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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

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Abidjan Cholera Outbreak: A Preventable Crisis Fueled by Poverty

Abidjan Cholera OutbreakOn the muddy quay of Vridi Akobrakré, a small fishing village just outside Abidjan, the economic capital of Côte d’Ivoire in West Africa, a Red Cross volunteer pours treated water into the hands of a mother. Her children splash barefoot in a stagnant lagoon, unaware that just days earlier, three of their neighbors died from severe diarrhea. At this moment, the Abidjan cholera outbreak is more than a headline. It is a preventable crisis, driven by poverty and poor sanitation.

The Abidjan Cholera Outbreak and Emergency Response

On June 5, 2025, the Pasteur Institute identified Vibrio cholerae in the water. This bacterium causes cholera, a severe diarrheal disease that can be fatal within hours if left untreated. Health authorities immediately confirmed a cholera outbreak in Abidjan — the first in 15 years. The rainy season had just started, with flooding quickly spreading contaminated water. The dense housing of the most impoverished neighborhoods further fueled the outbreak, resulting in 491 confirmed cases and 20 deaths.

The government executed a swift emergency response. Water trucks delivered clean water to affected neighborhoods and temporary treatment centers opened for rapid patient care. Local health teams collaborated with the World Health Organization (WHO), which provided support for water treatment, chlorine distribution and hygiene education. NGOs such as UNICEF and the Red Cross established hand-washing stations and trained volunteers to monitor symptoms within the community.

Poverty and Neighborhood Vulnerability

Vridi Akobrakré, where the bacterium was first confirmed and similar informal settlements around Abidjan remain highly vulnerable. Homes are built above lagoons and most have no latrines or sewage systems. Flooding spreads contaminated water through streets, schools and marketplaces.

Poverty compounds the risk. Families cannot afford safe water and crowded homes make it difficult to maintain proper hygiene practices. The repeated vulnerability of these neighborhoods shows that emergency measures alone cannot prevent future outbreaks. Without structural changes, cholera will continue to strike the poorest communities.

NGO Response and Preventative Solutions

NGOs play a crucial role in addressing immediate risks and building resilience. The Red Cross distributes chlorine tablets and treats water points. UNICEF runs hygiene campaigns in schools and markets. Médecins Sans Frontières operates mobile treatment centers and trains rapid response teams. Experts report that ongoing monitoring, broader distribution of hygiene kits and public awareness campaigns are essential to prevent future outbreaks.

Preventing another cholera outbreak in Abidjan also requires long-term investment. Governments must build sewage networks, drainage systems, formal latrines and pipe clean water for low-income neighborhoods. Equitable urban planning and continuous hygiene education help communities adopt safer practices. Subsidized access to safe water, community sanitation programs and strengthened health systems, along with the establishment of surveillance and rapid response teams, are crucial.

Since the cholera outbreak began, hygiene campaigns have reached thousands of schoolchildren, teaching proper handwashing and safe water practices. Early signs suggest these interventions are slowing the spread of cholera. However, experts warn that without continued support and infrastructure improvements, outbreaks will recur.

Turning Crisis Into Change

Back in Vridi Akobrakré, the mother dips her children’s hands into treated water and watches volunteers continue their rounds. For families affected by the Abidjan cholera outbreak, clean water remains fragile. But the crisis has sparked meaningful action. Community volunteers are now trained to monitor symptoms, treat contaminated water and educate their neighbors on proper hygiene.

NGOs continue to distribute chlorine tablets, hygiene kits and set up hand-washing stations in schools and markets. If governments and international partners invest in sanitation, infrastructure and poverty reduction, these efforts can become permanent. Safe water systems, drainage improvements and community-led education programs could protect residents from future outbreaks.

What began as a tragedy is turning into a blueprint for resilience, showing that even the most vulnerable communities can lead the way when crisis meets coordinated action.

– Tina Kusal

Tina is based in Montrose, CA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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The Last Mile Against River Blindness in Cameroon

river blindness incameroonIn the rugged highlands of western Cameroon, a silent threat loomed for decades: Onchocerciasis or “river blindness.” Transmitted by the bite of blackflies breeding in fast-flowing rivers, the disease causes severe itching, skin changes and, in its most advanced form, irreversible blindness. For communities living along the valleys of the Meme and Mbam rivers, onchocerciasis did not just affect health; it hampered schooling, work and development in already impoverished areas.

Background

Cameroon has long been an endemic country for onchocerciasis. Indeed, a geospatial modelling study of Africa and Yemen estimated that, as of 2018, national-level infection prevalence in Cameroon exceeded 5% and in some focal regions was much higher.

In response, Cameroon launched community-directed treatment with ivermectin in 1996 under the World Health Organization’s African Programme for Onchocerciasis Control. After APOC ended in 2015, the country continued elimination activities through the WHO’s Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN), which now coordinates regional support.

Mass Drug Administration

At the heart of Cameroon’s strategy has been annual mass drug administration of ivermectin delivered through community-directed treatment. Over 15 years of campaigns in several districts have sharply reduced infection levels. In the Tombel Health District, for instance, after 15 consecutive years of treatment, microfilaria prevalence fell to 1.5% and nodule prevalence to 6%, indicating progress but not full interruption of transmission
Yet, remote mountain villages present persistent challenges. A 2024 study along the Cameroon–Chad border noted that onchocerciasis transmission remains ongoing despite decades of CDTI.

Localised vector habitats, seasonal migration of workers, and gaps in treatment coverage are among the underlying factors. A detailed study in the Meme River Basin highlighted how poverty, farming occupations, housing conditions and limited health seeking behaviour all hamper elimination efforts.

Community-Directed Distributors

Community health volunteers, called community-directed distributors (CDDs), carry the burden of delivering ivermectin and tracking treatments in hardscrabble terrain. But their efforts are constrained by low motivation, logistical bottlenecks and limited training. A qualitative study in three rural districts of Cameroon found that inadequate numbers of CDDs and weak understanding of the disease among health staff hamper progress.

Despite these challenges, when coverage is high and sustained, the health benefits are profound. People treated with ivermectin experience relief from itching, healing of skin lesions and prevention of visual impairment, according to the World Health Organization (WHO). In Cameroon’s Meme River Basin, researchers also found that annual community-directed treatment improved productivity and reduced stigma around the disease.

The Future

Progress in Cameroon against river blindness shows how persistence pays off. National health authorities continue annual community-directed ivermectin campaigns with support from the WHO’s Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN). The country also participates in regional cross-border monitoring with Chad and Nigeria to track transmission and share data.

According to the WHO’s ESPEN program, several health districts in Cameroon have already transitioned to post-treatment surveillance after interrupting transmission, marking key milestones toward national elimination.

– Katie Williams

Katie is based in England, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Healing the River: Schistosomiasis in São Tomé and Príncipe

Fighting Schistosomiasis in São Tomé and PríncipeSchistosomiasis or bilharzia thrives where people lack safe water and sanitation. Schistosomiasis remains endemic in São Tomé and Príncipe, primarily caused by Schistosoma intercalatum. The World Health Organization (WHO) classifies the country as requiring preventive chemotherapy, indicating ongoing transmission. Despite multiple rounds of mass drug administration, the disease persists in certain communities, particularly near streams and rice fields, where children remain at risk. Ongoing surveillance is essential to monitor and address localized transmission hotspots.

A Low-Level but Stubborn Threat

Recent studies confirm that São Tomé and Príncipe maintains a low but persistent level of schistosomiasis transmission, primarily caused by Schistosoma intercalatum. According to research published in PLOS Neglected Tropical Diseases in 2023, national prevalence remains low following repeated rounds of mass drug administration and health education campaigns. Ongoing surveillance continues to identify limited transmission in certain communities, underscoring the need for sustained control measures under World Health Organization guidance.

Momentum Since 2014

After a nationwide mapping survey in 2014, the Ministry of Health launched preventive chemotherapy with praziquantel in schools. In 2015 alone, more than 31,000 school-age children received treatment—an essential step to cut infections and protect those most at risk. Continued surveillance has turned up only sporadic cases, including a rare neuroschistosomiasis report in 2020, underscoring why vigilance still matters even as prevalence drops.

A 2024 Milestone: Halting Mass Drug Administration

Regional partners now point to a major achievement. The WHO Africa region’s ESPEN program reported in its 2024 annual review that São Tomé and Príncipe halted mass drug administration (MDA) in all endemic implementation units, marking a key waypoint toward elimination. ESPEN’s 2025 data updates also list STP among countries that did not conduct MDA in 2024, consistent with a transition from blanket treatment to targeted surveillance and response.

Water, Sanitation and Hygiene: The Long Game

Treatment alone cannot finish the job. Lasting gains depend on safe water, sanitation and hygiene (WASH) so people aren’t re-exposed to rivers and irrigation canals. UNICEF reports recent WASH actions in STP, including strengthening handwashing behaviours and coordinating a multisectoral WASH platform—efforts that protect families from schistosomiasis and other infections. Global JMP updates from WHO/UNICEF show why this matters: many health facilities and households worldwide still lack basic WASH services, a gap that sustains NTD transmission.

What’s Needed Next

São Tomé and Príncipe continue national efforts aligned with World Health Organization (WHO) guidance to control schistosomiasis. Current work includes post–mass drug administration monitoring, integrating surveillance into primary health care and coordinating with education and water agencies to sustain prevention gains. The Ministry of Health, with support from WHO and international partners, maintains praziquantel distribution in areas where transmission remains and tracks infection data to guide control strategies. These ongoing initiatives reflect the country’s commitment to meeting the WHO’s 2030 targets for neglected tropical diseases.

Why it Matters

Eliminating schistosomiasis saves children from anaemia, abdominal pain and missed classes, and it strengthens primary health care. With MDA paused and WASH investments growing, São Tomé and Príncipe has a real shot at stopping transmission. Sustained funding for surveillance and water infrastructure can help the islands turn a quiet success into a permanent victory.

– Katie Williams

Katie is based in the United Kingdom and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Diseases Impacting Chile

Diseases Impacting ChileKnown for its long coastline and diverse landscapes, Chile has made significant strides in public health, with an average life expectancy of 81 and continued progress in reducing infant mortality. However, the nation continues to face public health challenges. These include a difficult COVID-19 response, high numbers of cancer deaths and ongoing problems with cardiovascular disease. Here is more information about the diseases impacting Chile and efforts to address them.

Cancer Progress

In recent years, cancer has rivaled cardiovascular disease for the title of leading cause of death in Chile, with 31,440 reported cancer-related deaths in 2022. In response to cancer being one of the most persistent diseases impacting Chile, the government has implemented multiple policies to fight the disease. The government passed laws to lower tobacco use, increase the number of HPV vaccines and facilitate more cancer research and clinical trials within the country.

In 2018, Chile implemented a national cancer plan. The plan focuses on shortcomings in prevention, diagnosis and treatment for patients across the country. Officials saw success with the formation of a national cancer registry and the existing tumor banks, with one example being roughly 700,000 cholecystectomies being performed since the start of the plan.

Cardiovascular Disease Concerns

Heart disease remains one of the leading causes of death in Chile, at around 25% of all deaths. According to the World Health Organization (WHO), this number was 33,504 in 2023 – an increase in deaths from 2019. Significant risk factors like hypertension, which affects nearly one in four adults in the country, are often unknown to patients and lead to an increased risk for Cardiovascular Disease (CVD). 

The Chilean government has embarked on a mission to increase awareness of hypertension and CVD as a whole. In 2013, the country partnered with the Pan-American Health Organization (PAHO) and the United States’ Centers for Disease Control and Prevention. Across the greater South American region, over three million people have received treatment for hypertension as a result of these partnerships. Concrete successes include the creation of public hypertension clinics, expansion of health coverage in the country and increased data collection to ensure patients are identified before cardiovascular disease can develop.

COVID-19 Difficulties

Chile never established a national lockdown, leading quarantine guidelines to be inconsistent in different localities. With more than 5 million total cases and more than 64,000 deaths, Chile was one of the most affected nations in South America. As recently as 2022, the country saw 13,433 COVID-19 deaths, despite having a vaccination rate of 94.62%. 

Although COVID still poses a risk, Chile has demonstrated its ability to mobilize quickly when it comes to vaccinations. The success of vaccine distribution, combined with low vaccine skepticism in the country, means that Chile is equipped to respond more effectively to the next potential pandemic.

Looking Ahead

Chile’s proactive public health policies and investment in health care infrastructure offer a model for other developing nations. The few diseases impacting Chile still have a grip on the population, with preventable deaths in cancer and cardiovascular disease making up more than 50% of deaths in the country. However, Chile has reasons to be optimistic, with progress being made each year when it comes to infrastructure and research in combating these issues. 

– Benjamin Pugh 

Benjamin is based in Kansas City, MO, USA and focuses on Good News and Politics for The Borgen Project.

Photo: Flickr

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COPD Underdiagnosis in Latin America: Challenges and Solutions

COPD Underdiagnosis in Latin AmericaThe PLATINO and PUMA studies from 2002 and 2016 outlined the rate of Chronic Obstructive Pulmonary Disease (COPD) underdiagnosis in Latin America. The data highlighted the importance of early intervention in minimizing the economic and social fallout associated with this respiratory illness.

COPD is caused by damage to the lungs. It can be a consequence of smoking or exposure to air pollutants from biomass fuels. According to the World Health Organization (WHO), the overwhelming majority of deaths of people aged 70 and younger from COPD take place in low- and middle-income nations.

Who Is at Risk?

In Puno, Peru, on the shore of Lake Titicaca, women’s risk of developing respiratory issues due to daily use of biomass fuels is 55%. In Colombia, older men who smoked or were exposed to wood smoke for more than 10 years were more likely to develop COPD. The findings of the 2016 PUMA study, which focused on primary care in Argentina, Colombia, Venezuela and Paraguay, revealed underdiagnosis of COPD in more than 70% of cases. The most affected group included younger men with low educational levels and no prior testing.

Consequences of COPD Underdiagnosis in Latin America

The burden created by the underdiagnosis of COPD in Latin American countries can turn into an even heavier burden that those already struggling with poverty cannot afford:

  • Productivity and work gaps decrease the earning power of people affected and their employers, placing most of the economic burden on the families of the sick.
  • A person whose COPD is more severe due to a lack of early treatment can expect higher health expenses due to the need for hospitalization. In Brazil, the cost of treatment rose from $5,891 in 2010 to $13,181 in 2015.
  • The rate of in-hospital mortality due to COPD in Mexico, Brazil and Argentina continued to rise significantly through the ’80s and ’90s. However, in Brazil, the mortality rate decreased by more than 25% from 2000 to 2019 thanks to local efforts.

The Challenges

In a survey by Vital Strategies and Umane, up to 62.3% of Brazilians did not seek medical attention due to several reasons. The surveyees stated long wait times, difficulties accessing specialists or underestimating the health issue. Up to 40.5% of those who did attempt to visit a doctor could not, due to extensive waiting times, lack of available doctors or proper equipment.

However, starting in 2024, the Breathe Well South America program has a plan to investigate access to primary care for people with COPD. It is being funded by the National Institute for Health and Care Research (NIHR). It’s driven by the work of the Institute for Clinical Effectiveness and Health Policy (IECS) in Argentina and several international universities.

Diagnostic Tools

Spirometers are a vital tool for the diagnosis of COPD. The test measures airflow and volume. In Latin America, it is often underused by primary care providers because of limited access to spirometers, short appointment windows and insufficient training to perform and interpret tests.

Throughout 2022 and 2023, the Brazilian Ministry of Health, in conjunction with the Hospital das Clínicas of the Federal University of Minas Gerais, began putting into place the Telespirometry System Brazil (TS-BR). The initiative aims to provide training and spirometers to specialists. As of 2024, 147 municipalities had participated in the program.

Pharmaceutical giant AstraZeneca launched Smart Spiros in Panama to improve the rate of diagnosis of COPD. Around 7,500 tests are expected to be performed by the end of 2025, which could help diagnose nearly 50% of COPD cases.

Increasing Awareness

The survey by Vital Strategies discovered that 34.6% of Brazilians questioned avoided seeking care because they assumed their health issue wasn’t serious enough to merit a visit. To combat this, World COPD Day takes place worldwide on the third Wednesday in November. It encourages health organizations to educate people about symptoms and possible treatments regularly.

In 2017, Paraguay’s Health Ministry dedicated an entire week to training, education and testing patients. This work is important because early diagnosis is crucial to preventing exacerbations that can result in costly, lengthy hospital stays.

From Underdiagnosis to Action

As of 2024, COPD was the fourth-leading cause of death globally. COPD underdiagnosis in Latin America has been a major issue that national and international organizations are working to quantify and resolve. For people living in poverty, illness and loss of income can become a crippling situation that further diminishes their earning capacity or entirely prevents them from earning a livelihood.

Despite challenges, such as a lack of education, spirometers and trained professionals, universities, international organizations and governments have come together to put into motion programs that bring much-needed solutions to the public.

– Johanna Lorena Arredondo Gonzalez

Johanna is based in Pittsburgh, PA, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Pexels

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Fighting the Silent Killer: Hypertension in Sub-Saharan Africa

Hypertension in Sub-Saharan AfricaHypertension, often called the silent killer, is surging across sub-Saharan Africa as cities expand and diets change. The World Health Organization (WHO) says more than one-third of adults in the region live with high blood pressure. Yet, many do not know they have it until they suffer a heart attack, stroke or kidney failure.

Unlike infectious diseases with obvious symptoms, hypertension can go undetected for years. Rural clinics may be miles away and often lack reliable blood pressure cuffs. Even in cities, routine screenings are rare outside hospitals. Poverty deepens the problem.

Many patients skip checkups because of travel costs or lost wages and medication can be hard to find or too expensive.

Community Health Workers Take the Lead

Governments and aid groups are training community health workers to screen residents where they live. In Kenya and Ghana, mobile teams set up at markets and churches to check blood pressure for free. When they discover hypertension in an individual, health workers give lifestyle advice and connect patients to inexpensive generic drugs.

These programs are low-cost and easy to expand, often costing only a few dollars per patient each year.

Medicine matters, but prevention depends on wider change. Public campaigns urge people to cut salt, eat more fruits and vegetables and exercise regularly. In Tanzania, radio programs and text-message reminders promote healthier cooking and daily walks. Urban planners in Nigeria and South Africa are adding walking paths and parks to make physical activity safer and easier.

Partnerships and Policy Momentum

The WHO’s HEARTS Initiative has been deployed in several low- and middle-income countries to standardize hypertension care protocols and strengthen primary care delivery systems. Similarly, regional bodies such as the Pan African Society of Cardiology (PASCAR) have collaborated with the WHO to produce the “Roadmap to Achieve 25% Hypertension Control in Africa by 2025,” guiding national hypertension policies.

National governments have adopted task-sharing and guideline frameworks under pressure from global advocacy groups. In Africa, the Innovative Epidemiology and a Vibrant Ecosystem (ACHIEVE) strategy outlines 10 strategic actions for integrating hypertension control into health systems policy. Furthermore, donor agencies and international NGOs, including Resolve to Save Lives, support the procurement of affordable medications, provide training and provide technical assistance to governments launching hypertension control programs.

Within Africa, the Centers for Disease Control’s (CDC) strategic plans emphasize strengthening partnerships, workforce development and institutional coordination across member states. These efforts aim to embed noncommunicable disease (NCD) control—including hypertension—into broader health systems.

A Vital Step Toward Stronger Health Systems

Controlling hypertension in sub-Saharan Africa strengthens health services overall. Routine blood pressure checks create chances to spot diabetes and other chronic diseases. Reliable supply chains for hypertension drugs improve access to other essential medicines. By fighting a silent but deadly disease, sub-Saharan Africa can prevent countless premature deaths and build a healthier, more productive population. This shows that tackling chronic illness is as important to development as battling infectious disease.

– Katie Williams

Katie is based in the United Kingdom and focuses on Global Health for The Borgen Project.

Photo: Unsplash

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Dr. Fairlie and the Breakthrough in the Fight Against TB

Dr. FairlieTuberculosis (TB) is a contagious disease that generally affects the lungs, but also affects other parts of the body. Prevention of TB involves screening those at high risk, treatment of cases and early detection. TB is the leading cause of death worldwide despite the bacillus Calmette-Guérin (BCG) vaccine. However, people who are already exposed to the disease are required to go through multiple antibiotic treatments over a long period of time.

More than Just Numbers

In 2023, 1.3 million people died from TB. In 2022, 10.6 million people fell ill with TB. This is a disease that has claimed countless lives and will not stop unless someone discovers a proper vaccine, and soon. As more time passes, TB becomes more resistant to the vaccines that doctors already use.

This large death toll from TB is not only due to infection, it is also due in part to the large population living with HIV as well. Of those 1.3 million who died of TB, 167,000 of those people were diagnosed with HIV. TB is also the leading cause of death among people with HIV and a major cause of antimicrobial resistance-related deaths.

Progress

Preventing the TB disease, rather than the infection, has been the main target for vaccine development. Development of an effective TB vaccine is a top global priority that many scientists have been working on for decades.

It is because of this that the paediatrician and researcher in Johannesburg, South Africa, Dr Lee Fairlie, has made it her mission to help the people in need. She has seen more than her fair share of TB-related deaths over the course of her career, mostly because of the large population of those with HIV that live in South Africa.

Though the search for a TB vaccine has been slow, researchers are making progress nonetheless. Dr. Fairlie has made it her mission not to give up, and now, she and her colleagues may be on the verge of a breakthrough.

A New Vaccine and Hope for the Future

Her team is one of the sites conducting a landmark M72/AS01E TB vaccine trial, with the help of Gates Medical Research Institute and funded by the Gates Foundation and Wellcome, which includes sites across four African countries (including South Africa) and Indonesia. At first, GSK developed it in collaboration from Aeras and the International AIDS Vaccine Initiative. M72 could possibly be the first new TB vaccine in more than a century and the first-ever to help protect adults and adolescents from the disease.

While the clinical trial is still in its early stages, M72’s initial reports have filled the team with hope. M72 reportedly had a near 50% efficacy after three years in preventing TB-infected adults from developing active disease, which would make them both sick and contagious to others.

While the results are years away, Dr. Fairlie is hopeful for the future, as this could be a step further towards a world without TB.

– Avery Carl

Avery is based in Scottsbluff, NE, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr