Information and news on advocacy.

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Health care in a Crisis State: Living with Diabetes in Ukraine

Diabetes in UkraineOn February 24, 2022, Russia invaded Ukraine, marking the beginning of a violent occupation which has resulted in more than 1 million casualties as of January 2025, including civilians and soldiers on both sides. In 2022 alone, Ukraine’s poverty rate “increased from 5.5% to 24.1%” – a humanitarian crisis that impacted all aspects of life for Ukrainian citizens, including but certainly not limited to access to safe drinking water and food, energy, transportation and housing. The humanitarian crisis also affected people living with diabetes in Ukraine.

Diabetes in Ukraine

Russia’s occupation of Ukraine did not only have an impact on the immediate physical safety of innocents – it also created a huge issue surrounding the management and treatment of chronic illness. According to the Diabetes Spectrum, “among the displaced Ukrainian population, more than 2.63 million Ukrainians have cardiovascular disease and more than 615,000 people have diabetes.” Furthermore, according to the National Library of Medicine, of “40,000 adults in diabetes care, only approximately 25% [maintain] sustained glucose control.”

Many people with chronic illnesses, specifically diabetics, require consistent medical care on top of strict lifestyle changes – including taking daily medications, undergoing frequent blood sugar level tests and in some cases, having surgery. In a crisis state, where even the most basic necessities are limited, these complex treatments are simply not accessible to the majority of individuals who depend on them. However, several organizations are providing aid and support to individuals struggling with diabetes in Ukraine.

TeleHelp Ukraine

Originally founded at Stanford University, TeleHelp Ukraine is a non-profit organization that specializes in providing telemedical assistance to individuals in Ukraine and Poland. TeleHelp Украïна “completed more than 2,400 consultations as of April 2024… [including] 61 consultations with people with diabetes,” Diabetes Spectrum reports.

Its consultations are completely free, although it does not currently have the resources to cover the costs of medication and other treatment. Additionally, the organization has an extensive staff of translators knowledgeable in medical terminology it is accessible to non-English speakers.

The Ukrainian Diabetic Federation

The Ukrainian Diabetic Federation (UDF) collaborates with government officials, heads events to raise awareness about diabetes in Ukraine, and provides aid to diabetics within the country. UDF also helps to distribute and administer aid to the needy. It distributed “almost 30,000 glucose meters with strips provided for people with diabetes by Direct Relief to cities and villages, to children’s hospital emergency rooms in military hospitals and to ophthalmology clinics across Ukraine. As of July 12, 2022, Direct Relief’s efforts to respond to the crisis in Ukraine have resulted in the delivery of more than 800 tons of emergency medical supplies.”

Diabetes Disaster Response Coalition

The Diabetes Disaster Response Coalition (DDRC) is an international organization that provides support to those on the ground in crisis states. One resource they provide is insulin switching guides in several Eastern European languages. These guides are helpful to ensure that local health care providers who may not have a specialization in diabetes care “safely utilize available insulin options” when it becomes necessary to switch “formulations due to limited supplies or options.” DDRC also manages the collection of donations such as “in-date and unneeded insulin, test strips, [and] meters” to be allocated to those in need.

Although the statistics about diabetes in Ukraine appear overwhelming, there is a multitude of incredible organizations advocating and providing direct aid to those in need.

– Helena Birbrower

Helena is based in Davis, CA, USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr

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USAID cuts deprioritizes Women’s Health in Afghanistan

Women’s Health in Afghanistan The Trump Administration’s USAID cuts have affected many in Afghanistan, severely fracturing their already vulnerable health system. The U.S. previously provided more than 40% of foreign aid to Afghanistan, one of the poorest nations in the world, with a population of roughly 40 million. The World Health Organization (WHO) claims that more than 200 clinics have been closed, deprioritizing women’s health in Afghanistan.

Clinics Closing

Midwives in Afghanistan claim that mother and infant deaths have increased since the health clinics in many remote villages have been permanently closed. Women have not been able to reach the leading hospitals in time to receive proper care from a midwife. Many European nations have also revoked their foreign aid, leaving Afghanistan in a grueling position. The WHO believes 200 more facilities will be permanently closed by June 2025, NPR reports. These foreign aid cuts affect the most vulnerable patients in this developing nation: women, children and low-income populations. There is no direct data on complications and deaths due to the 206 clinics that closed as of March 2025. Midwives from village to village are spreading awareness to each other about pregnancy and childbirth deaths. USAID cuts are deeply deprioritizing women’s health in Afghanistan.

Midwives Testimony

In the western provinces of Herat, a midwife, Faezeh, experienced her clinic closing due to aid cuts. Previously, the clinic had been active at all hours. Many health clinics in Afghanistan not only assist with maternal and newborn care but also provide for the most vulnerable patients, including malnourished children and the elderly, NPR reports. The clinics offer vaccination and nutrition. The clinic in Herat was not reopened despite the older generation’s efforts to negotiate with the public health officer. There is no donor funding available to establish a reopening. Faezeh believes that if the clinic had not closed, the women who recently experienced maternal and infant death would have been able to make it, according to NPR. Clinics that remain open are distantly spaced out, making it virtually inaccessible for Afghans to receive care.

Karima, a maternal care doctor at a regional hospital in Afghanistan, believes that maternal and infant death rates are increasing due to the cuts in prenatal and postpartum services, previously provided by foreign NGOs. The NGO cuts only further deprioritizes women’s health in Afghanistan. A woman in a rural area of Herat lost her baby due to a condition known as meconium aspiration syndrome. A condition in which the baby has been in the womb for too long. This condition only occurs in 5% to 10% of births, NPR reports. It is treatable, but not having professional care in her community prevented this mother from having a life with her child. Women already have strict travel regulations imposed on them by the Taliban. The closing of the clinics is imposing a higher risk on women who do seek to travel to a further village to receive maternal care.

Women for Afghan Women

Foreign aid cuts have affected many nations in the developing world. Women for Afghan Women is partnering with organizations in Afghanistan to expand its help. Like many organizations trying to establish aid and funding for Afghanistan, they have been limited in their pursuits due to government control of the nation. Afghan midwives are the hope for maternal care. Private funding is being sought, but grassroots support is limited. International financing is persistently in conversation in U.S. government relations settings. Support from congressional leaders for the International Affairs budget could bring resolution for the deprioritization of women’s health in Afghanistan and developing nations across the world.

– Mackenzie Inman

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

Photo: Flickr

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Safer Births Bundle of Care Program: Neonatal Care in Tanzania

Safer Births Bundle of Care ProgramNewborn and maternal mortality remain major global health challenges, particularly in sub-Saharan Africa, where nearly 50% of the world’s perinatal deaths occur. While the global maternal mortality rate stands at 211 deaths per 100,000 live births and the newborn mortality rate at 18 deaths per 1,000 live births, Tanzania faces higher rates—556 maternal deaths per 100,000 and 25 newborn deaths per 1,000 live births. Norwegian-backed nonprofit Laerdal Global Health has partnered with Haydom Lutheran Hospital in Tanzania and Stavanger University Hospital in Norway to address these disparities since 2012. Together, they have worked on solutions through research and innovation to save lives during childbirth.

The Safer Births Bundle of Care Program

The Safer Births Bundle of Care (SBBC) program combines simulation-based training and medical innovations to reduce newborn and maternal mortality. Over a decade and 150 research studies have informed its development. Originally launched across 30 health facilities in Tanzania, SBBC is a collaborative effort involving Laerdal Global Health, UNICEF Tanzania, the Tanzanian Ministry of Health and the President’s Office for Regional and Local Government.

The “bundle” refers to their four-step approach: training innovations, clinical innovations, sustainability and scalability and continuous quality improvement. SBBC’s training innovations showcase the effectiveness of simulation-based training. The SimBegin training program, a combination of online learning and on-site training, trains facilitators to run simulation scenarios, mentors to support the implementation of simulation training and faculty to train new facilitators and mentors.

Essential tools used in training include:

  • NeoNatalie Live. A newborn resuscitation manikin for practical simulations.

  • MamaNatalie. A wearable simulator that helps health care workers practice postpartum hemorrhage management.

  • Moyo Fetal Heart Rate Monitor. For fetal heart monitoring during labor.

  • NeoBeat Heart Rate Meter. Helps assess newborns’ heart rate quickly to distinguish between asphyxia, hypoxia or stillbirth.

  • Upright Bag Mask. A resuscitation tool for nonbreathing newborns.

Recent Findings in Tanzania

In a 2025 study published by the New England Journal of Medicine, researchers observed a 40% reduction in neonatal deaths and a 75% reduction in maternal deaths following SBBC implementation. These outcomes were drawn from data collected across 300,000 mother-baby pairs recorded in the 30 hospitals.

The analysis found that the estimated risk of death during the perinatal period—defined as 22 weeks of gestation to seven days after birth—was 18% lower following the implementation of SBBC. This overall decline was largely driven by a nearly 40% reduction in neonatal deaths within the first 24 hours after birth.

The decline has been linked to training on newborn resuscitation using the NeoBeat heart-rate monitor and the Upright resuscitator. Frequent simulation practice appears to have improved health care workers’ preparedness and efficiency during the “golden minute” after birth, when it is critical to ensure the baby begins breathing independently.

Scaling Beyond Tanzania

Initially rolled out in five Tanzanian regions—Manyara, Tabora, Geita, Shinyanga and Mwanza—the SBBC program now operates in 150 facilities. Its success has gained attention beyond Tanzania’s borders. As of 2025, Nigeria has begun introducing SBBC in the Borno and Gombe states. Ethiopia has also expressed interest in adopting the model.

Looking Ahead

The success of the Safer Births program illustrates the potential of targeted training, low-cost innovations and international cooperation. With continued investment and adaptation across low-resource settings, SBBC could support efforts to lower maternal and newborn mortality rates across the Global South. Programs like these reveal that scalable, evidence-based solutions could drive long-term health outcomes in underserved communities.

– Sandhya Mathew

Sandhya is based in Los Angeles, CA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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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 will 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

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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

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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

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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

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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

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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

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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