesfa Social and Development Association (TSDA), which aids HIV patients with food, clothing and school supplies, according to The Guardian. The funding cut has crippled the organization, leaving those who depend on TSDA in even worse health and poverty. Staff layoffs and operational challenges have worsened the already dire situation for those relying on the organization’s support.

Solutions

The government has tried to enhance its support for local NGOs by trying to empower them by simplifying regulatory frameworks, in the hope this will enhance the operational efficiency and sustainability of NGO’s despite the budget constraints they are now facing. Following the advice of the Ethiopian Civil Society Organisation Authority, NGOs that did not rely on USAID funding are forming alliances with other local NGOs, enabling them to share resources, have joint fundraising efforts, and increase advocacy for policy changes to support the nonprofit sector during this challenging period.

NGOs such as the Mekedonia Humanitarian Association focus on supporting the critically disabled, elderly and mentally ill by providing housing, clothes and other vital amenities. Another organization is the Ethiopian Human Rights Council, which focuses on providing legal aid and investigating human rights abuses. These have turned out to be important practices for non-USAID-funded NGOs as it has provided support for these NGOs to allow them to continue their work during the period of the suspension.

Conclusion

The suspension of USAID has left Ethiopia’s health care system in an unprecedented crisis, affecting disease eradication efforts, health care workforce expansion and the operations of vital NGOs. The abrupt withdrawal of $1 billion in aid has crippled essential programs, forced widespread layoffs and disrupted Ethiopia’s ability to meet global health commitments. The impact on HSTP-II and organizations like the Tesfa Social and Development Association underscores how deeply intertwined USAID funding was with Ethiopia’s healthcare infrastructure.

Efforts to diversify funding streams, improve private sector involvement and empower local NGOs mark a shift towards long-term self-sufficiency, though the short-term outlook remains dire. Ultimately, while Ethiopia is making strides to mitigate the crisis, the loss of USAID has left an undeniable mark on its healthcare system. Whether the government’s measures will be enough to compensate for the loss of funding remains uncertain, but one thing is clear: The suspension has deepened Ethiopia’s health crisis, and the road to recovery will be long and arduous.

– Oliver Hedges

Oliver is based in Lancaster, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

, ,

Fighting Type 2 Diabetes in India

India’s Fight Against Type 2 Diabetes CrisisAccording to the Lancet, global diabetes rates among adults have doubled since 1990, rising from 7% to 14% in 2022. The most significant increase occurred in middle- and low-income countries. Notably, the study found that 60% of people with Type 2 diabetes lived in just six countries, with India accounting for the largest share at 212 million adults. As India’s economy and population have expanded rapidly over the past 35 years, so has the prevalence of Type 2 diabetes, particularly among the nation’s poorest communities.

Demographic Changes

Since 1990, India’s economy and population have surged, making it one of the world’s fastest-growing nations. The country’s economy has grown tenfold, increasing from $320 billion to $3.57 trillion. Meanwhile, its population has nearly doubled, rising from approximately 870 million to 1.42 billion.

The country has also experienced a significant rise in urbanization since 1990, with 519 million urban residents. While these demographic changes suggest economic progress, rapid population growth and urbanization have placed a strain on infrastructure and public services. Without sufficient investments in health care and education, these shifts can potentially widen inequalities, including access to health care. The increasing rates of Type 2 diabetes in India illustrate this challenge.

Since 1990, the number of people in India living with diabetes or classified as pre-diabetic has risen to 237 million as of 2023. Type 2 diabetes occurs when the body fails to use insulin effectively to regulate blood sugar levels. If not diagnosed early or treated properly, complications can include heart and kidney disease, as well as foot and leg amputations.

Challenges in Diabetes Care Across India

Studies reveal that urbanization in India leads to higher consumption of energy-dense foods and reduced physical activity, increasing obesity rates and the risk of Type 2 diabetes and other cardiometabolic conditions. Low awareness of diabetes among India’s adult population underscores the need for better health monitoring and education. Treatment and control rates remain low, particularly in rural areas and among low-income populations, due to barriers to health care access and high treatment costs. Although low-cost glycemic medications are available, many individuals cannot afford them.

With too few trained diabetes educators in India, physicians bear the burden of patient education. Variations in diabetes education standards among universities lead to inconsistent patient education. The absence of national certification requirements and low-quality diabetes training at some universities hinder efforts to regulate diabetes care and education programs.

Disparities in diabetes funding across Indian state governments likely stem from varying awareness levels and the economic burden of diabetes care. Some states allocate significantly more resources to diabetes management than others, highlighting the need for a more standardized national approach. Without sufficient investment in awareness campaigns, medical training and affordable treatment options, diabetes will continue to pose a growing public health challenge in India.

A Hybrid Approach

Since 2010, the Indian government has introduced several measures aimed at increasing diabetes awareness through both physical and technological initiatives. These programs seek to reach as many people as possible, especially in underserved areas.

  • National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke (NPCDCS) – 2010. Launched in 2010, NPCDCS was designed to curb the growing burden of noncommunicable diseases, which had become more prevalent than communicable diseases. The program focuses on prevention, early screening and disease management while improving access to treatment—particularly for low-income populations.
  • mDiabetes Initiative – 2011. Developed by Arogya World in collaboration with Nokia, this mobile health initiative delivers text messages on diabetes management in 12 languages. It has reached 130 million people. A follow-up study found that 51.9% of participants underwent diabetes screening and 67.3% monitored their glucose levels. The Indian Ministry of Health later adopted the program, recognizing its success in raising awareness.
  • Ayushman Bharat Health and Wellness Centers – 2018. These centers provide comprehensive health care services, including screenings for Type 2 diabetes. The initiative has significantly improved health care infrastructure, with 150,000 wellness centers now operational.
  • E-Sanjeevani Telemedicine Service – 2020. Launched by India’s Ministry of Health and Family Welfare, E-Sanjeevani is a telemedicine platform that has facilitated more than 100 million virtual consultations since 2023. The service has played a vital role in bridging the gap between health care providers and patients, particularly for those in poverty who may struggle to access in-person consultations.

Looking Ahead

India’s rapid economic growth has coincided with a surge in Type 2 diabetes, particularly among low-income communities facing limited health care access and education. While urbanization and dietary shifts have contributed to rising cases, the government has implemented multiple initiatives to address the crisis. Programs such as the NPCDCS, mDiabetes, E-Sanjeevani and Ayushman Bharat have improved awareness, screening and access to treatment, especially in rural and underserved areas. However, continued investment in public health care, education and preventive measures could be essential to curb the growing burden of diabetes and ensure equitable health outcomes across all socioeconomic groups.

– Oliver Hedges

Oliver is based in Lancaster, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

, ,

High-Risk Diseases in Botswana and Their Impact

High-Risk Diseases in Botswana and Their ImpactBotswana, a landlocked country in Southern Africa, is known for its economic stability and reliance on diamond exports. The government maintains strong trade partnerships with nations such as the United States (U.S.) and the United Kingdom (U.K.), but economic disparities persist. Unemployment remains high at 27.6% and Botswana’s Gini index—a measure of income inequality—stands at 53.3, indicating significant economic inequality. Public health challenges further compound economic hardships. Diseases in Botswana are a challenge. The country faces a high disease burden, particularly from HIV, tuberculosis (TB) and Kaposi sarcoma. While the government has made strides in addressing these conditions, limited resources, health care infrastructure challenges and economic instability continue to hinder progress.

HIV in Botswana: Progress and Challenges

Human immunodeficiency virus (HIV) remains a critical public health issue in Botswana. HIV attacks the immune system by targeting CD4 cells (T cells), weakening the body’s ability to fight infections and diseases. If untreated, it progresses to acquired immunodeficiency syndrome (AIDS), increasing vulnerability to opportunistic infections.

To combat HIV, Botswana’s Ministry of Health (MOH) partnered with the U.S. Centers for Disease Control and Prevention (CDC) to expand testing, prevention and treatment services. This collaboration has resulted in an extensive network of more than 200 HIV prevention sites nationwide. The Botswana AIDS Impact Survey collects critical data on sexual behaviors and risk factors, allowing policymakers to tailor interventions effectively. Additionally, the country has invested in widespread antiretroviral therapy (ART) programs to ensure HIV-positive individuals receive life-saving treatment.

Efforts have yielded significant progress. By 2021, Botswana achieved a 97% viral suppression rate among HIV patients on ART. Additionally, more than 334,000 people received antiretroviral treatment, contributing to a 9% decrease in HIV transmission over the past decade. Despite these advancements, challenges remain, including stigma, treatment adherence and reaching remote populations.

Tuberculosis: A Persistent Public Health Threat

Tuberculosis (TB) is an infectious disease that primarily affects the lungs but can also spread to other organs. TB is airborne and spreads when an infected person coughs or sneezes, releasing bacteria into the air. Symptoms include persistent cough, chest pain, fever, fatigue and weight loss.

Botswana has seen a rise in HIV-related TB cases, as individuals with weakened immune systems are more susceptible to the disease. The government has taken several measures to address TB, including expanding screening programs at hospitals and clinics, increasing access to diagnostic tools for early detection and ensuring the availability of effective TB medications, including aminoglycoside antibiotics.

Despite these interventions, co-infection rates of HIV and TB remain high, making TB prevention and treatment more complex. Ensuring consistent medication access, early detection and public awareness campaigns are essential to further reducing TB cases in Botswana.

Kaposi Sarcoma: Botswana’s Leading Cancer

Kaposi sarcoma (KS) is the most prevalent malignancy in Botswana. It affects the lining of blood and lymphatic vessels and is strongly associated with human herpesvirus 8 (HHV-8). KS is especially common among individuals with weakened immune systems, such as those living with HIV.

Kaposi sarcoma presents significant health risks, causing purple or dark-colored skin lesions, swelling, enlarged lymph nodes and respiratory complications if the disease spreads to the lungs. To address KS, Botswana’s government has established four public oncology centers that provide cancer treatment services, including chemotherapy and radiation therapy. However, the country continues to face significant challenges, such as limited access to advanced diagnostic tools, shortages of experienced oncologists and delays in treatment due to resource constraints.

Increasing investments in cancer research, early detection programs and expanded health care infrastructure is crucial for improving Botswana’s ability to manage and treat Kaposi sarcoma effectively.

Strengthening Health Care Response in Botswana

While Botswana has made notable progress in combating HIV, tuberculosis and Kaposi sarcoma, challenges remain. Limited health care resources, economic instability and high co-infection rates continue to strain the public health system. Ongoing government initiatives and international partnerships—such as those with the CDC—are vital in ensuring continued progress in fighting diseases in Botswana. Expanding health care infrastructure, medical training programs and public awareness campaigns could be key to improving disease prevention and treatment outcomes. By addressing these high-risk diseases, Botswana can potentially enhance public health, reduce economic strain and improve the quality of life for its citizens.

– Hayden Reyes

Hayden is based in Iowa, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr