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Dangerous Diseases Impacting Djibouti

Diseases in DjiboutiThe residents of Djibouti face many challenges. Natural factors such as drought and higher temperatures affect not only residents’ basic needs but also their quality of life with disease and poverty distressing the population constantly. Here is information about some of the diseases impacting Djibouti.

Diseases Impacting Djibouti

Diseases impact the majority of communities in Djibouti. These are examples of some of the most severe illnesses harming vulnerable members in society. Both communicable and non-communicable diseases are threatening.

  • Malaria
  • Human Immunodeficiency Virus (HIV)
  • Cholera
  • Tuberculosis
  • Hepatitis B 

How Effective Is Medical Care in Djibouti?

Health centers are limited. This is attributed to a lack of staff and resources, which impacts Djibouti’s health care system. Medical systems are strained from pressure and the heavy disease rate.

There is a substantial divide in medical care between rural and urban areas. Urban areas are more likely to have a stronger infrastructure and more funding. Djibouti has 66 medical centers and most of them are located in the capital, Djibouti City. Peltier Hospital is the biggest hospital there, which is not only a place to treat disease, but also home to medical discoveries as research takes place there.

Poverty in Djibouti

A main cause of Djibouti’s hardships is because of poverty, which one can see through its medical care. Even though public health care costs less and is easier for people to access in Djibouti compared to private health care, there are lengthy wait times and staff shortages. Meanwhile, private health care has shorter wait times and more advanced staff.

About 79% of people in Djibouti live in poverty but 42% live in the most extreme conditions. Health care is a constant battle due to people lacking income and having a constant threat of disease. As private health care is more costly, most of the population cannot afford it.

Malaria and Genetically Engineered Mosquitos

Malaria is an ongoing issue in Djibouti. In the year of 2012, 27 cases took place but over the following years to 2020, it has dramatically grown to above 73,000. 

These statistics show how malaria is an increasing issue. Malaria is spread when a mosquito is infected and bites a living organism. This is not communicable, but the infection spreads in the blood stream. The cycle continues as a mosquito will bite the infected person and it resumes. In rare cases, people can catch it through blood transfusions.

In 2024, tens of thousands of genetically engineered mosquitos were created to mitigate the spread of infection thanks to Oxitecs Friendly™. The male mosquitos carry a gene that kills the female mosquitos, reducing malaria. Only female mosquitos carry the disease, so reducing them mitigates the spread of malaria.

HIV and Mobile Brigades

More than 1% of local people are diagnosed with HIV. This is classed as a high rate, underlining the conditions people of Djibouti experience daily. This chronic condition is a virus, that harms the immune system.

HIV passes from person to person through close contact with bodily fluids. Unfortunately, there is no current cure, but treatment can help. If it is not quickly treated, it can develop and become more serious.

Djibouti faces the harshest realities of poverty and this heightens HIV rates. Due to a lack of funding and awareness into health care, more people will unfortunately suffer. Women are more vulnerable to this because they are fearful to reach out for help to help end HIV. This is because of the negative stigma attached to HIV/AIDS.

However, new developments are emerging to reduce the negative stigma. One example is mobile brigades. These are vehicles with medical professionals that go to communities, test for HIV and bring awareness. In 2019, they raised awareness of HIV/AIDS to about 26,000 people who were at risk. Additionally, the mobile brigades provided 6,000 tests and treatment to 2,900 people.

Addressing Cholera

Another of the diseases impacting Djibouti is cholera. Cholera is a disease that is bacterial and passes through contaminated food sources. Cholera can cause stomach pain, sickness, dehydration and death in some severe cases. 

The latest cholera outbreak that Djibouti considered a threat was in 1893. However, the country continued to view cholera as high risk in 2007, and it is significantly dangerous for children. This is because children with cholera often do not show symptoms and fatalities can come about quietly.

UNICEF is implementing WASH interventions in several countries across the globe to eliminate cholera and Djibouti is one of its target countries. Some strategies include implementing reliable and safe water sources and medical treatments, and improving hygiene practices.

The Impact of Tuberculosis

There are around 40 to 499 cases every 100,000 people of the Djibouti population. Tuberculosis is a bacterial infection that is passed from one infected person to the other. This occurs through direct encounters as people can get it through contact with a contaminated person.

The statistics show that this disease is a persistent problem. This is reflected through safety information, as travelers are advised to do screening for their safety and others. This highlights the importance of medical care. Fortunately, it is a curable disease, although if not treated, it can be fatal.

The Prevalence of Hepatitis B

Hepatitis B is a virus that can cause liver issues and is another of the diseases impacting Djibouti. Depending on its severity, it can either be short term or long term. Hepatitis B is spread through bodily fluids or infection spread through blood.

Many see Hepatitis B as a prevalent issue because there is no cure. However, vaccines and treatments can reduce the possibility of Hepatitis B. According to recent data, out of every 100,000 people of the population of Djibouti, 1,044.47 people are diagnosed with Hepatitis B. The statistic is considered high. Sometimes people can be a carrier of it without their knowledge, making it more dangerous.

Looking Ahead

Overall, disease impacts all parts of life in Djibouti. With the hardships of natural disasters and lack of funding, poverty still continues to be the main issue. Funding gives access to medical care and education, and a better life for people of Djibouti. However, with more awareness, this can happen. The new medical achievements show a more positive future for the Djibouti nation.

– Daisy Maidment

Daisy is based in Manchester, UK and focuses on Global Health for The Borgen Project.

Photo: Wikimedia Commons

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The Maldives’ Triple Elimination: A Blueprint for Health

Maldives’ Triple EliminationIn October 2025, the World Health Organization (WHO) announced that the Maldives’ historic triple elimination of mother-to-child transmission of Human Immunodeficiency Virus (HIV), syphilis and hepatitis B had been officially validated. This certification makes the Maldives the first country in the world to successfully eliminate the transmission of all three life-threatening diseases from mother to child simultaneously. The milestone represents a major triumph for maternal health and provides a clear strategy for other low- and middle-income countries (LMICs) to follow.

Understanding Triple Elimination

Triple elimination is a public health standard that ensures the next generation is born free of three specific infections that often cause lifelong health complications or infant mortality. To achieve this, the Maldives had to meet rigorous WHO criteria, including maintaining antenatal care coverage and testing rates above 95%. The nation also proved that its newborn interventions, such as the hepatitis B birth dose, are consistently delivered within 24 hours of birth. Data show that the Maldives recorded zero babies born with HIV or syphilis in both 2022 and 2023. Additionally, a national survey in 2023 confirmed that no young children entering school carried hepatitis B.

A Decentralized Approach to Maternal Care

Progress toward the Maldives’ historic triple elimination was made possible by a decade of systemic reform focused on reaching people in remote areas. Because the population is dispersed across more than 1,000 islands, the government prioritized a decentralized, community-based health care system. In 2018, the nation implemented the “Agenda for Integrated Service Delivery,” which standardized data collection for all three diseases. This ensured that even on the smallest islands, pregnant women could access free testing and treatment. By removing financial barriers, the government addressed a primary cause of health vulnerability among low-income families.

The Role of WHO and United Nations Children’s Fund (UNICEF)

The WHO and UNICEF played essential roles in supporting the Maldives during the validation process. The WHO provided the technical framework and training to ensure that screening and vaccination programs were integrated into routine maternal and child health services. UNICEF South Asia contributed by reviewing and refining national reports to ensure they met global standards for data accuracy. These organizations worked alongside the Indira Gandhi Memorial Hospital, which serves as the national reference laboratory for validating test results. This partnership allowed the Maldives to use digital monitoring tools such as the Electronic Immunization Registry to track children’s health status in real time.

Promoting Equity With the Migrant Health Policy

The path to the Maldives’ historic triple elimination also involved ensuring that no resident was left behind due to background or legal status. The government recently launched a Migrant Health Policy that guarantees equal access to health services for all residents, including migrant populations. This inclusive policy reduced gaps in disease surveillance and ensured that every mother living in the country received the same standard of care. Experts note that including marginalized groups in national health frameworks is a critical factor in achieving disease elimination goals.

A Beacon of Hope for Global Health

The success of the Maldives serves as a beacon of hope for other nations working to eliminate preventable infections. By combining political leadership with a decentralized health system and strong international partnerships, the country has protected future generations from chronic disease. The Maldives’ historic triple elimination demonstrates that geographic isolation and resource constraints are not insurmountable barriers to public health progress. As countries move toward the 2030 global goal for triple elimination, the Maldives shows that equitable, high-quality health care can play a significant role in reducing poverty and improving lives.

– Elena Cárdenas

Elena is based in Monterrey, México and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr

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Ending the Ebola Outbreak in the DRC

Ebola Outbreak in the DRCOn Dec. 1, 2025, the Democratic Republic of Congo’s (DRC) Ministry of Health declared the end of the Ebola outbreak that occurred in Kasai Province. Since 1976, this was the 16th outbreak recorded in the country. The outbreak first occurred in the Bulape Health Zone and was declared on Sept. 4, 2025. A total of 64 cases were reported, with 45 deaths and a case fatality rate of 70.3%.

The urgent national and international response, including surveillance, case management, vaccination and community engagement, achieved successful containment of the disease. The outbreak occurred in a rural, hard-to-reach area with poor roads and limited infrastructure. The response illustrates how effective disease control safeguards vulnerable populations, minimizes economic disruption and supports poverty reduction while strengthening health systems in low- and middle-income countries. The last Ebola patient was discharged on Oct. 19, 2025, in Bulape, triggering the required 42-day countdown before officially declaring the outbreak over. Since Sept. 25, 2025, no new Ebola cases have been reported.

National Response and Vaccination Campaign

The leadership of the DRC government and the Ministry of Health led to a rapid response to the Ebola outbreak. Pre-existing agreements with vaccine manufacturers ensured immediate availability, and Gavi, the Vaccine Alliance, played a vital role in delivering 300,000 investigational doses of the rVSV-ZEBOV Ebola vaccine. As a result, ring vaccination was rapidly implemented on Sept. 14, 2025, in the Bulape Health Zone, focusing on high-risk contacts and frontline health workers. The World Health Organization (WHO) and Médecins Sans Frontières (MSF) also contributed operational support.

A total of 112 WHO experts and frontline responders were deployed to support field operations, and more than 150 tons of medical supplies and equipment were delivered to safeguard health workers and communities. Strong government coordination and decision-making also resulted in the introduction of an Infectious Disease Treatment Module (IDTM) to deliver higher-quality patient care while enhancing health worker safety. As a result, more than 47,500 people were vaccinated against Ebola.

The United Nations Children’s Fund (UNICEF) also played a vital role in preserving vaccine cold chain integrity in a region with limited infrastructure while working in close partnership with the DRC Ministry of Health, WHO and other United Nations (U.N.) agencies. Beyond vaccination, UNICEF supported medical care for Ebola patients, strengthened hygiene measures in schools and health facilities and delivered community education on disease prevention. Operational challenges were addressed by improving access to clean water at Bulape Hospital through the installation of a piped water system, delivering lasting benefits for both the facility and the wider community. The coordinated response halted transmission, minimized secondary infections and enabled the outbreak to be declared over.

Treatment Center and Clinical Efforts

The establishment of a new treatment center in Bulape supported the successful management of the Ebola outbreak. The 32-bed facility has been operational since Oct. 9, 2025, and was built on a 4,500-square-meter site located 200 meters from Bulape General Hospital. The center features 14 tents with private rooms to ensure patient dignity and privacy. Patient monitoring systems allowed staff to provide care without direct exposure to the disease, clearly separating “red zone” (high-risk) and “green zone” (low-risk) areas for safer workflow. The center also included a water, sanitation and hygiene system with a 20,000-liter capacity supplied from a protected source 1.2 kilometers away.

Another key innovation was the introduction of the Infectious Disease Treatment Module (IDTM) to provide more humane care. The module included the use of a “patient liner,” which allows constant patient visibility while maintaining safety, and a deliberate shift in language to emphasize dignity by referring to people as “patients” rather than “cases” and facilities as “treatment centers” instead of “isolation centers.”

In terms of staffing, 50 health professionals and 75 hygienists were trained, all staff were vaccinated and 64 WHO experts were deployed.

As a result, continuous collaboration between the Ministry of Health, WHO, Africa CDC and NGO partners made timely access to treatment and vaccines critical to reducing fatalities and stopping the outbreak. The WHO Africa director, Dr. Mohamed Janabi, said, “The recovery of the last patient … illustrates the strength of partnership, national expertise and collective determination to overcome obstacles to save lives.”

Looking Ahead

The successful containment of the Ebola outbreak in the DRC demonstrates the strength of coordinated public health action, effective partnerships and community engagement. Beyond ending transmission, the response improved preparedness, strengthened health systems and built community resilience. This achievement reinforces regional health security and reflects the DRC’s growing capacity to respond effectively to future outbreaks.

– Angela D’Avino

Angela is based in Preston, UK and focuses on Good News and Global Health for The Borgen Project.

Photo: Pixabay

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GPEI Funding: $1.9 Billion Toward the Fight Against Polio

Fight Against PolioPoliovirus is a highly infectious viral disease that attacks the nervous system and could lead to paralysis or even death, mainly affecting children. Today, the virus mainly affects Afghanistan and Pakistan, along with other developing nations. The Global Polio Eradication Initiative (GPEI) is a partnership between the World Health Organization (WHO), Rotary International, U.S. Centers for Disease Control and Prevention (CDC), the United Nations Children’s Fund (UNICEF), the Gates Foundation and Gavi, the Vaccine Alliance that works to eradicate polio completely.

On December 8, 2025, it was announced that political leaders had collectively pledged $1.9 billion to the GPEI. In the fight against Polio, this generous fund has the potential to protect hundreds of millions of children from polio each year and possibly eradicate the virus.

How Polio Affects the World Today

Afghanistan and Pakistan remain the only countries where vaccines have not eliminated wild poliovirus. Other developing nations with low immunization rates continue to experience outbreaks of virus variants. This year, there have been 39 paralysis cases across Pakistan and Afghanistan.

Although polio cases are currently rare, “failure to stop polio in these last remaining areas could result in a global resurgence of the disease.” It is important to eradicate this virus in order to prevent it from spreading once again. Efforts have come very close to eradication and the recent GPEI funding will help bring the world even closer to this goal.

Successes in the Fight Against Polio

The GPEI was established in 1988 with the goal of ensuring that every child receives a polio vaccination. Since then, polio cases have dropped by 99% and vaccines have prevented approximately 20 million cases of paralysis. The virus once affected thousands of children across more than 100 countries but has now been eliminated in all except two, Afghanistan and Pakistan, where only a handful of cases occur each year.

About the Funds Against Polio

Pledges to the GPEI came from multiple donors, including:

  • $1.2 billion from the Gates Foundation
  • $450 million from Rotary International
  • $140 million from the Mohamed bin Zayed Foundation for Humanity
  • $100 million from Bloomberg Philanthropies
  • $154 million from Pakistan
  • $62 million from Germany
  • $46 million from the United States
  • $6 million from Japan
  • $4 million from the Islamic Food and Nutrition Council of America (IFANCA)
  • $3 million from Luxembourg

These funds will help protect 370 million children from polio through vaccination and reduce GPEI’s remaining resource gap. The shortage of vaccines and resources is a key reason polio still persists. With this recent funding, the complete eradication of poliovirus could become achievable.

– Renata Hirmiz

Renata is based in San Diego, CA, USA and focuses on Global Health for The Borgen Project.

Photo: Unsplash

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ASPIRE in Haiti and Community-Driven Development in Myanmar

ASPIRE in HaitiThe onset of this decade has been marked by a surge in conflicts worldwide, with the number of conflicts and related fatalities having more than tripled since the early 2000s. These intensifying conflicts are causing severe and long-lasting economic damage. Currently, there are 39 economies classified as fragile and conflict-affected situations, with more than half of them facing active conflict. Due to the escalation of conflicts, global poverty and food insecurity are predominantly concentrated in these economies.

Poverty and Conflict

In these economies, close to 40% of the population lives in extreme poverty. According to the 2024 Global Multidimensional Poverty Index, out of 1.1 billion people living in acute poverty, 455 million resided in countries experiencing war or fragility. In 2025, although these regions accounted for less than 15% of the world’s population, they were home to 421 million people living in extreme poverty, more than the total in the rest of the world. Estimates indicate that by the end of this decade, nearly three-fifths of the global extremely impoverished population, approximately 435 million people, will be living in these economies.

As the conflict has intensified, food insecurity has also risen sharply, with approximately 200 million people, accounting for 18% of the population in these regions, facing acute food insecurity. Countries affected by conflict often experience high levels of poverty and ongoing conflict slows progress in poverty reduction. Poverty, in turn, interacts with other underlying grievances to fuel instability, while conflict further deepens economic hardship.

United Nations Security Council

At a United Nations Security Council open debate in New York, U.N. Secretary-General António Guterres emphasised how poverty can fuel conflict.

He said: “Poverty breeds despair. Despair fuels unrest. And unrest tears at the fabric of societies — feeding mistrust, fear and violence.” Conflict, in turn, weakens already weak institutions and exacerbates poverty and food insecurity. In cases of severe conflicts, after five years, the GDP per capita drops by around 15%. It has also negatively impacted employment creation and average life expectancy.

In this manner, conflict and poverty become mutually reinforcing, creating a vicious cycle. A World Bank report suggests that although these countries face significant challenges, they have untapped potential that could reignite growth with effective policymaking. One such advantage is having a large working-age population. By 2055, around 60% of the population in areas affected by conflict or instability will be of working age, larger than anywhere else in the world.

Transforming this into growth would require investment in education, health care, infrastructure and the private sector to create employment opportunities.

Breaking the Cycle

The World Bank, through its programs, aims to provide basic services, foster development opportunities and create employment in these economies by remaining engaged during conflict and after to assist in recovery and transition. The Adaptive Social Protection for Increased Resilience Project (ASPIRE) in Haiti and the National Community-Driven Development Project in Myanmar are two notable examples.

The ASPIRE program in Haiti supports nearly 23,000 households in the department of Grand’Anse. As Haiti continues to struggle with conflict and political instability, the initiative helps strengthen its ability to cope with recurring shocks by providing it with a monthly cash transfer. The program also aimed to provide training on financial literacy and health and hygiene practices to 50% of households. It helped identify more than 100,000 vulnerable households, enabling targeted investments. It not only addressed immediate challenges but also laid the groundwork for future investments in human capital.

The National Community-Driven Development Project in Myanmar, which comprised 37,000 sub-projects, positively impacted more than seven million people in the country. Nearly a fifth of the country’s population benefited from the improved infrastructure, transportation, water supply, education and electrification. Although the World Bank halted the disbursements of the Myanmar Partnership Multi-Donor Trust Fund in 2021, it continued to monitor the situation and provide analyses.

Final Remarks

Addressing conflict can lead to growth only when immediate humanitarian needs are met and paired with long-term investment in human capital. Through the ASPIRE program in Haiti and the development project in Myanmar, the World Bank routed investments toward education, health care and infrastructure. In doing so, the World Bank sought to break the vicious cycle of conflict and poverty.

– Priya Doshi

Priya is based in Edinburgh, Scotland and focuses on Good News and Politics for The Borgen Project.

Photo: Wikimedia Commons

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How AI Systems Are Predicting Outbreaks of Malaria in Ghana

Malaria in GhanaMalaria remains a major public health challenge in Africa, causing about 95% of the continent’s malaria-related deaths. Malaria impacts many African countries, including Ghana, where pregnant women and children under 5 face the highest risk because of their lower immunity. The disease affects millions each year and deepens poverty by placing heavy financial pressure on vulnerable rural households.

Traditional malaria tracking methods often create delays because they rely on slow reporting and limited surveillance tools, which prevent health officials from responding quickly to rising cases. Recently, Ghana has begun integrating artificial intelligence into its disease surveillance systems to enhance malaria control. AI-powered malaria prediction systems, such as the District Health Information Management System (DHIMS2) and the Noguchi Memorial Institute for Medical Research (NMIMR), collect real-time health data and conduct malaria surveillance. These systems use climate information, satellite images and health reports to predict outbreaks.

Background

Ghana, located in West Africa and home to about 33.8 million people, shares borders with Burkina Faso, Ivory Coast and Togo. Historically known as the Gold Coast due to its abundant gold resources, Ghana has played a significant role in Africa’s development. Despite this history, malaria continues to affect the country heavily.

Ghana ranks among the top 15 countries with the highest malaria burden, accounting for about 5.3% of all malaria cases in West Africa. Ghana’s tropical climate provides perfect conditions for mosquitoes to breed rapidly, resulting in year-round malaria transmission. However, over the years, Ghana has introduced various malaria control strategies, ranging from early treatments such as chloroquine and quinine to modern interventions.

These include artemisinin-based combination therapies (ACTs), insecticide-treated bed nets and indoor residual spraying. Even with these efforts, malaria continues to strain Ghana’s health care system. Rural communities often submit reports late, struggle to access prevention tools and face drug resistance—factors that reduce the effectiveness of malaria control. These ongoing challenges have pushed Ghana to adopt AI-powered malaria prediction systems to strengthen early detection and reduce malaria cases.

AI-Driven Malaria Prediction Tools in Ghana

AI gives Ghana a more accurate and efficient way to understand and manage malaria. AI enhances data processing, health record management, feature identification, machine learning analysis, geospatial mapping and technical infrastructure—tools that aid researchers in studying malaria patterns more effectively. In recent years, Ghana has expanded the use of advanced AI-powered malaria prediction systems, such as the DHIMS2 and AI models developed by the NMIMR. These tools represent a major shift toward proactive, technology-driven malaria prediction.

DHIMS2

DHIMS2 serves as Ghana’s national digital health information management system, enabling health workers to collect and analyze data for enhanced health care management. Hospitals and clinics across the country upload information, including confirmed malaria cases, test results, treatment records and patient demographics. Because health workers enter data continuously, researchers and health officials can quickly identify unusual increases in malaria cases, rather than waiting for the slow processing of paper-based reports.

The platform covers every region, which helps experts create malaria risk maps, track seasonal changes and train AI models that forecast new outbreaks. By delivering fast and accurate data, DHIMS2 enhances Ghana’s ability to respond to malaria trends in real-time.

Noguchi Memorial Institute’s AI Surveillance Models

The NMIMR enhances malaria surveillance by gathering detailed data on mosquitoes, climate conditions and local disease patterns. Supported by a $3.5 million USAID grant, Noguchi researchers study malaria parasites, mosquito resistance and transmission trends.

The organization’s work contributes to the development of geospatial risk-mapping tools that combine health data with environmental factors, including rainfall, humidity, aridity and access to health care. These models help identify communities with a higher risk of malaria. Noguchi researchers also build on earlier studies that explore how climate conditions and mosquito behavior influence the spread of malaria. By producing this critical data, the NMIMR enhances Ghana’s early warning systems and improves malaria prediction.

Looking Ahead

As Ghana expands its use of AI-powered malaria prediction systems for malaria control, the country moves toward a more efficient and responsive public health system. Improving internet access, data accuracy and digital training for health care workers will further improve the effectiveness of AI tools. Partnerships with research institutions, technology companies and global health organizations will enhance Ghana’s ability to predict outbreaks in different regions.

With continued investment, Ghana can detect malaria risks earlier, direct resources to communities that need them most and reduce the incidence of new infections. Indeed, by embracing AI-powered solutions, Ghana can become a leader in modern malaria control and make significant progress toward long-term malaria reduction.

– Emmanuel Fagbemide

Emmanuel is based in Winnipeg, Canada and focuses on Technology and Global Health for The Borgen Project.

Photo: Unsplash

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Eliminating TB in Chhattisgarh Through Community Programs

TB in ChhattisgarhIn India, tuberculosis (TB) is a public health challenge that mainly affects vulnerable communities. Earlier this year, the eastern state of Chhattisgarh declared 4,106 gram panchayats (basic governing institutions in Indian villages) TB-free. The TB-Free Panchayat Program achieved this milestone by combining government action and community involvement.

Other programs, such as the Nikshay-Niramay Chhattisgarh 100-Day Campaign, intensified TB detection and treatment through door-to-door screenings and immediate diagnostic testing. TB affects the most vulnerable groups and has severe socioeconomic consequences for individuals, families and communities. For this reason, eliminating TB through community programs is a turning point for India.

The Problem

Between 2015 and 2023, India experienced a significant decline of 17.7% in TB incidence. However, 2.7 million cases were still registered in 2023. Also, the disease costs India an estimated $23 billion annually and the global TB response is underfunded.

For example, only 20% of the $5 billion research funding target was met in 2022. Most importantly, socioeconomic and health care factors affect diagnosis and treatment in the country, with often uneven progress across different areas. The main issues of national TB control are:

  • programmatic data quality
  • testing variation
  • gaps in TB preventive treatment (TPT)
  • variability in district-level performance

Consequently, vulnerable, rural, tribal and remote populations face the most significant access barriers, as distance from health facilities is a major reason for not seeking care. Although the public sector covers vulnerable groups financially, HR shortages, drug stockouts and poor diagnostics limit the services provided.

Especially among the needy, lack of trust and poor facility experience contribute to diagnostic delays and missed cases. As an example, rural districts like Niwari have poor awareness of TB and its stigma leads to delayed care. Also, for vulnerable groups, the economic burden of TB is often devastating since the spread of the disease increases unemployment.

A study based in Assam, Maharashtra, Tamil Nadu and West Bengal found that more than 50% of patients incurred catastrophic costs before diagnosis due to a nine-week delay in diagnosis.

TB in Chhattisgarh

Chhattisgarh, where about 80% of the population lives in rural areas, carries a heavy burden of communicable diseases. Tribal and remote communities face major health care barriers, including long travel distances, poor transportation, a shortage of qualified health care providers and limited diagnostic facilities. In addition, many TB cases in the state are diagnosed at secondary and tertiary health facilities, which reduces the effectiveness of household contact investigations.

A study conducted in urban slum areas of Durg district revealed that the population is particularly vulnerable due to high-density living, low socioeconomic status and limited access to structured health care.

The Solution

Chhattisgarh’s progress toward TB-free panchayats emerged from a model that placed communities, local governments and frontline workers at the center of the response. The TB-Free Panchayat Program built its strength on systematic door-to-door surveys, household contact screening and rapid referral. The program was led primarily by ASHAs (village health volunteers) who coordinated closely with gram sabhas (village-level legislative bodies) and primary health center teams.

These teams were trained to dispel stigma, identify presumptive cases and support adherence. Gram panchayats were encouraged to integrate TB activities into their regular development plans, including sputum transport and social support for vulnerable families. Special gram sabhas in tribal districts brought together youth groups, traditional leaders and TB champions.

These groups worked together to screen high-risk households. This joint effort helped communities see TB as a shared problem rather than an external medical issue. This approach produced measurable results. In Rajasthan, similar assessments showed that active case finding and community awareness reached some of the highest scores in programme evaluation, demonstrating that village-led structures can sustain screening and follow-up at scale.

Local voices in Chhattisgarh echoed this shift. Health Minister Shyam Bihari Jasiwal noted that success was possible only when society participated alongside the government, underscoring the sense of ownership communities have developed in their path toward TB-free status.

Looking Forward

Chhattisgarh’s progress demonstrates that TB can be reduced when communities take the lead in the fight against the disease. As panchayats take responsibility for screening, awareness and support, they strengthen trust and make early care possible for the people who need it most. The state’s experience proves that local leadership and consistent engagement can overcome long-standing barriers in rural and tribal areas.

With continued investment in frontline workers and community participation, Chhattisgarh can sustain these gains and serve as a guide for other states working toward a TB-free future.

– Angela D’Avino

Angela D’Avino is based in Preston, UK and focuses on Good News, Global Health for The Borgen Project.

Photo: Pixabay

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Elimination of Malaria in Suriname: A First for the Amazon Region

Malaria in SurinameOn June 30, 2025, Suriname became the first Amazonian country to achieve malaria-free certification from the World Health Organization (WHO). This accomplishment marks a turning point not only for Suriname, the 46th country worldwide to achieve this status, but also for the wider region, demonstrating that malaria elimination is possible even in challenging tropical contexts. WHO Director-General Tedros Adhanom Ghebreyesus hailed the certification as “a powerful affirmation of the principle that everyone — regardless of nationality, background or migration status — deserves universal access to malaria diagnosis and treatment.”

The 70-Year Journey to Malaria Elimination in Suriname

Suriname’s elimination efforts began in the 1950s, targeting the country’s densely populated coastal regions with indoor pesticide spraying and the provision of antimalarial treatment. By the 1960s, these regions became malaria-free, yet the forested interior, covering 90% of the country, presented different challenges. Traditional open-style homes offered minimal protection against mosquitos, and economic activity, particularly resource extraction, facilitated widespread transmission.

In 1974, Suriname decentralized medical responsibility in the interior to its primary health care service, which recruited and trained health care workers from local communities to provide early diagnosis and treatment. Investment in community-based approaches such as this would prove vital.

However, a surge in often illicit gold mining around the turn of the century threatened elimination efforts. Research across the Amazon region demonstrates strong positive correlations between mining activity and malaria incidence. Mining involves frequent travel between malaria-endemic areas, and because 75% of gold miners in Suriname are migrant workers from neighboring Brazil and French Guiana, cross-border transmission rates grew dramatically.

By 2001, Suriname recorded more than 15,000 cases — the highest transmission rate in the Americas.

Yet with the adoption of several vital strategies, cases dropped dramatically after this peak. The last locally transmitted case of Plasmodium falciparum — the most dangerous variant — was recorded in 2018, followed by the final Plasmodium vivax case in 2021. After three consecutive years with zero indigenous transmissions, Suriname was granted a certification of malaria elimination from the WHO.

How Suriname Turned the Tide

Suriname’s government demonstrated strong commitment to malaria elimination, supported by international projects such as the Global Fund and the Amazon Malaria Initiative (AMI-RAVREDA). Nationwide malaria screening was implemented, including at border crossings, to build effective surveillance mechanisms and tackle cross-border transmission.

The introduction of rapid diagnostic self-tests proved crucial in addressing malaria in remote regions, including Indigenous territories and mining zones beyond the reach of central services. The Malakit Project was vital in accelerating the decline in malaria incidence between April 2018 and March 2020 by 43%.

The ability to self-test and, if necessary, self-administer appropriate medication prevents miners from leaving work sites for treatment. The financial burden of such absence has contributed to non-adherence to treatment and the pervasiveness of the disease.

Efforts similarly focused on the training and involvement of local communities. Marthelise Eersel, who leads Suriname’s Malaria Program, explained: “everywhere where there is a community, you can train people to diagnose and treat malaria and report back to you.” Malaria Service Deliverers have provided free diagnosis, treatment and prevention services, as well as education, in areas where central health systems have struggled to reach.

Because much of the country’s mining activity is illegal and many miners are undocumented, engaging with the central health system has been difficult. Hedley Cairo, Malaria Diagnosis Coordinator with the Ministry of Health, explained that health workers are never accompanied by police on visits to mining sites, nor do they ask for documents — an approach that has built trust with vulnerable populations.

Breaking the Poverty-Malaria Cycle

Research consistently demonstrates the economic burden of malaria. Increased transmission is estimated to slow economic growth in endemic countries by 0.7% to 3% per year. The disease contributes to absenteeism, hampers children’s educational development, discourages foreign investment and tourism and strains health care systems.

In Suriname, this connection is particularly evident in the interior. Indigenous and Maroon communities suffered consistently higher malaria rates than coastal and urban areas and are among the country’s most economically disadvantaged, with 29% and 32.9% of each community living under the World Bank poverty line. Gold mining, driven by economic necessity, became both a livelihood strategy and the primary driver of malaria transmission, affecting miners and their families.

Suriname’s Minister of Health, Amar Ramadhin, celebrated that elimination “will have positive effects on our health care sector, boost the economy and enhance tourism.” The timing is significant: Suriname is emerging from a severe economic crisis, with current poverty rates at 17.5%.

Malaria elimination removes one major barrier to economic development, freeing resources and human capital for education, infrastructure and other priorities. The health care system, previously stretched thin managing malaria cases, can now refocus on other pressing needs.

A Blueprint for the Region

The Amazon region accounts for 90% of the malaria burden in the Americas, with Brazil, Peru and Venezuela still recording high transmission rates. Successful malaria elimination in Suriname offers evidence that elimination is achievable, even in climates conducive to transmission. However, regional coordination is essential to sustain elimination in the face of reintroduction threats from neighboring countries and to support other nations’ elimination goals.

Looking Ahead

Suriname’s achievement offers a replicable blueprint: community-based solutions, universal health care access, innovative approaches to reach marginalized populations and sustained political commitment. There are encouraging signs that surrounding countries are learning from this approach. The Malakit Project operates in French Guiana, and Brazil and Colombia are beginning to establish networks of community health workers in some Amazon regions. As the first Amazon country to reach this milestone, Suriname has led the way forward.

– Caroline Sheehan

Caroline is based in Edinburgh, UK and focuses on Good News and Politics for The Borgen Project.

Photo: Flickr

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Marburg Virus in Ethiopia

Marburg Virus in EthiopiaMarburg virus is a rare disease that can be spread between humans via contact with bodily fluids from another infected individual. The disease is severe and in 80% of cases fatal. The virus causes symptoms such as fever, headaches, muscle aches, rash, vomiting and more. 

The virus is most commonly found in sub-Saharan Africa. Multiple countries in this region have been affected in the past, with the most recent outbreak reported in Ethiopia. Ethiopia is a country located in the Horn of Africa, with the second-largest population on the continent.

The country has already battled multiple viruses, such as yellow fever, hepatitis, HIV and more. On November 12, 2025, a new outbreak of Marburg virus was detected in Ethiopia. This strain is reportedly the same strain that had broken out in other African countries. There are at least nine cases of Marburg virus in Ethiopia, with six confirmed deaths.

The Cause

The virus spreads to humans from infected Egyptian rousette bats. According to scientists, there is an increased risk of outbreaks as “climate [instability], as well as deforestation and urbanization, is steadily destroying the habitats of the fruit bats that harbor diseases like Marburg and Ebola…” Once the virus has infected humans, it can be transmitted to others through contact with infected bodily fluids.

To prevent transmission, experts recommended that those working in or visiting areas inhabited by bat colonies take protective measures, such as wearing gloves and masks. They also advised avoiding contact with individuals who are already infected.

Treatment

Treatments and vaccines for the virus currently do not exist. However, some vaccines are under investigation and early supportive care has also been shown to improve the survival rate of those infected. Nonetheless, multiple other countries, such as Rwanda, Tanzania and the Democratic Republic of the Congo, have experienced Marburg outbreaks but managed to control the virus in a short period through several effective methods.

This was achieved through community engagement and intervention practices, such as case management, reducing the risk of human-to-human and bat-to-human transmission (through isolation, masks and other measures), surveillance, contact tracing and more. These methods may be implemented to combat the virus in Ethiopia.

Responses

Multiple responses have been implemented to aid those who were infected, prevent transmission and eliminate the virus from the country. Various health organizations have carried out these measures:

  • Ministry of Health: The Ethiopian Ministry of Health has taken multiple measures to fight Marburg virus in Ethiopia. This includes establishing a National Task Force to aid in decision-making and resource mobilization, along with a three-month response plan. It has also been informing the public about the outbreak and conducting surveillance and response activities.
  • The World Health Organization: The WHO has also been supporting Ethiopia during this time. The organization has deployed a team of expert responders and provided the necessary medical supplies and equipment.
  • Africa CDC: Ethiopia’s molecular diagnostic and genomic surveillance capacity was immediately put to use during the outbreak. Africa CDC supported these efforts by providing sequencing equipment, PCR detection kits with Marburg-specific assays, extensive training and other resources.

– Renata Hirmiz

Renata is based in San Diego, CA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Typhoid in Bangladesh: A Bold Vaccination Campaign

Typhoid in Bangladesh: A Bold Vaccination Campaign to Counter a Drug-resistant Menace Typhoid is a highly contagious infection that typically causes high fevers of up to 39-40 degrees Celsius, along with symptoms such as headache, cough, extreme fatigue, constipation, loss of appetite and diarrhea. If left untreated, there are risks of intestinal and neuropsychiatric complications. The cause of the disease is the bacteria S. typhi, and the primary mode of transmission is through food or water that is undercooked or contaminated from contact with an infected individual.

Typhoid in Bangladesh

Typhoid in Bangladesh is endemic. In fact, there were approximately 477,518 cases of typhoid, with 7,998 deaths in 2021. According to a 2017 study, Bangladesh is one of the top five countries worldwide in terms of clinical incidence, deaths and disability-adjusted life years due to typhoid fever. Typhoid is closely linked to poverty; the highest clinical incidence occurs in poorer communities with limited access to clean water, uncontaminated food and hygienic environments.

Based on the national poverty line, Bangladesh’s poverty rate was 18.7% in 2022, according to the World Bank. Data shows that this rate has risen in recent years, with estimates projecting an increase to 21.2% in 2025. Factors contributing to this include weak labor markets, high inflation and depressed wages. Children face a disproportionately high impact. Studies in Dhaka have shown that children under 15 are at an abnormally high risk for typhoid, with elevated clinical incidence rates. This has driven the government of Bangladesh to prioritize child-focused prevention efforts.

Antibiotic Resistance: A Growing Barrier

One major factor complicating typhoid control initiatives is antibiotic resistance. S. typhi continually evolves, developing resistance to medications that were once highly effective. As of 2022, the newest strain—extensively drug-resistant (XDR) typhoid—could resist both first- and second-line treatments. Few medications remain effective, posing significant challenges for countries with limited health care infrastructure, fewer resources and higher poverty rates.

To address this, the government of Bangladesh proposed introducing typhoid conjugate vaccines (TCVs) to prevent typhoid among children. Compared to live vaccines, TCVs offer increased efficacy, stronger immune responses and the ability to be administered to children as young as 6 months. A 2024 study assessing cost-saving strategies for vaccine administration found that any rollout strategy would be cost-saving compared to current conditions.

The 2025 Nationwide Campaign

In October 2025, Bangladesh launched a nationwide vaccination campaign to protect children from drug-resistant typhoid. The monthlong campaign aims to vaccinate 50 million children between the ages of 9 months and 15 years with one dose of a TCV. The vaccine offers five years of protection, helping slow transmission among children.

The campaign specifically targets low-income areas such as urban slums and poorly connected rural regions due to the elevated clinical incidence and associated risks in these settings. Once the campaign ends, the TCV will be integrated into the national vaccination schedule in 2026 for children under 1, ensuring continued protection.

The campaign, supported by Gavi, the Vaccine Alliance, United Nations International Children’s Emergency Fund (UNICEF) and the World Health Organization (WHO), has already led to the vaccination of 38 million children across Bangladesh, despite interruptions caused by misinformation and vaccine hesitancy. As the campaign approaches its end date, some field officers and parents have voiced interest in extending vaccination deadlines to ensure broader coverage.

Looking Ahead

Overall, this vaccination campaign is a significant step toward the eradication of typhoid in Bangladesh and improving the standard of living for not only children but for the nation at large.

– Nikhil N Kumar

Nikhil is based in Lexington, MA, USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr