Archive for category: Disease

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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

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Diseases Impacting Colombia

Diseases Impacting ColombiaColombia is a resource-rich country in the north of South America that is diverse and full of contrasts. Considering their challenging history, the nation has grown to become more resilient in terms of democracy and culture. Colombia is the world’s 55th largest exporter, with about $41 billion in exports to foreign markets. However, diseases impacting Colombia continue to be a serious threat as a whole, mainly due to its tropical climate and low awareness of some diseases which play a role in making the country more vulnerable to a variety of illnesses.

Understanding the difference between communicable and noncommunicable diseases (NCDs) is crucial to comprehending the illnesses that most commonly impact Colombia. Diabetes and cancer are examples of NCDs, which have a tendency to spread slowly. On the other hand, communicable illnesses such as TB or measles are more contagious and easier to transmit. 

NCDs

According to data from 2014, NCDs were responsible for 71% of Colombian deaths, with injuries and other incidents accounting for the remaining 17%. The three primary NCDs in Colombia as of 2014 were diabetes, cancer and cardiovascular illnesses.

In Colombia, 28% of all deaths were from cardiovascular diseases, with men dying at a higher rate than women. Furthermore, a report indicated that 35,000 Colombians lost their lives to cancer in 2014. By 2035, cancer-related mortality may rise by 31%, according to the International Agency for Research on Cancer. Additionally, diabetes claimed the lives of almost 19,000 Colombians in 2015, making up 10% of all fatalities in the nation that year. One million more people in Colombia may have diabetes without a diagnosis, making it one of the most underdiagnosed conditions that are impacting Colombia. 

NCDs were responsible for 22% of premature deaths among people under the age of 70. A report stated that Government health spending as a percentage of GDP rose from 5.4% in 2003 to 6.8% in 2013, indicating that NCDs have apparently had a significant economic impact on Colombia. Furthermore, individual health expenditure has also increased from $133.59 in 2002 to $569.19 in 2015 as a result of the rise of NCDs within the country. 

Communicable Diseases

Due to Colombia’s tropical environment and a lack of awareness about the seriousness of some diseases, communicable diseases impacting Colombia including malaria, HIV and tuberculosis (TB) are more common and transmit quickly among people.

According to Reports, in 2022 alone, TB affected 32 out of every 100,000 individuals, with a fatality rate of 2.4 per 100, 000. Within the same year, there were 25 HIV diagnoses for every 100, 000 people, resulting in a total 5.1 deaths per 100,000. However, one should note that in recent years, the HIV rate has dropped by 7.4%. This can be credited to Colombia’s strong and growing health sector. But due to its tropical climate, Colombia, like many other nations, the ever-increasing malaria sickness plagues it. Up until 2019, Colombia recorded between 60,000 to 80,000 cases of malaria annually for almost 10 years.

Despite being more contagious, communicable diseases typically have more treatments and medications available. The World Health Organization (WHO) ranks Colombia Healthcare sector as the 22nd best in the world, ahead of the United States and Australia. The government allocates 20% of its budget on health care, increasing access to care for individuals from a variety of circumstances.

Unemployment and Poverty in Colombia

Unemployment and the expenditures of health care for both individuals and families are two important elements to take into account when examining how poverty in Colombia contributes to a higher rate of illness infection. One major contributing cause to poverty is unemployment with Colombia’s unemployment rate currently at 9.1% at the moment, but it has remained constant since 2023. Since 9.1% of the population is unemployed, the majority cannot afford the present health care costs, which as of 2022 total $558 per individual.

A report showed that 19 million Colombians lived on just $97,94 a month in that same year. Alongside this is undernourishment, which has been a growing problem in Colombia, especially for women and in 2019, 88% of unemployed people, or 8% of the population, were undernourished. Furthermore, since inadequate nutrition is known to affect or weaken immune systems, more people are vulnerable to illnesses with the bulk of the unemployed population undernourished. Eventually, it leads to high health care costs, which furthers poverty.

The Colombian Government’s Efforts

The Colombian government introduced a national strategy to accomplish the “eradication and elimination” of the most contagious communicable illnesses in May 2024. It is strategy to improve the efficiency of medical care and expand public health services for Colombians. By 2035, the goal is to eradicate 30 additional communicable diseases; the eradication plan includes diseases that are impacting Colombia, such as HIV, malaria and tuberculosis. In order to accomplish its objectives, the Colombian government has established the “One Health” approach, which attempts to close the gap between communities and medicine. The Colombian government intends to pool medical resources in order to fully implement this policy, making it more efficient and providing services that benefit everybody. The Ministry of Health and Social Protection hopes that the one health strategy, which just originated in 2024, will yield benefits soon.

Looking Ahead

The health landscape in Colombia is shaped by both communicable and NCDs, each posing significant challenges to the nation’s well-being. NCDs such as diabetes, cancer and cardiovascular illnesses are leading causes of death and economic burden, contributing to premature mortality and escalating healthcare costs. At the same time, communicable diseases like malaria, tuberculosis and HIV remain persistent threats, exacerbated by Colombia’s tropical climate and limited awareness in some areas. These diseases disproportionately impact vulnerable populations, especially those living in poverty and facing unemployment, further straining the healthcare system.

However, the country’s resilient health sector and government initiatives, such as the “One Health” strategy, offer hope for tackling diseases impacting Colombia. By focusing on prevention, treatment, and greater accessibility to health care, Colombia aims to improve health outcomes and eradicate many infectious diseases in the coming decades. As the country continues to navigate these health complexities, effective policy interventions and improved public awareness will be key in reducing the impact of both communicable and NCDs on the Colombian population.

– Zacc Katusiime

Zacc is based in Kampala, Uganda and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Global HIV Infections and Deaths Are Declining

Global HIV Infections and Deaths Are DecliningGlobal efforts to combat HIV/AIDS have led to significant progress in reducing infections and deaths. Some countries are advancing faster than others, leaving vulnerable populations behind. As of 2023, approximately 39.9 million people were living with HIV/AIDS worldwide, with 53% being women and girls. Despite progress, disparities remain: while 83% of women aged 15 and older have access to treatment, only 72% of men in the same age group do.

Progress Through Antiretroviral Treatment

Antiretroviral (ART) drugs treat HIV by preventing the virus from replicating, which lowers the virus to undetectable levels and significantly reduces the risk of transmission to partners or unborn children. Since 2010, new infections have dropped by 39% and AIDS-related deaths have declined by 51%.

Despite this progress, challenges remain. In 2023, approximately 630,000 people died from AIDS-related illnesses, far from the United Nations (U.N.) target of fewer than 250,000 deaths by 2025. Over the past decade, new initiatives have expanded access to treatment in resource-limited countries, leading to significant improvements. However, barriers like HIV-related stigma, discrimination, social inequalities, national instability and conflict continue to hinder efforts to combat the epidemic.

Countries Leading the Fight

  • South Africa. Although South Africa has the highest number of people living with HIV worldwide, it runs the world’s largest free ART program. Over the past 25 years, new HIV infections have decreased by 75%.
  • Eswatini. Eswatini has achieved the ambitious U.N. 95-95-95 target, meaning 95% of people living with HIV know they are living with it, 95% are on ART and 95% of those on ART are virally suppressed.
  • Thailand. Thailand was the first country to achieve the WHO organization mother-to-child transmission target of less than 2%. 

Countries Facing Significant Challenges

  • South Sudan. South Sudan’s ongoing conflict is exacerbating struggles with inadequate health care infrastructure and limited access to ART. UNAIDS and Médecins Sans Frontières (MSF) play a critical role by providing testing, treatment and advocacy. The on-the-ground charity Crown, the Women of South Sudan, additionally mitigated the social and economic impact of HIV and AIDS by improving awareness and giving psychosocial support to vulnerable groups.
  • Nigeria. The nation faces challenges such as insufficient funding, poor health system coordination and social stigma. The country’s ART coverage is below the global average and rural areas are especially underserved​. The United States (U.S.) President’s Emergency Plan for AIDS Relief (PEPFAR) is a major contributor in the country. In PEPFAR countries, there have been 52% fewer infections since 2010. The Indigenous NGO, the Society for Family Health, also contributes by increasing community awareness and access to treatment.
  • Philippines. The Philippines has the fastest-growing HIV burden, with a 237% increase in new infections and a 315% increase in AIDS-related deaths from 2010 to 2020. Additionally, since 2010, the number of new infections among men who have intercourse with men has increased by six times in the country. Love Yourself is one of the nation’s leading organizations working to combat the epidemic. 7,000 of its clients are on free treatment and since 2011, it has reached 5 million through its campaigns. Its focus also extends to providing mental health support to those affected.

Looking Forward

Global progress in the fight against the epidemic has led to a decline in new HIV infections and deaths, but challenges remain in several countries. While nations like South Africa and Eswatini have made significant strides, others, including South Sudan, Nigeria and the Philippines, continue to face barriers such as health care gaps and stigma. Efforts from international organizations and local charities are crucial in addressing these ongoing issues and advancing treatment and prevention globally.

– Georgia de Gidlow

Georgia is based in Watford, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Fight Against Malaria in Ethiopia

Malaria in EthiopiaEthiopia is still amid its long-lasting battle against malaria, which is one of its most persistent challenges. As of October 2024, Ethiopia has faced more than 7 million cases of malaria. Additionally, the country has dealt with more than 1,000 malaria-related deaths this year alone, indicating that the disease currently shows little sign of slowing down.

Causes

Malaria, a disease caused by the Plasmodium parasite, has historically been a significant threat to Ethiopia. One notable example is the devastating 1958 epidemic, which affected 3 million people in a 100,000-square-mile radius and resulted in an estimated 150,000 deaths. Ethiopia’s battle against malaria is deeply rooted in its geographic and climatic conditions. The severity of the 1958 epidemic was partly attributed to the harsh natural conditions of the area where the outbreak occurred, where the altitude range was estimated to be between 1,600 and 2,150 meters above sea level.

The country’s varied landscapes, from lowland plains to highland areas, create ideal environments for the Anopheles mosquito, which carries the malaria parasite, to thrive. Seasonal rains, especially in the western and southern regions, such as in and around the Gambella National Park, help mosquitoes breed, leading to spikes in malaria cases. Varying climatic conditions have made weather patterns less predictable, making it even harder to control the spread of the disease.

Combating Malaria in Ethiopia

Efforts to combat malaria in Ethiopia have evolved over the decades. The country has implemented various strategies, including widespread distribution of insecticide-treated bed nets (ITNs). Further measures include indoor residual spraying (IRS) and access to effective antimalarial drugs. Community health programs, such as the Health Extension Program, have played a crucial role in improving early diagnosis and treatment in rural areas.

Despite these efforts, gaps remain in reaching the most vulnerable populations, particularly in remote regions with limited health care infrastructure, such as the Benishangul-Gumuz state in northwest Ethiopia. Additional challenges are posed following the rise of insecticide resistance among mosquito populations and the potential for drug-resistant malaria strains. This underscores the need for sustained investment in research, developing new tools such as next-generation antimalarials and vaccines and adapting strategies to local contexts.

Ethiopia’s partnership with international organizations like the World Health Organization (WHO) and the Global Fund has been vital. However, the scale of the problem demands a coordinated and persistent effort from local and global stakeholders.

Final Remark

Addressing the socioeconomic factors contributing to malaria transmission in Ethiopia is equally essential. Poverty, inadequate housing and limited access to clean water and sanitation exacerbate the spread of the disease. Strengthening health systems, enhancing community awareness and promoting economic development are essential components of Ethiopia’s comprehensive approach to malaria elimination.

Maintaining a strong fight level for Ethiopia is paramount, as malaria looks like it will be around for a while. The disease is a health issue and a developmental challenge affecting education, economic productivity and overall well-being. By intensifying its efforts and leveraging innovations in public health, Ethiopia can move closer to a future free from the devastating impact of malaria.

– Joe Lockett

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

Photo: Flickr

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Barriers to Cancer Treatment in Brazil

Cancer Treatment in BrazilAccess to health care in Brazil is fraught with challenges, particularly for cancer treatment, which remains difficult to obtain for many, especially the country’s most impoverished and marginalized populations. Millions of Brazilians live in favelas, where overcrowding and inadequate infrastructure complicate the delivery of health care and the maintenance of sanitary conditions. Similarly, those in remote areas often face lengthy and costly journeys to reach health care facilities for essential treatments. Although Brazilian law mandates that cancer treatment must begin within 60 days of diagnosis, research reveals a stark gap between policy and reality—60.11% of women living with breast cancer patients are still unable to start treatment within this time frame.

While various organizations are working to improve access to life-saving cancer care for all Brazilians, treatment centers remain concentrated primarily in the southern and northeastern regions of the country. This geographic disparity poses significant challenges for those living in more remote areas, particularly in the Northeast and Central-West regions, where health care infrastructure is less developed. As a result, many patients from these regions face the added burden of traveling outside their municipalities to attend appointments and receive necessary treatments.

Interregional Disparities

Significant disparities in cancer treatment access exist across Brazil’s regions and states, with treatment generally more accessible in the wealthier southern states than in the North or Northeast. This disparity aligns with regional economic conditions: the five richest states are located in the Southeast and West, while the five most impoverished are in the Northeast.

More than half of cancer patients in the Northeast and West regions have to travel outside of their home municipality to receive treatment. For patients in more vulnerable areas, this presents a formidable barrier; many lack personal transportation or funds for public transit, making access to care prohibitively difficult. These logistical and financial challenges can have dire consequences—when patients cannot reach treatment centers promptly, they risk worsening health outcomes or even death due to delayed care.

Poverty

Poverty, along with factors such as race and household position, significantly influences whether a woman with breast cancer in Brazil can access the necessary treatment. There is a clear need for broader access to breast cancer care across the country. Research has shown that factors like age, wealth, location and race all play a role in determining how quickly women receive treatment.

In particular, vulnerable, nonwhite women from the Northeast are disproportionately affected, facing greater barriers to care compared to their wealthier counterparts. These socioeconomic and racial disparities mean that poverty remains one of the primary obstacles preventing underprivileged Brazilian women from seeking or receiving timely treatment for breast cancer.

Geographic and Infrastructural Barriers

Indigenous Brazilians face numerous challenges that exacerbate their health outcomes, including living in remote areas with limited access to nearby health care facilities or educational institutions. These geographic and infrastructural barriers, coupled with their overrepresentation in poverty statistics, make it difficult for many Indigenous groups to access cancer treatment. This disparity is starkly reflected in health statistics. Indigenous men from Goiás in the Midwest, for example, are twice as likely to die from liver, stomach and colorectal cancers compared to the general population. Similarly, Indigenous women from the same region are 30% more likely to die from cervical, stomach or liver cancer.

Fundação Laço Rosa

In Brazil, numerous campaigns aim to raise awareness about cancer risks and advocate for patients’ rights, with organizations like Fundação Laço Rosa playing a crucial role. This nonprofit supports breast cancer patients through educational and empowering initiatives. It runs campaigns that educate underprivileged women about their rights as breast cancer patients, providing valuable information on navigating treatment and health care systems. 

Additionally, Fundação Laço Rosa offers support through acts of kindness, such as donating wigs to women undergoing chemotherapy, helping restore their dignity and confidence during a challenging time. Fundação do Câncer is also responsible for many educational campaigns that aim to educate people on preventing cancer. Some of these campaigns include showcasing the dangers of vaping and awareness of multiple types of cancer, such as skin and breast cancer.

Conclusion

Access to cancer treatment in Brazil remains a critical challenge, exacerbated by regional disparities, socioeconomic inequality and racial barriers. While efforts by organizations like Fundação Laço Rosa provide much-needed support, significant gaps persist, particularly for marginalized groups such as women in poverty and Indigenous communities. Greater investment in health care infrastructure, transportation and equitable policies is essential to ensure that all Brazilians, regardless of location or socioeconomic status, can access timely and life-saving cancer care.

– Callum Bennett

Callum is based in Colchester, Essex, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Improving Health Care Accessibility in Developing Countries

Improving Health Care Accessibility in Developing Countries Approximately 1.2 billion people live in acute, multidimensional poverty across 111 developing countries. Many suffer from preventable and curable diseases due to limited access to health care services. According to a Geneva report by the International Labour Organization (ILO), 56% of rural residents do not have access to essential health care services. Currently, 800 million people allocate at least 10% of their household budgets to health expenses for themselves, a sick child or another family member. For nearly 100 million people, these expenses are substantial enough to push them into extreme poverty, forcing them to survive on $1.90 or less per day. Globally, many countries collaborate with the World Health Organization (WHO) to provide essential health services to the most vulnerable and needy populations.

Implementation of Telemedicine in Cambodia

Implementing telemedicine in Cambodia has significantly improved health care accessibility, largely through initiatives like Operation Village Health, part of the broader Village Leap program. This program, established by Japan Relief for Cambodia and American Assistance for Cambodia, aims to rehabilitate the country after the Khmer Rouge reign and the Vietnam War by bringing technology to rural areas. Operation Village Health uses this infrastructure to support local health workers, build capacity and provide medical care to those without expertise. An email-based telemedicine program established in 2001 allows Harvard-affiliated physicians to offer clinical recommendations to Cambodian health workers, enhancing the quality of care in remote areas.

Mobile Clinics in Madagascar

Since June 2022, mobile clinics have been crucial in improving health care accessibility in Madagascar. Funded by the United Nations Central Emergency Response Fund, 20 mobile clinics have been reaching remote and hard-to-access areas, providing essential health services to around 1 million people. These clinics have been especially vital in restoring health care services, such as vaccinations, following the destruction caused by cyclones Batsirai and Emnati, which destroyed more than 150 health facilities and left 800,000 people without access to health care. Staffed by trained health professionals who travel by various means, these mobile clinics have provided care and vaccinations and strengthened epidemiological surveillance and the detection of vaccine-preventable diseases in isolated communities.

Training Health Care Workers in Liberia

Training health care workers in Liberia through the Last Mile Health’s From Response to Recovery program has significantly improved health care accessibility. This initiative focused on building resilient health systems by investing in community and frontline health workers. Over three years, the program strengthened the National Community Health Assistant Program, rolled out a digital training platform and developed online educational resources for health system leaders. Additionally, it advocated for integrated community health worker systems, which improved the capacity to deliver essential health services, especially in remote areas. This approach enabled better health care access and quality for the communities in Liberia.

Investing in Health Care Infrastructure in Morocco

With the population steadily increasing in Morocco and a large segment entering an age group that typically requires more medical attention, demand for health care facilities, medical services and pharmaceuticals has surged. The Moroccan government has shown a strong dedication to upgrading health care infrastructure and services through initiatives like the National Health Plan (Plan Santé 2025). This plan offers long-term stability and support for the health care sector, creating a secure environment for investments. Investors can explore opportunities in public-private partnerships (PPPs) and other investment options in health care. This collaborative approach has led to the development of a robust health care system, ensuring better access to essential medical services for the Moroccan people.

Health Information Technologies in Nigeria

Utilizing health information technology, particularly through the adoption of electronic medical records (EMRs), is significantly improving data management and resource distribution in Nigeria, thereby improving health care accessibility in developing countries. By implementing EMRs, Nigeria’s health care system has seen improvements in patient care and overall health care efficiency. EMRs facilitate better data management, enabling health care providers to track patient histories, streamline workflows and reduce errors. Despite challenges such as inadequate infrastructure, lack of training and limited funding, the Nigerian experience emphasizes the importance of government support and investment in technology and training. This approach not only addresses the unique needs and constraints of developing countries but also sets a precedent for other nations looking to improve their health care systems through advanced health information technology.

Looking Ahead

Improving health care accessibility in developing countries requires a multifaceted approach that addresses various barriers to quality care. The innovative strategies discussed, telemedicine in Cambodia, mobile clinics in Madagascar, community health worker training in Liberia, infrastructure investment in Morocco and health information technology in Nigeria, demonstrate the potential for significant improvements in health care delivery. By focusing on these targeted interventions, developing regions can potentially make significant advancements toward fair and effective health care systems. These ongoing efforts not only improve the quality of care but also foster healthier communities, facilitating sustained development and well-being.

– Maria Urioste

Maria is based in Maspeth, NY, USA and focuses on Good News for The Borgen Project.

Photo: Flickr

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Diseases Impacting Papua New Guinea

Diseases Impacting Papua New Guinea
Papua New Guinea is an Island in the Asian Pacific, with rainforests covering 75% of the country’s area. A lack of basic infrastructure puts the population at a higher risk of contracting diseases. More than 76% of the population “lacks access to safe toilets,” and “66% do not have access to clean drinking water,” according to UNICEF.

Additionally, delivering health care in Papua New Guinea is a significant challenge. Eighty-five percent of the population lives in rural territories with limited transport infrastructure. To combat this, the government allocated $30 million in funding for Provincial Health Authorities as a part of the IMPACT Health Project. This funding will improve the delivery of services of the ground, ensuring that medical drugs, equipment and expertise reach rural areas.

Diseases Causing the Most Deaths

Diseases impacting Papua New Guinea are eight out of the 10 top causes of death in the nation. Of these. five are noncommunicable, with strokes being the leading cause of death in the nation. Coronary heart disease, a common lung disease, diabetes and respiratory infections (e.g. pneumonia) make up the other non-contagious diseases, according to the World Health Organization (WHO).

The three contagious diseases are malaria, diarrhoea and tuberculosis, which is the second leading cause of death in Papua New Guinea. Malaria cases have been improving since 2004. A Global Fund Grant of $109 million in 2009 financed the distribution of more than 7.5 million nets over six years in Papua New Guinea. This, alongside improved treatment and diagnosis, has contributed to the progress.

Children Diseases

Papua New Guinea has an infant mortality rate of 33 per 1,000. The leading cause of death for under 5-year-olds is diarrhea.

Medical care barriers for pregnant women further exacerbate the country’s infant mortality rates. Only 5% of health facilities have the equipment to provide emergency prenatal care 24/7. Moreover, just 32% of women receive skilled care during childbirth.

Endemic and vaccine-preventable infections cause 82% of the deaths in children under 5. In 2018, only 35% of children had received basic vaccinations, according to UNICEF.

Tropical Diseases Impacting Papua New Guinea

The remote geographical location of the PNG and its tropical environments has contributed to the presence of rare and neglected tropical diseases (NTDs). These include Lymphatic Filariasis – the contraction of parasitic worms, trachoma – a bacterial infection affecting the eyes and yaws.

A Mass Drug Administration campaign launched in 2023 by the WHO aims to distribute medicinal drugs to 37 health facilities in two districts.

Yaws is a skin disease caused by bacterial infection, which begins with wart-like tumors and can turn into ulcers. Without treatment, the infection can lead to disability. More than 80% of yaws cases are reported from the West Pacific region, particularly PNG.

In 2012, it was demonstrated that a single dose of the inexpensive oral antibiotic azithromycin was effective at treating yaws. The WHO target for eradication is now 2030.

Looking Ahead

The tropical and rural environments of the nation provide significant challenges to combating the diseases impacting Papua New Guinea. They make it harder to access clean water and lack sanitation infrastructure, and create barriers to delivering medical assistance. Changing weather patterns and antibiotic resistance have additionally given rise to new challenges. However, the tireless efforts of the international, national and provincial communities, ensures that progress is being made to cure diseases in PNG. 

– Georgia de Gidlow

Georgia is based in Watford,UK and focuses on Global Health for The Borgen Project.

Photo: Flickr