Archive for category: Disease

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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

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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

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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

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Ebola in Uganda: Strengthening Response and Prevention

Ebola in Uganda: Strengthening Response and Prevention
Since the initial discovery of orthoebolavirus during the 1976 disease outbreaks in Zaire and Sudan, nearly 40 additional incidences have occurred. While these Ebola disease (EBOD) episodes have been reported globally, Sub-Saharan Africa accounts for most of them. Countries such as Sierra Leone, Guinea and Uganda have all experienced EBOD outbreaks. In fact, Uganda itself has had several different episodes over the last 20 years. While these disease outbreaks cause harm and disruptiveness to many communities, they also provide valuable learning opportunities. Additionally, information that medical professionals glean from previous events can be useful for addressing future epidemics. To successfully control emerging outbreaks of Ebola disease in Uganda, medical professionals should heed lessons they learned from past orthoebolavirus outbreaks.

Knowledge Gains

Lessons learned from past orthoebolavirus outbreaks are plentiful and many partnerships between the country’s Ministry of Health (MOH) and global agencies have led to positive improvements for addressing Ebola disease in Uganda. These include:

Additionally, lessons learned from past orthoebolavirus outbreaks in Uganda involves supporting culturally appropriate burial processes. For this, the MOH is working closely with Uganda’s Red Cross teams. These teams include individuals from the community who understand the culture and who can work directly with those who have lost loved ones due to EBOD. Team members receive training in using personal protective equipment (PPE) and following rigid universal precaution requirements. This is especially important when addressing orthoebolavirus outbreaks.

Ongoing Challenges

While progress has occurred in addressing Ebola disease in Uganda, communication remains a challenge. Even though the government shares disease information about orthoebolavirus outbreaks, people do not always trust it and are hesitant about vaccines.

Because of the current Ebola disease in Uganda, many countries have implemented travel bans and advisories. Those in the tourist industry believe that the lack of clear communication from the government is causing a decrease in their revenue. This is significant for an industry that gained more than $1 billion in revenue during 2023. This is of great concern for the more than 42% of the people living in poverty.

Lessons learned from past othoebolavirus outbreaks also revealed the depth of distrust and culturally embedded conspiracy theories developed from previous Ebola disease in Uganda events. Some believe the outbreaks are a way for the government to remove certain populations or cover up the selling of people. They also believe that those infected with EBOD have had a hex cast upon them.

To remove communication barriers, more engagement with local communities needs to occur. Besides clear information, people also need increased education regarding Ebola disease in Uganda, especially as the country tries to initiate a new vaccine trial to fight the EBOD outbreak of 2025.

Summary

Uganda is located in East-Central Africa. It is home to six major lakes including Lake Victoria, which is the second-largest inland freshwater lake in the world. The country has a population of more than 48 million people of which almost 75% live in rural communities along Lake Victoria, roughly 72% of the rural population does not have access to improved sanitation facilities and nearly 20% of the rural population does not have access to clean drinking water.

These are significant aspects to consider when managing any orthoebolavirus outbreak. As Peter Piot, (the Belgium-British microbiologist involved with identifying Ebola) states, “We shouldn’t forget that this is a disease of poverty, of health systems and of distrust.” But with the lessons learned from past orthoebolavirus outbreaks and ongoing global support, efforts to contain future outbreaks of Ebola disease in Uganda will prevail.

– Kelly Chalupnik

Kelly is based in Kirkland, WA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Guinea Worm Disease: Nearing the End of a Neglected Disease

Guinea Worm DiseaseDracunculiasis, also called guinea worm disease (GWD), is a crippling parasitic infection that has afflicted humankind for thousands of years. The parasite Dracunculus medinensis causes this infection, which spreads when infected copepods (water fleas) contaminate drinking water. Historically endemic across large swathes of Africa, Asia and the Middle East, GWD has long been linked to excruciating pain, disabling disease and economic deprivation in affected populations. However, a global eradication campaign led by the Carter Center, supported by the World Health Organization (WHO) and UNICEF, has nearly eradicated this parasitic disease. The near-elimination of GWD highlights the power of coordinated global health efforts to combat neglected tropical diseases (NTDs). Here is more information about guinea worm disease eradication across the world.

The Lifecycle of the Guinea Worm Parasite

People contract GWD when they drink water containing copepods infected with Guinea worm larvae. Once ingested, the copepods die, releasing larvae into the host’s body. The larvae penetrate the stomach and intestinal walls, eventually maturing into adult worms. Female worms, which can grow up to one meter long, migrate to the skin’s surface about one year after infection. The worm forms a painful blister, typically on the lower limbs, which eventually ruptures, allowing the worm to emerge over several weeks. This agonizing process causes intense pain, inflammation and secondary infections. Many victims submerge the affected area in water to seek relief, inadvertently releasing new larvae into the water source and completing the transmission cycle.

Health and Socioeconomic Impact

Although rarely fatal, guinea worm disease wreaks havoc on affected communities. The intense physical pain and immobility render individuals unable to work, farm or attend school. In rural agricultural settings, this loss of productivity can jeopardize food security and local economies. Beyond health consequences, GWD perpetuates cycles of poverty, increasing economic strain on already overburdened healthcare systems.

Global Guinea Worm Disease Eradication Campaign

In 1986, GWD affected 3.5 million people annually across 20 countries. The Carter Center spearheaded a global guinea worm disease eradication campaign to combat this debilitating disease. The strategy included four main interventions: improving access to safe drinking water using water filters, conducting health education to promote behavior changes, containing cases to prevent water contamination and applying larvicides to kill copepods in stagnant water. By 2023, these efforts reduced cases to a handful in South Sudan, Chad, Mali and Ethiopia, with most countries, such as Ghana and Nigeria, declared free of GWD.

Challenges Eradicating GWD

Despite significant progress, several challenges impede the final push toward eradication. Guinea worm infections in animals, primarily dogs in Chad, complicate efforts to interrupt transmission. Political instability and conflict in countries like South Sudan and Mali hinder surveillance and containment efforts. Environmental factors, such as changing weather and shifting water patterns, may also alter transmission dynamics, creating new challenges for eradication teams.

The Role of Community Engagement

Community involvement has been the cornerstone of the eradication campaign. Empowering local populations to take ownership of the process has accelerated progress. Several community-driven initiatives have played crucial roles in combating guinea worm disease (GWD) with measurable successes.

In 2010, Chad implemented a cash reward program, offering financial incentives to individuals who reported suspected cases of GWD in humans. In 2015, this program was expanded to include reports of infections in animals, significantly improving case detection and containment efforts. Public awareness campaigns through radio, television and community outreach have been key to the program’s success.

Another critical initiative launched in South Sudan, where extensive surveillance networks originated, engaging thousands of volunteers to track and report cases. By 2018, these efforts led to the country announcing the interruption of GWD transmission after 15 consecutive months of zero reported cases.

Health workers and volunteers have also played an essential role in educating communities on water filtration and promoting early case reporting. In addition, local leaders have enforced containment measures and promoted safe water practices, fostering a sense of shared responsibility and resilience in affected areas. Through these sustained efforts, community engagement continues to be a driving force in the final push toward eradicating guinea worm disease.

Looking Ahead

The near-eradication of guinea worm disease represents a historic milestone in global health. It demonstrates how long-term collaboration among diverse partners, community engagement and innovative solutions can overcome even the most persistent health challenges. While obstacles remain, the lessons learned from this campaign will inform future efforts against other NTDs. Achieving eradication will improve millions of lives and affirm that with the right tools and strategies, even the most neglected diseases can be defeated.

– Maheer Zaman

Maheer is based in Fairfax, VA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Clean Cooking Alliance: Push for Clean Cooking Solutions

How CCA Offers a Solution to Clean Cooking Shortages Each year, millions suffer the consequences of cooking with traditional fuels such as wood, charcoal and kerosene. According to the World Health Organization (WHO), more than 4 million people die annually from illnesses linked to household air pollution caused by burning solid fuels like wood and charcoal. In Africa, nearly four in five people are exposed to hazardous indoor smoke, making it a leading cause of premature death—especially for women and children. Globally, 99% of the population breathes air that the WHO considers unsafe, highlighting the widespread impact of polluted cooking.

Health and Environmental Impact of Polluted Cooking

More than 850 million people in Africa still rely on traditional fuels for cooking, making toxic indoor smoke the second-leading cause of premature death after malaria. The health risks include pneumonia, heart disease, stroke and lung cancer, disproportionately affecting women who spend extended hours cooking.

Beyond its health implications, polluted cooking contributes significantly to environmental degradation. Each year, burning wood fuels releases one gigaton of carbon dioxide, accounting for 2% of global carbon emissions and accelerating deforestation. Switching to cleaner energy alternatives, such as liquefied petroleum gas (LPG), biofuels or solar-powered cookstoves, could mitigate these impacts while preserving biodiversity.

The burden of collecting fuel for cooking falls heavily on women and children, who spend up to 20 hours per week gathering firewood. This time-consuming task limits educational opportunities, keeping children, particularly girls, from attending school and perpetuating cycles of poverty. Without access to clean cooking, families face economic hardship, poor health outcomes and environmental risks, making this issue one of the most pressing challenges in global development.

Clean Cooking Alliance: Driving Change

The Clean Cooking Alliance (CCA) is leading efforts to expand access to clean cooking solutions. The organization collaborates with governments, businesses and nonprofits to create a sustainable, scalable industry focused on modern cooking technologies. CCA’s strategy revolves around:

  • Driving Consumer Demand – Increasing awareness and behavioral change to encourage the transition to clean cooking.
  • Mobilizing Investment – Attracting funding to grow businesses that produce and distribute affordable clean stoves and fuels.
  • Supporting Policies – Advocating for government policies that prioritize clean energy solutions.

CCA has already made a measurable impact by providing $8.6 million in grants to clean energy companies, investing $2 million in gender-focused initiatives and reaching 40 million people through awareness campaigns. Alex Eton, CEO of Sistema.Bio, calls clean cooking “a pathway out of poverty.”

Challenges and Opportunities for Expansion

While Africa’s renewable energy sector is booming, clean cooking solutions remain underfunded. Between 2019 and 2020, investment in clean cooking businesses dropped from $25 million to just $10 million, limiting growth and accessibility. Low consumer demand and insufficient financing continue to hinder widespread adoption. Despite these obstacles, clean cooking offers significant health, economic and environmental benefits. Cleaner stoves reduce fuel consumption by 30-60%, lowering household costs and carbon emissions. Access to clean cooking solutions lowers the risk of respiratory infections, cardiovascular diseases and pregnancy complications.

Spark+ Africa Fund: Scaling Clean Cooking Solutions

To address the funding gap, CCA launched Spark+ Africa—the world’s first impact fund dedicated to financing clean cooking solutions. This initiative aims to create greater access to capital for businesses while delivering:

  • Improved respiratory health for millions of people.
  • Gender equality by reducing time poverty for women.
  • Lower greenhouse gas emissions and deforestation.
  • Job creation in the renewable energy sector.

Empowering Women Through Clean Cooking

CCA’s commitment to gender equity is central to its mission. The organization states, “Women must be part of the process,” emphasizing its role in both using and promoting clean cooking solutions. The Women in Clean Cooking (WICC) mentorship program, launched in 2020, connects female professionals with industry leaders to support career growth, entrepreneurship and leadership in sustainable energy.

Engaging Youth in the Clean Cooking Movement

With 90% of the world’s 1.8 billion youth living in developing countries—where access to clean cooking remains limited—CCA recognizes the importance of engaging young people. The organization has launched youth-driven initiatives to promote leadership in the clean cooking sector, including:

  • Sponsoring the 2023 YES! Youth Energy Summit, featuring youth-led discussions on clean energy.
  • Sending the first youth delegation to the 2022 One Young World Summit, increasing awareness and advocacy efforts.
  • Creating a youth consultation process to ensure that young voices influence policy and investment decisions.

The Road Ahead

The Clean Cooking Alliance continues to expand its efforts, with upcoming global conferences in March 2025, focusing on clean energy, climate action and poverty reduction. However, achieving universal access to clean cooking by 2030 requires stronger commitments from governments, private investors and international organizations. The Clean Cooking Alliance’s work represents a crucial step toward a future where clean cooking is no longer a privilege but a right. By addressing health risks, environmental concerns and economic barriers, CCA is leading a movement that has the potential to transform millions of lives worldwide. With continued investment and innovation, clean cooking could not only improve health and environmental conditions but also drive sustainable development in communities most in need.

– Amani Almasri

Amani is based in Durham, UK and focuses on Good News and Technology for The Borgen Project.

Photo: Flickr

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HIV/AIDS in Paraguay: UNAIDS at the Forefront of the Response

HIV/AIDS in ParaguayHIV/AIDS left 7,000 children as orphans in Paraguay in 2023 alone. Natanael, an HIV-positive boy living in Paraguay, became an orphan after his mother died of HIV.

What Is HIV?

The human immunodeficiency virus (HIV) is an illness that affects a person’s white blood cells, specifically ones called CD4 cells, that are responsible for immune function. HIV is transmitted through the exchange of bodily fluids. 

Methods of preventing the virus includes using a condom, avoiding used or unclean needles, getting tested regularly, and in some cases, preexposure prophylaxis (PrEP). Treatment for HIV/AIDS involves antiretroviral therapy (ART). 

HIV/AIDS in Paraguay

Despite there being both preventative measures and treatments, HIV/AIDS is an epidemic that continues to burden many parts of the globe. In Paraguay, at least 22,000 people are currently living with HIV/AIDS. Of that number, about half are receiving ART for HIV/AIDS, meaning at least 10,000 are going without life-saving treatment.

HIV/AIDS is concentrated both geographically and among populations in Paraguay. Greater than 75% of those infected with HIV live in the country’s capital, Asunción, with the total number of nationwide cases rising each year. HIV/AIDS is also more prevalent among men who have sex with men (MSM) and sex workers.

Natanael, a young boy living with HIV in Paraguay, became an orphan when his mother died of the virus. Natanael’s mother contracted the illness at her work at a children’s home for kids with HIV, where she and her son also lived.

After her passing, Natanael became an orphan and had to continue living in the home without his mother, because his own family rejected him and his mother after discovering that they were diagnosed with HIV.

UNAIDS Response

To bring aid to people like Natanael, The United Nations has a Joint Programme called UNAIDS. UNAIDS is a global health effort that aims to address HIV/AIDS as a public health crisis. 

As a result, HIV/AIDS in Paraguay and other countries may begin to see a decline as the Joint Team successfully implements different health services throughout the country.

With a program expenditure of $425,483 USD in 2022-2023, UNAIDS was able to: 

  • Provide nearly 550,000 students in Paraguay with comprehensive sex education. 
  • Provide more than 15,000 people in uniform with information regarding HIV/AIDS.
  • Provide more than 5,000 people in Paraguay’s armed forces with rapid HIV and syphilis testing services.
  • Distribute nearly 11,000 condoms throughout the country to prevent the transmission of HIV/AIDS, and other STIs.

The Future

Looking to the future, UNAIDS hopes not only to continue to meet their 90-90-90 goal – 90% of those with HIV are diagnosed, 90% of those diagnosed are treated with ART and 90% of those on ART become virally suppressed — but have targets of 95-95-95.

UNAIDS in Paraguay has worked not only to achieve its 95-95-95 goal but to prevent HIV/AIDS altogether through comprehensive sex education for students and the distribution of condoms throughout the country.

Without education or awareness of HIV, the couple who fell in love with Natanael may have never felt prepared to adopt him. At 12 years old, Natanael finally met his new parents. He was able to go to a loving home and maintain his HIV treatment. 

Other initiatives, such as SOS Children’s Villages, work to provide stable and nurturing homes to children around the globe living in poverty and other extreme situations. Anyone can donate or sponsor a child living in Paraguay, and help them gain access to medical care, food, clothes and love. 

Looking Ahead

HIV/AIDS is a global epidemic. The efforts of UNAIDS in Paraguay since 2022 have expanded public awareness of HIV and its transmission, provided HIV self-testing programs in key areas, and provided health services and information to those in uniform. Efforts such as these are at the forefront of the HIV/AIDS response and should help to decrease the number of cases in the future. 

– Hannah Pacheco

Hannah is based in Boston, MA, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Diseases Impacting Lesotho

Diseases Impacting Lesotho
Lesotho is a tiny country totally encircled by South Africa. It has a land mass more than 11,000 square miles. With the country sitting within the mountain range of Maloti, Lesotho is frequently called the “Kingdom in the Sky.” While nature-made peaks and valleys provide the country with a beautiful landscape, the population struggles under an ineffective health care system that is challenged with managing several diseases impacting Lesotho.

3 Diseases Impacting Lesotho

  • Tuberculosis (TB): Tuberculosis in the country ranks as the second-highest in the world. The World Health Organization (WHO) indicates that TB is the leading cause of death in Lesotho, and among men. It is the second-leading cause of death among women and almost three quarters of TB incidences occur in individuals who are also HIV positive.
  • HIV/AIDS: HIV infections in Lesotho are high. In fact, the country ranked as the second-highest country with HIV in 2023. HIV/AIDS is the number one cause of death among women and the second leading cause of death among men. In 2023, there were approximately 260,000 adults living with HIV and more than half of these individuals were women.
  • Cervical Cancer: Cervical cancer rates are also high in this country. While globally this type of cancer falls within the top five most common cancers affecting women, it is the number one type of cancer impacting Lesotho’s female population. On average, more than 500 women in Lesotho are diagnosed yearly with this type of cancer. Unfortunately, more than two-thirds of them die from the disease. The main virus contributing to developing cervical cancer is the Human Papillomavirus (HPV). A common virus easily spread during sexual activity. However, women infected with HIV have a six-time greater risk for developing cervical cancer compared to women who are not HIV infected.

Optimism in Lesotho

The good news is that the country is making progress in addressing the diseases impacting Lesotho. Lesotho’s Ministry of Health (MOH) is working jointly with the Center for Disease Control (CDC) on several projects focused on improving the country’s health care system. Some of these changes include:

  •         Updating processes for disease surveillance and detection in general.
  •         Improving policies addressing public health concerns.
  •         Providing additional training for medical personnel regarding testing and samplings.
  •         Modernizing laboratory facilities to work with the newest diagnostic tools.

With support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the CDC and Lesotho’s MOH also made improvements with testing, diagnosing and treating, specifically for HIV and TB.

Addressing TB in Lesotho

Regarding TB, the partnership between the World Health Organization (WHO) and MOH is focusing on identifying individuals with TB in a much quicker fashion. With many of the population living in difficult-to-reach areas, local health facilities are making an effort to screen and test individuals who seek care. This cost-effective practice is helping to identify TB positive individuals sooner and get them started on medication treatment quicker. In doing so, a higher survival rate is being achieved along with decreasing the risk for spreading the disease.  

Although the burden of TB is still high in Lesotho, the country is seeing success. As of spring of 2024, approximately 77% of positive TB individuals were on medication treatment. Many of the partnered organizations are confident that Lesotho will achieve WHO’s established goals for ending TB by 2030.

Lesotho and the 90-90-90 Goals

 As for HIV/AIDS, the country met the United Nations Programme on HIV/AIDs (UNAIDS) 90-90-90 goals. These goals roughly defined are:

  • 90% of people with HIV will know their diagnosis
  • 90% of people with HIV will receive antiretroviral medication
  • 90% of people with HIV on antiretroviral medication will have their viral load suppressed

Lesotho achieved these goals impart through partnerships between the MOH, CDC and PEPFAR. The joint efforts created a survey tool called the Lesotho Population-based HIV Impact Assessments (LePHIA). The purpose of this tool was to identify how the country was managing HIV disease. Data collection involved trained surveyors making home visits to evaluate people’s risks for contracting HIV. The surveyors also provided preventive education and performed HIV testing and counseling. These same surveyors also helped to ensure HIV positive individuals were receiving medication treatment.

Although rates continue to be high, additional data finds Lesotho improving with addressing HIV disease. Data collected from a second survey (LePHIA 2020) found the rate of new HIV infections dropped more than 50%. Furthermore, the data indicates that more HIV positive individuals are being appropriately treated for maintaining viral suppression. Similar to TB, improvements with the management of HIV are leading to higher survival rates and lower disease transmission rates. 

The HPV Vaccine

To address cervical cancer, Lesotho’s MOH and the CDC jointly implemented a nation-wide vaccination program. This program focused on immunizing young girls with the HPV vaccine. The program effectively immunized 93% of young girls with the HPV vaccine. With an efficacy rate more than 98%, the program is a strong effort towards decreasing the occurrence of cervical cancer.

Looking Ahead

In a country where more than 40% of the population lives in the remote areas of the mountain and foothills, controlling diseases country-wide is crucial. Especially when access to care is challenging. With meaningful changes to the health system, the health of the population will improve and with new processes in place for TB, HIV and cervical cancer, individuals will have much healthier lives. The life expectancy rates which averaged around 48 and 54 years of age for men and women respectively in 2021, will rise. With longer life expectancies, family life will improve. Besides providing loving and nurturing environments for children, having parents living longer will also help to ensure the education and personal growth of children. These are crucial elements for a population to retain its identity and to feel of value. These changes in the health system will go far for addressing the diseases impacting Lesotho and its population.

– Kelly Chalupnik

Kelly is based in Kirkland, WA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Sierra Leone Launches Successful Ebola Vaccination Campaign

Ebola Vaccination CampaignSierra Leone’s Ministry of Health launched a nationwide preventive Ebola vaccination campaign. Starting on Dec. 5, 2024, the three-week effort aimed at protecting 20,000 frontline workers against the Ebola virus. While similar higher-coverage campaigns were conducted in Guinea-Bissau (2021), Uganda and the Democratic Republic of Congo (2022), this initiative is the first of its kind in West Africa. Gavi, the Vaccine Alliance, provided a single dose of the Ervebo vaccine to frontline workers, with training, technical assistance and logistical support from the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF).

In an interview with The Borgen Project, Francisco Luquero, Gavi’s Head of High-Impact Outbreaks, highlighted the importance of the initiative. “The campaign’s impact will be significant to strengthen the country’s preparedness for future outbreaks by protecting frontline workers.”

Campaign Successes

The nationwide campaign targeted various at-risk communities, including health care professionals and first responders such as ambulance and motorcycle drivers. Village hunters were also vaccinated to prevent the spread of the Ebola virus from animals to humans. Luquero told The Borgen Project that Gavi achieved 94% coverage among the target group of 20,000 frontline workers. 

“Health care workers expressed satisfaction with the campaign, recognizing its importance in protecting themselves and their communities from future outbreaks,” says Luquero. He also stated that vaccine confidence and awareness also improved due to information provided about the vaccine’s benefits and side effects, as well as guidance on what to do in case of Adverse Events Following Immunization (AEFI). Gavi noted that these information dissemination efforts, along with “robust logistical support” from WHO and UNICEF, were crucial to the campaign’s successful rollout.

Ebola 2014 – 2016 Outbreak

The 2014 Ebola virus epidemic began in Guinea. It spread to at least 10 other countries, firstly through neighboring Liberia and Sierra Leone. With no vaccine available at the time of the outbreak, health care workers were limited in their response capacities. The epidemic resulted in 28,000 confirmed infections and approximately 11,000 deaths, making the outbreak “the deadliest in history.” Sierra Leone was the hardest-hit country, accounting for an estimated 36% of recorded deaths and losing 7% of its medical personnel.

Ebola Vaccinations

Gavi funded a stockpile of half a million doses of Ervebo in 2021, just three years after WHO and the European Medicines Agency approved the vaccine. The majority of the vaccines are allocated for preventive Ebola vaccination campaigns similar to the one in Sierra Leone, targeting at-risk communities. About 5% of the remaining stockpile is reserved for emergency outbreaks. This distribution is due to Ebola outbreaks being relatively uncommon and not having a large enough stockpile to cover entire populations.

WHO defines at-risk persons through a ring vaccination strategy, which “captures a social network of individuals and locations” comprising around 150 people per vaccination ring. To be included in a preventive Ebola vaccination campaign, one must either be a frontline worker or have in the last 21 days:

  • Lived in the same household or been in close contact with an infected person displaying symptoms of the virus,
  • Had physical contact with an infected person’s “body, body fluids, linen or clothes.”
  • Being a neighbor or family member (including extended family) “at the closest geographic boundary of all contacts.”
  • Or lived in the same residence as anyone else included within the vaccination circle.

For the Future

Following the campaign in Sierra Leone, Luquero shared that Gavi plans to improve several aspects of its vaccination efforts. “Key lessons include enhancing vaccine confidence, strengthening case management protocols for adverse events, and improving supply chain and data management.” Indeed, a total of 18 countries are eligible for a preventive Ebola vaccination campaign, with the Central African Republic expected to be the next to participate.

Although the likelihood of Ebola epidemics is low, vaccinated persons must continue to take precautions to protect themselves from infection. This includes avoiding direct contact with the bodies, bodily fluids and clothing of infected individuals. Additionally, Sierra Leone would also need to improve its population’s access to clean water, sanitation and hygiene (WASH) to help mitigate the risk of the virus spreading.

While the vaccine does not eliminate the threat of an Ebola virus outbreak, these preventive vaccination campaigns can fortify health care systems and enhance community preparedness in case the virus spreads in endemic regions.

– Nesreen Yousfi

Nesreen is based in Watford, Hertfordshire, UK and focuses on Good News and Politics for The Borgen Project.

Photo: Flickr

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Cancer in West Africa: A Growing Health Challenge

Cancer in West Africa: A Growing Health Challenge Cancer remains a significant health challenge in West Africa, with its impact steadily increasing in recent years. In 2022, the Global Cancer Observatory recorded 263,255 new cancer cases in the region. Late diagnoses and limited access to treatment facilities have pushed mortality rates above 60%, highlighting urgent public health and socio-economic disparities that demand attention.

Common Types of Cancer in the Region

Breast, cervical, liver and prostate cancers are the most prevalent types in West Africa. Among women, breast and cervical cancer dominate diagnoses, while prostate and liver cancer are the leading causes among men. Cervical cancer, largely preventable through HPV vaccination and regular screening, remains a major cause of death due to the absence of widespread immunization programs and early detection services. Similarly, liver cancer is often linked to exposure to aflatoxins—poisonous substances found in mold-contaminated food—compounding health risks in the region.

Environmental and Lifestyle Factors

Geographic and environmental factors also play a significant role in cancer prevalence. Increased exposure to environmental pollutants from urbanization and industrialization has raised cancer risks. Lifestyle changes, including dietary shifts, reduced physical activity and higher rates of tobacco and alcohol consumption, have further exacerbated the burden of noncommunicable diseases in West Africa.

Health Care Gaps and Access Issues

Limited health care infrastructure presents one of the most significant barriers to addressing cancer in West Africa. A shortage of oncologists, inadequate diagnostic equipment and poorly resourced health care systems mean that many patients receive diagnoses in advanced stages of the disease. Countries such as Sierra Leone and Guinea have minimal specialized medical personnel, leaving large portions of their populations without adequate care. This stark disparity in access to treatment makes combating cancer in the region considerably more challenging.

Efforts to Combat Cancer

Despite these ongoing challenges, efforts to tackle cancer in West Africa have grown over the past decade. Public health campaigns, led by organizations like the West African Health Organization (WAHO) and supported by global entities such as the World Health Organization (WHO), have focused on:

Notable success stories include Ghana’s cervical cancer screening expansion and the introduction of HPV vaccines in schools, as well as Nigeria’s national cancer control plans, which aim to improve early detection rates.

Looking Ahead

Beyond its medical implications, cancer poses a developmental challenge, straining families, communities and economies in a region already facing significant vulnerabilities. Addressing the rising cancer burden in West Africa requires comprehensive strategies that prioritize preventive care, education and strengthening health care systems. Furthermore, collaborative efforts that focus on expanding vaccination programs, improving access to diagnostic tools and training medical personnel are essential. By investing in sustainable health initiatives, the region can potentially work toward reducing mortality rates and mitigating the socio-economic impact of cancer on communities.

– Joe Lockett

Joe is based in the Wirral, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr