Archive for category: Disease

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Chagas Disease in Bolivia: A Public Health Crisis in Rural Areas

Chagas Disease in Bolivia: A Public Health Crisis in Rural Areas Bolivia is a landlocked country in South America, bordered by Brazil to the north and east, Paraguay and Argentina to the south and Chile and Peru to the west. With a population of more than 12 million people, Bolivia is one of the most culturally diverse nations on the continent, home to numerous Indigenous groups. Politically, it is a presidential republic and around 78% of its population identifies as Roman Catholic. Despite progress in democratization and economic development, Bolivia still grapples with poverty, limited access to health care in rural areas and stark regional inequalities.

When it comes to public health, Bolivia faces a unique and often overlooked challenge: Chagas disease. Caused by a parasite transmitted by blood-sucking insects, this tropical disease has quietly affected hundreds of thousands, particularly in impoverished, rural communities. Bolivia has one of the highest rates of Chagas infection in the world, making it both a public health burden and a social justice issue. This article explores the reality of Chagas disease in Bolivia and the ongoing efforts to fight it.

Chagas Disease in Bolivia

Chagas disease in Bolivia, caused by the parasite Trypanosoma cruzi, continues to pose a serious public health challenge across Latin America and Bolivia remains one of the most affected countries. The disease is widespread across Bolivia, with seven out of the country’s nine departments considered endemic, regardless of altitude. Although major international health efforts, especially those targeting insect vectors and the safety of blood transfusions, have led to a significant decline in infection rates over the past two decades, the burden is still considerable.

By 2005, Bolivia reported around 620,000 cases of infection, down from more than a million in the mid-1980s. Before large-scale control efforts began in 2000, infection rates in Bolivia were alarmingly high, with 90% of adults infected. In 2025, approximately 80% of Bolivian territory is considered endemic. Despite progress, health authorities still diagnose more than 10,000 new cases each year.

The Knowledge of Citizens

People living in rural parts of Bolivia are much more familiar with the insect that spreads Chagas disease. In many rural communities, more than 80% of people could easily recognize the vinchuca, a blood-sucking bug responsible for spreading the parasite. In contrast, only about half of the residents in cities like La Paz and around two-thirds in Santa Cruz were able to identify it correctly. Many rural communities know when it’s most active—often during hot and dry weather—and describe how it enters homes from nearby forests or hides near animal shelters. Locals also talk about its nighttime activity and blood-feeding habits. Interestingly, some communities have noticed a decline in the number of vinchucas in recent years, though the threat is still very real.

Fighting the Illness

Since 2015, Médecins Sans Frontières has been working with Bolivia’s Ministry of Health to improve care for Chagas disease, especially in remote rural areas. One of its most innovative efforts is eMOCHA, a mobile system that allows people to report sightings of triatomine bugs (vinchucas) via free SMS messages. The system uses GPS technology to send technicians directly to affected homes for fumigation and follow-up. Previously, this process could take up to a month—now it happens within days. The pilot project in Narciso Campero Province has shown promising results and may be expanded nationwide or adapted for tracking other diseases.

MSF has also provided training to rural health centers, donated medical supplies like electrocardiography devices and rapid tests and helped treat hundreds of Chagas patients in areas like Monteagudo. Its model suggests that it’s possible to deliver diagnosis and treatment at the primary care level—even in Bolivia’s most remote communities. MSF is now working on a comprehensive manual, in partnership with the Ministry of Health, to help scale the program to other endemic regions.

Looking Ahead

While often overlooked, Chagas disease remains a daily reality for many Bolivians—especially those in rural areas. With the impact of community knowledge, international support and smart technology, progress is underway. However, the road to full disease control remains long and sustained investment is essential.

– Julia Skowrońska

Julia is based in Wrocław, Poland and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Organizations Advancing Disease Prevention in Serbia

Disease Prevention in SerbiaSerbia, a country in the Western Balkans between Southeastern and Central Europe, faces many diseases. It is suffering from the dual burden of communicable and noncommunicable illnesses to the growing threat of antibiotic-resistant bacteria spreading across Europe. Health organizations are working relentlessly to strengthen disease prevention efforts in Serbia.

European Center for Disease Prevention and Control

Over the past few months, the European Center for Disease Prevention and Control (ECDC) has visited Serbia. It aims to better understand the strengths and weaknesses of Serbia’s handling of communicable diseases, antimicrobial resistance (AMR) or antibiotic-resistant bacteria.

AMR is a major global concern as antibiotic use continues. Within the European Union (EU) alone, 35,000 people die each year from antimicrobial-resistant bacteria. The visits by ECDC experts ensure that roadmaps can be produced to follow AMR trends across the country, focusing on important sectors such as public safety, human and animal health.

The ECDC organized these visits using a “One Health” approach. The approach is a collaborative, multi-sectoral goal to achieve positive health for humans, animals and the environment, recognizing that the health of these three groups is interconnected. Using the approach, the EU hopes to increase disease prevention in Serbia and throughout Europe.

In addition to supporting the One Health initiative, the ECDC visited Serbia to help strengthen the surveillance of communicable diseases. On March 18, 2025, the agency released a report on its visit outlining several key recommendations:

  • Case definition revision. Revise case definitions within Europe’s most recent legal framework to understand “notifiable” diseases at the EU level in 2025.
  • Decrease surveillance burden for data providers. An automatic “integration of clinical and laboratory data” will decrease the chance of error within the system.
  • Improve notification timelines. Hold more meetings with stakeholders to collect overviews of notifications, which will aid in the surveillance of diseases.

The World Bank Group

The World Bank Group began a Noncommunicable Disease Prevention and Control Project for Serbia to aid in improving the Serbian health system. Efforts within the project include five main goals:

  • Improving the competence of providers.
  • Increasing accessibility to services.
  • Strengthening clinical and public health services.
  • Supporting project management, monitoring and assessment.
  • Improve government response in cases of emergency.

The World Bank Group initiated the project in December 2024. Efforts in the project are primarily focused on health facilities and construction, with a secondary focus on health and a tertiary focus on public administration. While the completion ratings and results have yet to be reported, the World Bank Group has reported “satisfactory” reviews for its management and progress in achieving the project goals.

Conclusion

The initiatives taken by groups like the ECDC and the World Bank Group are the first but the most important steps in securing a healthy future for the people in Serbia and worldwide. Suppose projects like the One Health approach improve Serbia’s prevention and control of disease. In that case, the broader application of this method can improve health systems in other developing countries.

– Matthew Perduk

Matthew is based in Chantilly, VA, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Clearing Invasive Water Weeds in Senegal Fights Disease

Clearing invasive water weeds in SenegalIn rural northern Senegal, a surprising anti-poverty strategy is taking root: cutting down invasive aquatic weeds. These plants, often seen as nothing more than a nuisance, are now at the center of a low-cost, community-led solution to two pressing issues: disease and declining farm productivity. Local villages are improving public health and raising agricultural incomes by removing vegetation that hosts disease-carrying snails and turning it into compost.

Schistosomiasis: A Barrier to Health and Economic Growth

This initiative targets schistosomiasis, a parasitic infection spread by snails that inhabit stagnant water. The disease affects more than 200 million people globally, mostly in sub-Saharan Africa. Infected individuals, especially children, suffer from fatigue, stunted growth and organ damage, which limit both education and income-generating potential. Senegal’s Saint-Louis region has long been a hotspot for the disease.

However, rather than relying solely on drug treatments, researchers from Cornell University and the University of Notre Dame partnered with eight Senegalese villages to try a local intervention: vegetation removal. Over three years, communities cleared more than 400 tons of invasive aquatic weeds from rivers, lakes and irrigation points. Within months, snail populations dropped by and schistosomiasis infections among children declined significantly.

Composting Waste Into Agricultural Wealth

The removed invasive weeds were composted and used to fertilize local crops such as onions, peppers and rice. Farmers who used the compost reported better soil quality, larger harvests and reduced need for synthetic fertilizers. As Molly Doruska, lead author of the study, explained, “This is about really thinking hard about the microeconomics in the cycle of poverty and disease, really thinking hard about households making decisions and the tradeoffs that they’re facing.”

Researchers developed a bioeconomic model to estimate the long-term impact of the intervention. The results were promising: communities that participated in vegetation removal and composting saw improved household incomes and lower rates of schistosomiasis. The low cost of implementation, using only machetes, baskets and compost pits, makes it both scalable and sustainable.

Environmental and Gender Benefits

The strategy yields environmental wins as well. Clearing invasive water weeds in Senegal helps restore freshwater ecosystems, reduces erosion and improves access to water. The composted material replaces chemical fertilizers, cutting input costs and supporting soil health. The approach also has significant gender implications. In many rural households, women are primarily responsible for water collection and caregiving. With fewer children getting sick, women could have more time for farming, education or income-generating activities.

Beyond physical health, the intervention contributes to long-term social development. Reduced infection rates mean more children can attend school regularly without suffering from the fatigue or pain associated with schistosomiasis. In addition, the project has sparked environmental awareness. In participating communities, residents now better understand the link between environmental care and health outcomes and many have begun to self-organize cleanup efforts.

Scalability Across the Continent

Experts believe this “win-win-win” model could be replicated across other parts of sub-Saharan Africa where schistosomiasis and aquatic vegetation are prevalent. Since the required tools are simple and the work is labor-based, it can be easily adapted to local conditions. It also aligns with several Sustainable Development Goals (SDGs), including No Poverty, Good Health and Well-being, Gender Equality and Life on Land.

Clearing invasive water weeds in Senegal has proven that locally driven, low-cost interventions can have wide-reaching benefits. By removing harmful plants and turning them into a resource, communities reduce disease and invest in their economic futures. In the global fight against poverty, sometimes the most effective tools are machetes, compost piles and a little teamwork.

– Mamie Hirsh

Mamie is based in Berkeley, CA, USA and focuses on Good News and Celebs for The Borgen Project.

Photo: Flickr

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Diseases Impacting Egypt

Diseases Impacting EgyptEgypt, a country known for its pyramids and ancient civilizations, is facing a public health crisis. Sanitation, lifestyle habits and limited health care access, which are all characteristics of poverty, have led to multiple diseases impacting the Egyptian population. Ischaemic heart disease, kidney disease, liver disease and strokes are the prominent diseases impacting Egypt. Though these illnesses are among the top leading causes of death in Egypt, there are organizations and researchers that are successfully making a change that incorporates ending poverty.

Ischaemic Heart Disease (IHD)

IHD is the leading cause of death in Egypt. Commonly known as coronary artery disease, the AHA describes it as heart damage due to narrowed heart arteries. According to the World Health Organization (WHO), it is responsible for 129.3 deaths per 100,000 in Egypt. Poor diet and low physical activity are both factors that can cause IHD and are also caused by poverty. Low-income communities are more likely to be exposed to unhealthy lifestyles like poor nutrition and limited health care access because of financial instability.

To fight this disease and any others, poverty has to be addressed. Extending clinics to rural regions with affordable care options will help fight the problem. Community education programs will bring awareness about diseases impacting Egypt and aid prevention. To raise awareness, the Egypt Healthcare Authority and the Egyptian Society of Cardiology teamed up to start the “Discover the Undiscovered” campaign. By partnering with 45 health facilities, they have been able to bring vast awareness to this dominating disease. Not only will each of these actions help IHD victims, but it also actively combats poverty.

Kidney Disease

Chronic kidney disease has become an increasing health concern for the adult population and is high among the diseases impacting Egypt. It has become so prevalent that it is among their leading causes of death. According to the Mayo Clinic, chronic kidney disease is the gradual loss of kidney function.

Limited health care access and the lack of annual screenings result in most of their diagnoses occurring at severe stages. Issues due to poverty like contaminated water, limited health screenings and low health literacy have all contributed to the rise in kidney disease. Polluted water can damage kidneys over time, and the effects are more dangerous in areas where there is no proper filtration. In underdeveloped areas, there is a low health literacy and limited access to health care, which leads to a lack of health screenings, and results in the disease advancing. Clean water access, early screening and awareness programs are ways to fight poverty as well as addressing the rise of kidney disease.

The Egyptian Society of Nephrology and Transplantation has begun a mission to raise awareness, gain early detection and research into kidney disease. They have successfully collaborated with other medical societies to exchange knowledge and gain expertise. These efforts have made changes to health access and ending poverty.

Cirrhosis of the Liver

Another disease that is taking hold in Egypt is liver disease, more specifically cirrhosis of the liver. According to the Mayo Clinic, cirrhosis disease causes the advanced scarring of the liver. The most likely cause of cirrhosis is typically alcohol consumption or hepatitis. Poor sanitation, lack of health care access and poor nutrition are poverty factors that have contributed to the rise of this disease. 

The Egyptian Association for Research and Training in Hepato-Gastroenterology (EARTH) aims to advance research and improve treatment for the millions of Egyptians who have liver disease. They have been able to foster research that has led to improved treatment options. EARTH has organized educational conferences with other medical organizations to exchange the latest clinical practices and innovations. They also use peer networking to communicate new knowledge and discoveries that through time leads to research findings that combats this disease. With these new efforts, they are building a stronger domestic health care system by reducing the dependence on foreign aid and making treatment more affordable and accessible. 

Stroke

Strokes are also among the diseases impacting the Egyptian population. According to the Cleveland Clinic, a stroke is a disease in which a blood clot or broken vessel prevents blood from getting to your brain. Low health literacy and financial problems that feed into poverty issues have led to treatment delays, thus the acceleration of the disease. Establishing stroke-ready hospitals in rural areas as well as adapting health care access to reasonable levels will fight strokes and poverty.

The Ain Shams Neurology is an Egyptian research department that has made progress in the research and treatment of stroke victims. Ain Shams established the first stroke units in Egypt, and it remains among the leading units in the country. It has not only been able to treat and manage patients, but the department also provides education programs for students. 

Looking Ahead

The people of Egypt face numerous health concerns. The diseases impacting Egypt are in fact poverty-linked. Fighting poverty as well as disease takes time and resources that Egypt is actively trying to find. Through this hardship, there have come many organizations that have fought to help the sick. Researchers have made substantial progress with the research of these diseases, bringing unprecedented attention and progress to Egyptian health care, and in ending poverty as well. 

– Emily Herlehy

Emily is based in Denton, TX, USAand focuses on Global Health for The Borgen Project.

Photo: Unsplash

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Drug-Resistant Tuberculosis Treatment in Peru

Tuberculosis Treatment in PeruPeru, located in western Latin America, has one of the highest tuberculosis rates in the region, with 33,000 reported tuberculosis cases in 2023. However, the country is leading efforts to improve treatment.

What Is Tuberculosis?

Tuberculosis is one of the most deadly infectious diseases in the world. It is an airborne disease that attacks the lungs, but it can also affect the kidneys, spine and brain. While antibiotics are used to treat tuberculosis, some people develop drug-resistant strains, meaning the bacteria no longer respond to the usual medications.

Treating drug-resistant tuberculosis requires special medications, which can cause side effects and may take months or even years to work. In comparison, non-drug-resistant tuberculosis typically takes up to nine months to treat.

Tuberculosis Treatment in Peru

Every year, doctors in Peru diagnose around 1,500 people with multidrug-resistant tuberculosis, one of the most difficult forms of the disease to treat. The standard treatment can take up to two years and involves daily pills along with two or three injections a day. That changed in 2024, when Peru became one of the first countries in Latin America to adopt new treatments for drug-resistant tuberculosis: bedaquiline, pretomanid, linezolid and moxifloxacin (BPaLM). These regimens are shorter, take just six months and eliminate the need for injections.

This shorter treatment period comes with several benefits. Patients need fewer visits to the health center, reducing their transportation costs. It also causes fewer side effects than previous treatments. Fewer visits make it easier for people to stay in treatment while continuing to work. Peru did not implement this new treatment program overnight. Since 2023, doctors, nurses and health monitors have been receiving training on how to use the treatment, manage its potential side effects and support patients throughout both treatment and recovery.

The new regimen is also included in Peru’s National Tuberculosis Plan, which makes tuberculosis treatment free for patients. The new treatment, with all its benefits, has proven successful. More than 1,200 people have received the shorter regimen as of March 2025 and treatment success rates have increased from 60% to 90%. Additionally, dropout rates, the number of people who stop treatment, have dropped from 25% to just 7%.

Leading the Way in Tuberculosis Treatment

As a result of its success in implementing the new treatment, Peru is leading the way in tuberculosis treatment. In June, Peru held a regional meeting that brought together 20 different countries to accelerate collaboration and scale-up of the implementation of the new treatment. The meeting was held with PeerLINC, a global peer-to-peer knowledge hub for tuberculosis. About 200 clinicians and health officials participated in the meeting and the training on the new treatment.

Peru’s experience shows that with strong national leadership, targeted training and patient-centered care, even the most challenging forms of tuberculosis can be effectively treated. By cutting treatment time, reducing side effects and improving success rates, Peru is setting a new standard for managing drug-resistant tuberculosis in Latin America and globally. As other countries look to replicate this success, Peru’s progress offers a powerful example of how innovation and commitment can transform public health outcomes.

– Axtin Bullock

Axtin is based in Georgetown, MA, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Unsplash

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Palliative Peace: Cancer Patients in Syria

Cancer in SyriaThe consequences of war are immense; it impacts every aspect of life, from transportation to crop cultivation and the ash and smoke of conflict taints everything. Countrysides are ravaged, cities are turned to rubble and families are displaced, but all that is widely known; however, what is not frequently discussed is the systematic harm.

For 13 years, Syria was plagued by a violent civil war and during this time, people who had cancer found themselves in a precarious situation. Oncology institutions suffered from scarce supplies, staff and necessary medical equipment. Even in the developed world, cancer remains a prominent reason for mortality. With conflict, this issue is exacerbated and worsened.

Challenges

War affects every aspect of ontology care. For one, the ability of patients to continue financing treatment is hindered. Despite the abundance of humanitarian assistance and aid programs, many Syrians experience severe financial distress, with social support, medical insurance frameworks and affordable treatment being conspicuously absent. This burden results in treatment costs exceeding 40% of a household’s capacity to pay. However, this matter is intensified by the number of internally displaced persons living in the territories of the Idleb and Aleppo governorates. It is a structural predicament, derived from the base of all institutions being shaken by the roar of artillery.

It’s not just patients who suffer; the oncology institutions are also affected. Supplies are limited due to the logistical challenges caused by the conflict. Most advanced oncology centers are concentrated in major cities, making it extremely difficult for people in other parts of the country to access essential care. The Al-Bayrouni center in Damascus is responsible for a significant portion of care; further, such an institution is the only location in the country able to address thyroid care. Uncommon cancers can only be treated in specialized departments, which are only present in specified localities.

Confounding factors, such as cost, location and scarcity, combine to worsen the effects of cancer. These barriers prevent patients from accessing essential palliative care, allowing the disease to progress unchecked. As a result, mortality rates rise, with early-stage cancers advancing rapidly to more severe stages. Between 2019 and 2022, 61% of cancer patients in Syria were stage III or above at diagnosis, which exemplifies the issue. Even at the conception of care, the ailment is too far developed for adequate and affordable remedies, making the process easy to ameliorate.

Solutions and Aftermath

The abdication of Bashar Al-Assad has induced a dramatic shift in the domestic conditions of Syria. The underlying conditions for many of the present maledictions abated with the presence of the new administration. The newfound peace rectifies issues derived from logistical limitations; roads no longer carry the burden of armed militants and paramilitary organizations, which means that both individuals can travel with relative ease and supplies can be rendered more efficiently.

In an important administrative step, the debt of Syria has been paid for by the Gulf States, thereby allowing for additional loans from the World Bank. This exciting opportunity heralds the possibility for the revitalization of infrastructure, such as medical institutions, roads and state-sponsored welfare programs. The creation of a robust framework is not possible and, in topological terminology, a base capable of holding additional structures is now present.

If these corrections are implemented, the people of Syria will benefit greatly. Tangible societal changes could make medical care in Syria more affordable, reducing mortality rates and giving low-income populations access to essential cancer treatment. Affordable health care is a cornerstone for survival; it creates a healthier, more productive population capable of working, saving and contributing to the economy. As the conflict subsides, medical institutions could be revitalized through international support, domestic stability and strengthened oncology infrastructure.

Conclusion

Many of the challenges rooted in the conflict may begin to ease as a transitional state takes shape, fostering a fragile but hopeful peace. This shift will directly benefit people with low incomes, who will gain access to a developing market capable of meeting critical health care needs. Additionally, the rate of brain drain is likely to fall, allowing for a stable labor force. A new horizon is emerging, with a bright future dawning over a land once shrouded in darkness.

– Jackson Hufman

Jackson is based in Glenwood, MD, USA and focuses on Good News and Politics for The Borgen Project.

Photo: Flickr

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Yemen’s Pervasive Health Care Crisis: Diseases Impacting Yemen

Yemen’s Pervasive Health Care Crisis: Diseases Impacting Yemen It has been more than a decade since the Yemeni civil war has thrust Yemen into one of the most dire humanitarian crises in modern history. Many of Yemen’s hospitals have collapsed or are now severely damaged by the prolonged political crisis, plunging Yemen’s health care system into a complete state of distress. As a result of its current state of political, economic and overall societal turmoil, 15.3 million Yemenis have no access to clean water, sanitation systems or hygiene supplies, leaving the majority of citizens at risk of exposure to diseases like cholera, diphtheria and measles. With a decline in feasible hospital facilities, sanitation systems and hygiene supplies, the risk of disease exposure has become even more probable in Yemen. Below are statistics highlighting diseases currently impacting Yemen and efforts that can potentially alleviate its current health care crisis.

Neglected Tropical Diseases (NTDs)

Neglected tropical diseases are diseases that stem from a combination of environmental conditions, poor sanitation infrastructure and poor health care conditions. Malaria, dengue fever, cholera and schistosomiasis are among only some of the most common NTDs. In 2022, an estimated 110,000 cases of malaria were reported in Yemen; there were more than 2.5 million suspected cases of cholera, accounting for the largest case of cholera ever reported. There have been annual reports of thousands of cases of dengue fever. These statistics cover only a fraction of NTD cases that currently taint Yemen’s health care system and are a product of its state of political strife, while simultaneously compounding Yemen’s current humanitarian crisis. 

Malnutrition

Malnutrition is one of the current prime causes of disease risk in Yemen. More than 18 million Yemenis currently struggle with food insecurity and at least 80% of its civilians currently live below the poverty line. More than 45% of children in Yemen suffer from malnutrition and the poverty crisis has left millions of Yemenis at risk of neurological, chronic and other long-term diseases like cystic fibrosis, renal failure, congenital heart disease and neuromuscular diseases.

The Impact of the COVID-19 Pandemic

The outbreak of COVID-19 completely exacerbated Yemen’s already severe health care and economic crisis. Due to Yemen’s severed health care system, there were only six COVID-19 testing sites available, a fairly limited amount of available protective equipment and a lack of health care professionals equipped to handle the consequences of the pandemic. The disruption of COVID-19 also caused a 19.6% decline in the influx of remittances, sequentially leading to an average 20% household income reduction. While the COVID-19 crisis has since smoothed over, the economic disruption has continued to pervade civilian life, as the percentage of Yemeni civilians susceptible to acute malnutrition and long-term chronic illnesses has increased since the start of the pandemic.

Looking Forward

While tragedy still persists in Yemen, there have been many initiatives dedicated to halting its humanitarian emergency. The World Health Organization (WHO) is currently providing medical aid to around 12.6 million people in Yemen, with an emphasis on alleviating acute malnutrition, improving maternal health care and improving disease surveillance, amongst many other focuses. 

UNICEF has also contributed to efforts in increasing health care services by providing primary medical care as well as vaccines, medical equipment and training. Doctors Without Borders has brought medical professionals to Yemen to support hospitals, health facilities and governorates throughout the country as well. The organization’s doctors have also been focusing on “maternal and child health, specialist and emergency care and responding to malnutrition and outbreaks of preventable diseases such as cholera, diphtheria and measles”. Through the efforts of Doctors Without Borders, medical teams in Yemen have admitted 165,200 people to hospitals, conducted 26,900 surgical interventions, enrolled 11,900 children in feeding programs and treated 12,800 patients for measles.

While many humanitarian organizations and nonprofits have contributed to alleviating diseases currently impacting Yemen, issues persist. Sustained humanitarian aid to countries like Yemen depends on continued advocacy to keep the issue a priority for lawmakers. This support is essential for achieving long-term, measurable change.

– Ava Lachini

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

Photo: Flickr

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Fighting Poverty by Preparing for the Next Pandemic

Preparing for the Next Pandemic After the COVID-19 pandemic, the World Health Organization (WHO) and the international community are trying to prepare for the next outbreak. Epidemiologists label this future pandemic as “Disease X,” likely from one of the 25 known virus families; they estimate that it could be significantly deadlier than previous pandemics. Fighting global poverty has been central to how the international community fights against disease.

Preparing for the next pandemic supports people in low- and middle-income countries in two key ways. First, addressing systemic challenges such as pollution, deforestation and limited access to sustainable health care can reduce the likelihood and impact of future outbreaks. Second, the effects of disease tend to be more severe for populations living in poverty. The international community can help by funding existing health initiatives—particularly in tropical regions of the Americas, Africa and Asia—and by supporting efforts like the Coalition for Epidemic Preparedness Innovations’ (CEPI) 100 Day Mission, which aims to accelerate vaccine development and save lives. 

Challenges in Pandemic Planning

Experts suggest that one of the most difficult parts of improving global public health is preparing for the next pandemic before it happens. The major challenge is getting governments to invest ahead of time, despite not knowing exactly when, where or how the next major disease will strike. Caroline Buckee, professor of epidemiology and associate director of the Center for Communicable Disease Dynamics (CCDD), noted,  

“One of the confirmatory lessons for me—it’s not a new lesson—was that governments and people are reactive. And it’s very hard to get significant investment in preparedness. When it comes to pandemics, or epidemics in general, one of the hardest things about preparedness is that if you’re doing it really well, no outbreak—or only a small outbreak—occurs. Proving that you have averted an epidemic is difficult, so politically, how do you justify the investment required? It’s a really hard problem.”

One of the ways epidemiologists prepare for something that is both unpredictable and inevitable is by ranking the likeliest outbreaks to become a major issue, including “another possible Disease X, a term used to describe a currently unknown pathogen with pandemic potential.” 

Tracking Zoonotic Threats

One of the ways health experts accurately prepare is through pathogen rankings like the Priority Zoonotic Disease Lists and the Research and Development Blueprint. The Coalition for Epidemic Preparedness Innovations, in partnership with the University of California, Davis, has developed a new analytical tool called SpillOver to help predict the most likely risks.

SpillOver evaluates the likelihood of animal-to-human spillover among viruses, like the zoonotic transfer that occurred with the 2020 coronavirus pandemic. So far, the project has isolated 12 separate zoonotic diseases that are most likely to infect, ranging from Simian foamy virus to Lassa virus. SpillOver 2.0 will incorporate more data in order to more holistically analyze which diseases we need to prepare for. 

The Impact on Global Poverty

This massive effort of analyzing and preparing for the next pandemic is critical to fighting global poverty for two major reasons. First, pandemics disproportionately harm the global poor. Analysis from The Lancet found that if a pandemic of similar proportions to the 1918 influenza epidemic were to occur in 2025, there would be 62 million fatalities, 96% of which would be in lower-income countries. By contrast, investing in poverty relief helps combat disease spread through improved health systems, increased health education and more effective sanitation. 

Secondly, the fight against poverty and the effort to control pandemics are linked. The wider systemic issues that cause global poverty also increase the risk of a disease outbreak and that same outbreak developing into a full-blown pandemic. The WHO has warned that this next pandemic, labeled Disease X, “could be 20 times more lethal than COVID-19, with very high costs, possibly no vaccines and enormous social and economic impacts.” 

The most likely risk is a zoonotic disease from a tropical region, all places suffering from high poverty rates, climate change and deforestation. These three main factors increase the likelihood of a tropical animal-to-human outbreak turning into the next COVID-19. While deforestation increases the possibility of spillover, combating deforestation not only helps prevent outbreak but also can reduce poverty as well. 

Rapid Response and Vaccine Development

As daunting as this may be for the global poor, the international community and health experts are learning from the last pandemic. CEPI is leading efforts to ensure that life-saving vaccines can be made available across the developing world in as little as 100 days, compared to the traditional five-year timeline. 

Started in 2014 to help combat Ebola, CEPI also played a critical role in reducing the COVID-19 vaccine development timeline to 12 to 18 months. By focusing on increased research, development and mass production, “…CEPI has simultaneously advanced the development of 11 rapid response platforms to deploy against unknown threats, or Disease X.” Being able to predict which diseases may emerge from and affect the developing world is critical to fast-tracking vaccines, which have historically saved an estimated 154 million lives worldwide. 

Looking Ahead: A Shared Global Strategy

While preparing for the next pandemic is difficult and full of uncertainties, expert opinions suggest that focusing efforts will be critical to combating global poverty. By identifying the most likely pathogens as potential future “Disease X” threats, the international scientific community has helped concentrate resources that can be used effectively in the developing world. Hence, fighting global poverty and protecting global health appear to be essential parts of the same strategy.

– Joseph Laughon

Joseph is based in Sacramento, CA, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Flickr

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Malaria Vaccine in Burundi

Malaria vaccine in BurundiBurundi boasts of two capital cities, Gitega in Burundi’s center serving as the political capital, with Bujumbura to the southwest as the economic capital. Burundi is the second poorest country in the world as of 2025, with more than 80% of the population facing the risk of contracting malaria.

Background

Malaria is an infection that mosquitoes spread to humans, and is most commonly found in sub-Saharan Africa and other regions such as South America and Southeast Asia. While a healthy person can survive the infection, the people who face the most risk are children, the elderly, people with no prior immunity to the disease, and pregnant women. Malaria can spread from mother to unborn child, causing the child to contract the disease through birth. This can result in premature births, low birth weights, stillbirths, and miscarriages. Malaria is an epidemic disease in Burundi and the leading cause of death throughout the country, but thanks to a recent vaccine initiative, life in Burundi is taking a turn for the better.

Malaria in Burundi

According to a recent study on Burundi people accepting the malaria vaccine, nearly 55% of people surveyed expressed worry about side effects from the vaccine. People being wary of the malaria vaccine in Burundi is not surprising when considering the lack of available information about the vaccine. These fears, together with an unawareness of the vaccine at all, are the reason that the vaccine was not more readily available in Burundi.

The malaria vaccine is becoming much more available in Burundi thanks to the new Vaccine Independence Initiative. Throughout an information and exchange workshop in Bujumbura, Burundimany global health organizations sent representatives to “mobilize national decision-makers around the Vaccine Independence Initiative and to develop concrete recommendations for integrating the initiative into the country’s strategic and operational plans.” With this new initiative, the malaria vaccine will become the standard vaccination for children and adults, ensuring that everyone receives protection against the disease.

The Future

The introduction of the malaria vaccine to Burundi’s standard vaccine regimen could help to lessen malaria hospitalizations and reduce symptoms of infection. The vaccine itself is only the first step, and together with other methods of malaria prevention, it helps lessen rates of infection even more drastically.  For the people of Burundi, coupling the vaccine with mosquito nets can show a much lower rate of infection and severity of symptoms. Using the vaccine with mosquito nets and anti-mosquito spray has shown to lessen rates of infection even more.

Adding the malaria vaccine to the standard regimen that children receive has shown a 13% drop in child deaths. These statistics show that the war on malaria in Burundi is beginning to slow, and the people are on the winning side.

– Zoe Felder

Zoe is based in Charlotte, NC, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Diseases Impacting Tonga

Diseases Impacting TongaTonga is a country located in the Pacific Ocean. It is made up of about 171 islands and atolls. The nation has more than 100,000 people, most of whom live on the main island, Tongatapu. The country is known for its pristine beaches and whale-watching hub. However, Tonga is dealing with many diseases that are impacting the lives of its citizens.

Main Health Issues

The main health concerns impacting Tonga are noncommunicable diseases (NCDs), such as obesity and diabetes. Tonga has the second-highest obesity rate in the world, with more than 70% of Tongans obese. Additionally, an estimated 40% of Tonga’s population has type 2 diabetes, while 30–40% are affected by NCDs.

The leading cause of NCDs in Tonga is poor diet. Tonga is a developing country and according to the Asian Development Bank, 20% of its population lives below the poverty line. Most people cannot afford healthier food options, relying on cheap imported fat, sodium and sugar foods. Mutton flaps, in particular, are a common and affordable staple despite their extremely high-fat content. Over time, they’ve become a prominent part of Tongan cuisine, with many people developing a lifelong taste for them from childhood.

Smoking is another major contributor to the high rates of NCDs in Tonga. Tobacco use is widespread, with an estimated 30% of adults smoking and 19.5% of youths aged 10–14 also using tobacco. Cigarette use significantly increases the risk of NCDs such as cancer, heart disease and diabetes.

Among communicable diseases, Tonga experienced a measles outbreak in 2019, with more than 500 confirmed cases but no reported deaths. The outbreak affected several Pacific island nations, including neighboring countries like Fiji and Samoa. In Tonga, the outbreak began after rugby players returned from New Zealand.

Solutions

The Tongan government has taken steps to combat the NCD epidemic in the country. It has increased taxes on unhealthy foods such as mutton flaps, turkey tails, corned beef and sugary drinks. The government also plans to make healthier options (such as fish) more available.

Nongovernmental organizations (NGOs), including the Pacific Community (SPC) and World Health Organization (WHO), are also active in Tonga. They support awareness campaigns, school-based health programs and community screenings for hypertension and diabetes.

The Tonga Health Promotion Foundation, a local NGO, collaborates with government and international agencies to promote physical activity and reduce tobacco and alcohol use. These combined efforts aim to shift dietary habits and reduce risk factors contributing to NCDs in Tonga.

Conclusion

Tonga faces a severe health crisis driven by poverty, poor diets and widespread tobacco use. NCDs like obesity and diabetes are rampant, affecting a large portion of the population. While government policies and taxes on unhealthy foods help, long-term change depends on partnerships with NGOs like WHO and SPC. These efforts aim to improve public health and secure a healthier future for Tongans through education and prevention programs.

– Samriddha Aryal

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

Photo: Flickr