Archive for category: Global Poverty

Key articles and information on global poverty.

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Things To Know About the Income Gap in Italy

Income Gap in ItalyAmong European countries, Italy experiences some of the widest income inequality. A deep divide between the North and South shapes access to infrastructure, income levels and health care. Northern Italians benefit from stronger public services and higher wages, while Southern Italians often face limited resources and economic hardship. This inequality has created numerous tensions between the two sides of the country. This tension creates an imperative need to fix the income gap in Italy.

Income Gap in Italy

Italy, as a country, has experienced numerous economic hardships. Italy’s poverty rate exceeds the European Union (EU) average, with nearly one in 12 Italians living in absolute poverty. Southern Italy holds significantly less of the nation’s wealth than the North. More than two million people in the region live in absolute poverty, which is defined as having low incomes to meet basic needs such as food, shelter, education and health care.

Southern Italy holds significantly less gross domestic product (GDP) and wealth than the North. In Lombardy, a northern region, GDP per capita reaches 127% of the EU average. In contrast, Calabria, a southern region, sits at just 56%, a gap of nearly 75%. The South has historically lagged behind in industrial development. It has had limited access to both domestic and foreign markets compared to the North, deepening the economic divide.

Solutions to the Income Gap

To address the country’s income gap, the Italian government has introduced a program called Assegno di Inclusione (Inclusion Allowance). This financial support targets households with at least one member who is disabled, a minor or aged 60 or above. Eligible families can receive up to €6,000 annually (approximately $7,050), with an additional €3,360 per year (around $3,950) to help cover rent. The allowance is issued for 18 months and can be renewed every 12 months thereafter.

Another effort to reduce income inequality in Italy comes from international nonprofit organizations, such as the Italian Food Bank Network. These organizations work to combat poverty and food scarcity via charity and international coalitions dedicated to ending poverty and hunger. The Italian Food Bank collects surplus food from the supply chain and redistributes it through its network of 21 regional organizations. This system supports nearly 9,000 charitable groups across the country, helping deliver essential resources to those in need.

Conclusion

Italy’s regional income divide is more than an economic issue; it’s a social and structural issue. While programs like the Inclusion Allowance and initiatives from nonprofits like the Italian Food Bank offer relief, long-term solutions require systemic investment in Southern infrastructure, job creation and inclusive policy reform. Without bridging this gap, Italy risks deepening the economic and social rift that holds back its national progress.

– Caelan Caukin

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

Photo: Flickr

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Russia’s Resilient Petrostate: Oil Economy and Poverty Reduction

Russia’s Resilient PetrostateEndowed with vast natural resources, Russia holds significant oil and gas reserves. After the financial crisis of 1998, Russia bounced back with an average annual gross domestic product (GDP) growth of 7%. Global demand for oil and gas fueled Russia’s economic recovery. The boom in hydrocarbon revenue contributed to domestic welfare. Between 2000 and 2008, poverty levels decreased by 16%.

Russia is a leader in oil and gas production. Natural resource rents account for 16.7% of Russia’s GDP as of 2024. Around 30-50% of the federal government’s revenue comes from Russia’s hydrocarbon sector. Any abrupt change in demand for energy can stimulate economic growth or trigger a recession. The government adopted various measures and policies to create and sustain Russia’s resilient petrostate.

Stabilization Fund

Minister of Finance Alexei Kudrin set out to limit vulnerability to and dependence on volatile energy prices. Kudrin put the Stabilization Fund into operation in 2004. The Fund accumulated surplus revenues from oil production and exports. The Fund helps the Central Bank accommodate external shocks to maintain a balanced budget and reduce inflationary pressures.

When raw material prices decreased in 2008, Russian GDP shrank by 8%. This prompted Kudrin to create a buffer to withstand larger fluctuations. The Stabilization Fund was split into the National Reserve and the National Wealth Fund in 2008. Despite continued dependence on oil and gas exports, Russia maintained macroeconomic stability.

Private-Public Partnership

President Putin improved state control over natural resources in the early 2000s. While two national champions, Rosneft and Gazprom, dominate, private companies still operate in a semi-competitive environment. Independent firms help generate output and investment in new technologies and infrastructure. Novatek is now a leader in the production of LNG. The Russian style “public-private partnership” improved the ability of the energy sector to absorb fluctuations in oil and gas prices.

Russia’s Pivot to the East

China surpassed America in energy consumption in 2009, which heightened hydrocarbon demand. In the 2010s, Putin launched Russia’s “Pivot to the East.” This shift in policy emphasis to Asia required new oil and gas routes. The Russian government developed production areas in Eastern Siberia and built two vast pipeline systems. The Eastern Siberia-Pacific Ocean (2012) and Power of Siberia (2019) represented a crucial diversification of Russian export markets.

When Russia invaded Ukraine in 2022, Western governments decided to cut imports of Russian energy. This put more pressure on Russia to redirect export flows toward Asia. Robust global prices for fossil fuel commodities softened the shock of Russia’s “Pivot to the East.” Moreover, Russia overcame unprecedented trade restrictions and avoided a forced oil output reduction.

Russia’s Resilient Petrostate 

The crisis in Ukraine provoked massive Western economic and political sanctions. Oil and gas exports are instrumental in Russia’s relative economic security. A resilient petrostate, Russia recorded GDP growth of 3.6% in 2023 and managed to keep inflation in check at 7.4%. Overall macroeconomic stability allows the Russian government to fulfill the social contract with citizens.

– Alessandra Lewis

Alessandra is based in Westport, CT, USA and focuses on Business and Good News for The Borgen Project.

Photo: Flickr

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Colton Dixon Uses Music To Fight Poverty and Inequality

Colton DixonDove Award-winning music artist Colton Dixon is using his voice and platform to spread hope and alleviate poverty. He’s partnering with organizations like Mercy Ships and Compassion International, making a difference, one step at a time.

Partnering With Mercy Ships To Bring Healing

In Dixon’s song “Build a Boat,” he partners with Mercy Ships to create the music video that shows the lives of two twins being changed and the boat Global Mercy being built. Dixon hopes to open more people’s minds to the idea that they are capable of doing anything.

Mercy Ships is a nonprofit organization that builds and operates hospital ships to deliver medical care to those without access. The charity addresses poverty by providing health care essentials and care services to some of the world’s most underserved communities. Operating in countries with limited health care infrastructure, Mercy Ships offers free surgical care and dental services, as well as medical training to local professionals in developing nations.

By delivering health care to impoverished communities and training local professionals, Mercy Ships helps alleviate suffering, improve health outcomes and enhance host countries’ capacity to provide medical care.

Championing Child Sponsorship With Compassion International

Dixon has also supported Compassion International through multiple tours and by spreading the word with his music. Compassion International is a Christian humanitarian organization dedicated to releasing children from poverty through child sponsorship and holistic care. During his “Build a Boat” tour, Dixon partnered with Compassion International and celebrated 1,000 sponsored children.

Compassion International combats poverty by partnering with local churches to deliver holistic child-centered support that spans nutrition education, health care, emotional care and spiritual guidance. Rooted in a Christ-centered mission, its model reaches more than 2.3 million children in 29 countries, helping them build resilience and fostering long-term community impact. By equipping children with resources and mentorship, the charity not only improves individual lives but also creates ripple effects of change as graduates return to uplift their communities.

Dixon has also made an impact in the fight against poverty by partnering with Compassion International through various tours, including “A Night with Colton Dixon,” set for this spring. His 2023 Love and Light tour also gave children in need the opportunity to be sponsored. These events not only featured inspiring music and personal stories but also encouraged the audience to give. This resulted in hundreds of lives being transformed. By combining entertainment with support for poverty, Dixon continues to use his platform to raise awareness.

Conclusion

Through heartfelt music, powerful partnerships and a commitment to uplifting those in need, Dixon proves that advocacy doesn’t require grand gestures. It starts with using your platform to inspire action by joining forces with organizations like Mercy Ships and Compassion International. He not only changes lives but empowers others to do the same. His journey reminds us that hope, compassion and purpose-driven art can truly shape a better world.

– Karisma Polly

Karisma is based in Sunrise, FL, USA and focuses on Global Health, Celebs for The Borgen Project.

Photo: Flickr

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Healthy Learners: Zambia’s School Health Program

Zambia’s School Health ProgramA Grade 4 pupil in Lusaka coughs during maths class. Instead of sending her home, a teacher, now a trained School Health Worker, opens a tablet, runs through a WHO‑style checklist, dispenses deworming pills, logs the visit and, if needed, fast‑tracks her to a clinic. The entire effort is part of Zambia’s Healthy Learners School Health Program and averages just $1.51 per child per year, which is less than 1% of what the Ministry of Education already spends per pupil.

The Poverty Trap: Preventable Illness = Lost Learning

Worm infections, vitamin A deficiency and other routine ailments quietly siphon school days and future earnings for Zambian children. Absenteeism forces caregivers to miss work too. By moving first‑line care into classrooms, Zambia’s Healthy Learners School Health Program targets that cycle where it begins: illness that keeps kids out of class.

Clinic in a Classroom: How the Model Works

Healthy Learners partners with the Ministries of Health and Education to train and equip teachers as School Health Workers. In 598 public primary schools, more than 5,300 teachers now use a mobile app (built with THINKMD). The app mirrors physician logic to triage, treat mild conditions (deworming, vitamin A, first aid) and fast‑track severe cases to clinics, plugging schools straight into the national health system.

The Numbers That Matter

  • Reach: More than 830,000 students served, about a quarter of Zambia’s public primary school population, with a goal of 2.2 million by 2028.
  • Health Gains: A study found a 38% drop in disease morbidity, a 48% jump in both deworming and vitamin A coverage, a 22% rise in health knowledge and a 52% reduction in the odds of stunting.

These improvements mean fewer sick days now and more substantial earning potential later.

Small Price, Massive Payoff

After an initial setup cost of $10 to $15 per child, the ongoing cost falls to about $1.50 thanks to economies of scale and government integration. That frugality is why Zambia’s Healthy Learners School Health Program is financially realistic for national ownership and replicable elsewhere.

In 2022, the Ministries of Health and Education signed an MoU to scale the program nationally, embedding data systems and training inside state structures. Spring Impact highlights this “design for integration” as the core reason the model can scale without ballooning costs.

A Call to Action

Zambia’s Healthy Learners School Health Program is a ready‑made template for any country where schools reach kids more reliably than clinics.

A child walks back to class, symptoms eased, lesson saved. Indeed, one tablet tap at a time, Zambia’s Healthy Learners School Health Program is proving that health in schools is one of the cheapest, most innovative ways to fight poverty.

– Arabella D’Aniello

Arabella is based in Toronto, Canada and focuses on Good News and Technology for The Borgen Project.

Photo: Flickr

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Vaccinations in Africa: How Gavi Advances Economic Development

Vaccinations in AfricaFor decades, Africa has faced a dangerous dependency: carrying some of the world’s highest disease burdens while producing less than 1% of its vaccines. This reliance on imports has long limited access to life-saving vaccinations in Africa, slowing responses to health emergencies and straining national development across the continent.

To reshape this narrative, Gavi, the Global Vaccine Alliance, is laying the foundations for a thriving, self-sustaining vaccine economy for the continent. Through continental partnerships, investments and innovations, the international organization created to ensure vaccine security is working to transform African health policy. The goal is to shift it from a long-standing area of weakness into a pillar of long-term economic strength.

Initiating Local Manufacturing

The COVID-19 pandemic exposed the risks of global supply chain disruptions and the weakness of economies reliant on vaccine importation. Many African countries struggled to access vaccines in the early rollout, sparking calls for regional self-reliance. In response, the African Union set a bold goal: to produce 60% of the continent’s vaccine needs locally by 2040, with Gavi central to achieving that ambition.

Through initiatives like the African Vaccine Manufacturing Accelerator, Gavi is shaping markets, lowering barriers and mobilizing funding to grow production capacity across the continent. More than 30 African vaccine manufacturing initiatives are now in motion, supported by a mix of government leadership and international investment. These efforts aim to build a sustainable, locally based supply of vaccines for routine immunizations. By producing vaccines within the continent, Africa is taking direct action to reduce its dependence on external sources and strengthen its resilience against future global health crises.

The strength of Gavi’s procurement and demand-forecasting models is crucial to growing an African vaccine economy. It allows local producers to see and rely on predictable, long-term vaccine demand figures. This crucial step sustains the development of a successful and relevant supply chain of vaccines within Africa, ensuring the local industries remain viable and successful as the continent builds to its 2040 goal.

Economic Growth Through Immunization

Gavi’s core mission of expanding access to immunization has driven development in Africa far beyond vaccine manufacturing. Vaccinations across Africa continue to deliver strong economic benefits, improving public health while boosting productivity and long-term growth. Healthier populations lead to fewer missed school days, lower health care costs and higher workforce productivity. According to Gavi, every $1 spent on vaccinations in Africa yields up to $21 in economic benefit through avoided illness, improved wages and long-term growth.

Since its inception in 2000, Gavi’s efforts have helped immunize more than 800 million children, averting more than 14 million deaths. In Africa alone, since 2000, coverage of the diphtheria, tetanus and pertussis (DTP3) vaccine across Gavi-supported African countries has increased from 52% to more than 70%. By building health systems around vaccine delivery, such as training workers, investing in cold chains and digitizing records, Gavi has strengthened public infrastructure in regions where such systems are often underfunded. This progress has not only saved lives but also helped countries make strides toward the Sustainable Development Goals.

Toward a Resilient Vaccine Future

A more secure future for African public health begins with Gavi’s support for the African Vaccine Manufacturing Accelerator. This initiative not only increases vaccine supply but also strengthens regional resilience against future pandemics. This resilience, however, is seen as only the starting point for an African vaccination economic sector. The developmental transition of African nations from Gavi support to self-financed immunization programs is hoping to create not just independence but also leadership in global health manufacturing.

In this vision, Gavi in Africa is more than a health initiative; it is an economic strategy, a security policy and a development model. As African-made vaccines begin protecting African communities, the continent moves closer to a future where health equity and economic strength go hand in hand.

– Tom Finighan

Tom is based in London, UK and focuses on Business and Global Health for The Borgen Project.

Photo: Flickr

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How Zzapp Malaria Uses AI Technology To Fight Malaria in Africa

Zzapp MalariaEvery year, malaria sickens millions and kills hundreds of thousands worldwide, with most cases concentrated in Africa. In 2023 alone, there were an estimated 263 million malaria cases and nearly 600,000 deaths, with children aged 5 and less accounting for about 76% of those deaths.

Despite decades of progress, including a 38% reduction in malaria incidence and a 60% drop in mortality from 2000 to 2022, gains have stalled. Challenges such as drug and insecticide resistance, underfunding and changing climatic conditions continue to hamper efforts. As traditional tools fall short, technology to fight malaria is becoming increasingly vital.

AI as a Solution

Malaria has been eliminated in several countries that are able to carry out comprehensive control operations, particularly by targeting mosquito breeding grounds in stagnant water bodies. However, such interventions require significant investment.

To overcome these barriers, innovative initiatives like Zzapp Malaria are using technology to fight malaria. They are transforming control operations with AI and mobile tools to offer scalable, cost-effective solutions to one of Africa’s most persistent public health threats.

How Zzapp Malaria Works

Zzapp Malaria is an Israeli nonprofit startup. It uses AI-driven software to plan and execute malaria control operations, particularly larviciding and house spraying, in low-resource and urban settings across Africa.

Its approach combines several key steps:

  • Planning and mapping. Neural networks analyze satellite images to detect homes, stagnant water areas and breeding hotspots, incorporating climate and topographic data to determine optimal intervention timing.
  • Task allocation. The platform segments areas into grids and assigns them to field workers through its mobile app.
  • Field operations. App-guided teams map, sample and treat water bodies with larvicides or sprays, with real-time data optimizing interventions.
  • Monitoring. The system flags areas with insufficient treatment or high mosquito levels for rapid response.

The app works offline, supports low-end smartphones and uses icons for low-literacy users. It recognizes traditional huts and modern homes and training is simple. For many field workers, using the app is their first digital experience, empowering them with new skills.

Proven Impact and Cost-Effectiveness

  • Obuasi, Ghana. In partnership with the AngloGold Malaria Control Program (AG­AMaL), Zzapp Malaria piloted its system in 2017. A 2018 randomized controlled trial showed app-guided teams detected 28% more breeding sites with more than 90% coverage than standard methods. By 2020, a full-scale operation reduced mosquito populations by 60% in less than four months at $0.20 per person protected, compared to about $5 for traditional spraying.
  • São Tomé and Príncipe. In collaboration with the Ministry of Health, Zzapp Malaria conducted an eight month-long larviciding operation covering 166,000 people across 240 square kilometers. Results included a 75% reduction in mosquitoes, malaria cases cut by more than half and an average cost of $0.86 per person protected, dropping to $0.44 in urban areas — about twice as cost-effective as bed nets.

Zzapp Malaria remains active in Ghana, São Tomé and Príncipe and has expanded to Mozambique, Zanzibar in Tanzania, Ethiopia and Kenya. Its pilots have reached 500,000 people, with expansion agreements aiming for at least five million.

Recent Developments

  • Ghana. In April 2025, The Ghanaian Times reported that AGAMal and Zzapp Malaria’s tools reduced malaria prevalence to about 1% in Obuasi East.
  • Mozambique. Following a successful pilot in Maputo with Mozambique’s National Malaria Control Program (NMCP) and Goodbye Malaria, Zzapp Malaria is preparing a nationwide urban rollout.
  • Zanzibar. Drone integration trials are underway, using drone maps and LiDAR to identify breeding sites. Zanzibar’s Ministry of Health has implemented this project as part of the spatial intelligence system funded by the Bill and Melinda Gates Foundation through the Innovative Vector Control Consortium (IVCC).

Why Zzapp Malaria’s Solutions Matter

Despite large global investments, conventional tools often fall short and progress has stalled. Technology to fight malaria, like Zzapp Malaria, enables task-shifting to community health workers while enhancing surveillance, diagnosis and treatment. Its AI-powered mapping, targeted larviciding and drone-assisted detection fill key gaps:

  • Cost-effective interventions. Optimize resources where funding is limited.
  • Complementary strategies. Strengthen existing interventions facing resistance.
  • Enhanced operations. Improve data-driven decision-making in challenging contexts.

Zzapp Malaria exemplifies the transformative potential of technology to fight malaria through digital health solutions:

  • Technology as a solution. AI and drones directly reduce mosquito populations and malaria cases.
  • Scalability and cost-effectiveness. Proven impact at minimal cost.
  • Empowerment. Tools designed for low-literacy, low-infrastructure settings democratize access.
  • Evidence-based results. Peer-reviewed studies and credible media confirm its effectiveness.

In a world where malaria continues to claim hundreds of thousands of lives each year, Zzapp Malaria shows how technology to fight malaria can provide scalable, cost-effective solutions to one of the world’s most persistent health challenges.

– Jacobo L. Esteban

Jacobo is based in Cali, Colombia and focuses on Technology and Politics for The Borgen Project.

Photo: Flickr

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Community Programs in Johannesburg and Pretoria

Community Programs in Johannesburg and PretoriaIn Johannesburg and Pretoria, cities in South Africa, it’s not just the government taking an active role in fighting against poverty; the cities’ communities are also taking active steps. Several volunteer community programs in South Africa, along with help from local universities, are striving to reduce homelessness and improve the lives of impoverished individuals in Johannesburg and Pretoria.

From setting up life training sessions and job safety nets to raising awareness through volunteer experience, the communities of Johannesburg and Pretoria are selflessly committed to poverty reduction in the cities.

U-Turn Homeless

One of the community programs in Johannesburg and Pretoria is U-turn Homeless Ministries (U-turn). The program is focused on raising awareness and correcting misconceptions about the homeless population in South Africa.

One of its most popular events involves citizens volunteering to spend a night on the streets to experience homelessness for one night. The event is done to raise awareness among citizens who are in a position to help and honor the homeless population.

The most recent U-turn event occurred on May 17, 2025, in Cape Town and Johannesburg, South Africa. The event also served as a fundraiser for homeless communities. Thanks to the strong turnout, enough funds were raised to provide 13,000 nights of shelter for 300 unhoused individuals.

The Community Work Program

One program prevalent in Johannesburg and Pretoria is the Community Work Program (CWP), which focuses on creating job safety nets for individuals. It offers many services to individuals looking for work and the unemployed youth.

The CWP helps establish mentorships to guide youth through difficult life situations and teach them how to handle them. In 2020, 43.2% of working-age youth in South Africa were unemployed. Programs like the CWP aim to reduce this number by creating safer and more accessible job opportunities for young people.

The Integrated Community Registration Outreach Program

The Integrated Community Registration Outreach Program (ICROP) focuses on reaching excluded and isolated individuals and communities. While its primary goal is inclusion, the broader objective is to reduce poverty significantly.

One of its biggest achievements was helping lower the national poverty rate from 57% to 45% in just four years. Furthermore, ICROP has also facilitated hundreds of thousands of child grant registrations and continues to expand its impact.

The University of Pretoria

The University of Pretoria (UP) stands out as a key driver of poverty reduction among South Africa’s many community programs. Indeed, UP has become a hub for integrating poverty solutions at both the local and national levels. The university has supported numerous student-led initiatives and volunteer efforts to tackle poverty in Pretoria.

It has also collaborated with international partners to address the root causes of poverty in South Africa. One example is the UP Law Clinic, which provides free legal assistance to low-income individuals. It involves law students directly in helping resolve legal issues that can trap people in cycles of poverty.

Conclusion

While the road to ending poverty in South Africa is still long and difficult, it’s encouraging to see that the fight isn’t left to the government alone. Citizens and communities across the country are stepping up with determination and compassion to drive real change.

– Russell Bivins

Russell is based in Phoenix, AZ, USA and focuses on Good News for The Borgen Project.

Photo: Flickr

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Education Reforms in Mexico

Education Reforms in MexicoIn the late ’80s and early ’90s, then-President Carlos Salinas de Gortari launched a nationwide program to modernize Mexico’s education system. He aimed to achieve this by improving textbooks and reforming the curriculum, all while continuing to work to close the equity gap. Since then, successive administrations have attempted various methods of improving educational outcomes, including the expansion of public universities and the establishment of compulsory basic education.

The current President of Mexico, Claudia Sheinbaum, took office in late 2024 and has since introduced a series of education reforms. These education reforms in Mexico fall under the Comprehensive Plan of the National Baccalaureate System, part of the New Mexican School framework originally developed by former President Andrés Manuel López Obrador. The plan is built on three core pillars:

  1. Comprehensive strengthening
  2. Integration
  3. Expansion

Comprehensive Strengthening

Sheinbaum aims to modernize the curriculum through conversations with educators and the establishment of educational equity programs. To achieve these goals, her administration would implement two programs: the Benito Juarez Universal Scholarship and the extension of the School is Ours program.

The Benito Juarez Universal Scholarship encourages students to enroll in upper secondary school by providing financial support to more than 5.6 million secondary school students. In the same vein, Sheinbaum plans to invest around 4.6 billion pesos (about $243 million) into the School is Ours program, which will ultimately benefit more than 6,000 schools nationwide by improving educator salaries and encouraging community involvement.

Integration

In addition to providing scholarships, the plan consolidates the existing 31 systems of secondary education into two: the National General Baccalaureate and the General Technological Baccalaureate. The unification brings about various benefits, including the reduction of administrative barriers when transferring between schools, easier transfer processes for students and teachers and equity in the quality of education.

As a part of the plan, the two systems of education will be validated by the National Polytechnic Institute and the National Technological Institute of Mexico, thus simplifying the transition between secondary and higher education.

Expansion

Sheinbaum hopes to expand educational offerings throughout the nation in an effort to increase equity and access. Through the plan, her administration sets forward to create 37,500 new spaces for students in upper secondary schools. She plans to achieve this by erecting 20 new high school campuses and expanding 30 already-existent but high-in-demand campuses.

In addition, 35 secondary schools that currently only offer morning classes will be converted to afternoon and evening schools, allowing more students to attend at flexible hours. By the end of six years, Sheinbaum hopes to have created more than 100,000 high school spots and 330,000 university slots.

Final Remarks

Though Sheinbaum has only been in office for a few months, her administration has made tangible progress in expanding educational access. With her six-year plan in action, she seeks to create an education system built on unity and equity. Suppose she continues to progress as she has in these past months. In that case, Mexico is on the way to ensuring quality education for its people.

– Ariana Wang

Ariana is based in Dallas, TX, USA and focuses on Technology and Solutions for The Borgen Project.

Photo: Unsplash

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The Hidden Burden of Depression in Africa

Depression in AfricaDepression is a word that embodies profound pain, despair and societal stigma. Despite growing mental health awareness, mental illness remains misunderstood as a sign of personal weakness. The reality is that depression can lead to suicide, which claims more than 700,000 lives worldwide every year. Treatment-Resistant Depression (TRD), a subset of major depressive disorder unresponsive to at least two treatments, affects approximately one-third of depression sufferers, raising suicide risk and posing a global concern.

In Africa, the situation is particularly acute. The continent has the highest suicide rate in the world, at 11 per 100,000 people, compared to nine globally. It is estimated that more than 20 million individuals in Africa have depression, representing 9% of the global burden. North, West and Central Africa are particularly affected, grappling with fragile health care systems, conflicts, stigma and limited mental health services.

The Central African Republic (CAR) has one of the highest suicide rates worldwide, often linked to untreated depression. In contrast, Nigeria has more than seven million sufferers. Even in better-resourced countries like Egypt, Tunisia and Morocco, depression rates remain high.

Africa’s Mental Health Crisis

Mental health systems in Africa are underfunded. African governments allocate less than $0.50 per person annually to mental health. This is far below the recommended $2 per capita for low-income countries. In 2020, only 94 mental health outpatient visits were recorded per 100,000 people compared to 2,001 worldwide, indicating a lack of formal treatment access for most Africans with mental health issues.

In West and Central Africa, psychiatric hospitals are scarce and located in large cities. The situation is further complicated by conflicts in Mali, the Democratic Republic of Congo (DRC), CAR and Libya, where many health facilities have been destroyed or are difficult to access. On average, sub-Saharan Africa has just one psychiatrist per million people. Specialists are often concentrated in capitals or major cities, leaving rural populations underserved. Patients usually face long-distance travel costs to tertiary hospitals, which are cost-prohibitive for many and rely on general practitioners with limited psychiatric training.

Furthermore, antidepressants and psychotropic drugs are often out of stock or unaffordable for many patients. According to the WHO, more than 75% of people with mental disorders in low- and middle-income countries, including most of Africa, receive no treatment for depression. Second-line TRD treatments, such as atypical antipsychotics and dopaminergic drugs, are rarely stocked in public health facilities or private clinics in Sudan, South Sudan, Niger, Mali and CAR. Even in Nigeria, Uganda and Ghana, which have better health care infrastructures, access to these treatments remains limited to tertiary referral hospitals in major cities, with frequent shortages.

Initiatives Addressing Mental Health in Africa

Despite challenges, promising efforts are underway, from policy reforms to community-led interventions.

  • Policy Reforms. Several countries have begun updating policies to prioritize mental health. Nigeria, for example, passed its first national Mental Health Act in 2023, replacing the colonial-era lunacy law. The legislation aims to improve access to mental health services and protect patients’ rights. It includes the creation of a Mental Health Department within the Ministry of Health and integrating mental health services into primary care. The Act also prohibits discriminatory and outdated practices like chaining or arbitrarily detaining individuals with mental disorders.
  • Community-Led Initiatives. StrongMinds, an NGO operating in Uganda and Zambia, uses group interpersonal therapy led by trained lay counsellors to address depression, particularly among women in low-income communities. Since 2013, StrongMinds has treated more than one million people. Addressing untreated depression helps break cycles of poverty, food insecurity, trauma and disruption. Strongminds also works with governments and other NGOs to incorporate mental health services into food security, health care and education programs. It intends to expand across Africa over the next decade. The International Medical Corps (IMC) also plays a crucial role. In Mali, IMC supports more than 100 health facilities and mobile clinics across northern and central regions. The IMC provides primary and mental health care. It offers psychosocial support alongside services for gender-based violence and nutrition. In CAR, IMC provides mental health consultations through health centers and mobile clinics in underserved areas, trains local health workers and community leaders to support those in distress and publishes educational booklets on mental health. IMC also collaborates with National Ministries of Health and Community-Based Organizations, ensuring its integrated Mental Health and Psychosocial Support (MHPSS) efforts respond to crises and build long-term resilient communities.

Conclusion

Depression in Africa is not just a personal struggle but a public health emergency driven by limited funding, poor access to care and deep-rooted stigma. With suicide rates among the highest globally and millions untreated, the call for action is urgent. Expanding community care, improving mental health training and ensuring access to essential medications are critical.

– Juliette Delbarre

Juliette is based in London, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Ending Mother-To-Child HIV Transmission in Botswana

Mother-To-Child HIV TransmissionIn a landmark achievement for global health, Botswana has become the first country with a high HIV burden to earn the World Health Organization’s (WHO) prestigious Gold Tier certification for eliminating mother-to-child transmission (MTCT) of HIV. As of 2023, Botswana has reduced vertical HIV transmission rates to just 1.2%, with fewer than 100 babies born with HIV annually. This is a remarkable feat given the country’s previously severe HIV epidemic.

A Triumph Against the Odds

Botswana has long been one of the nations hardest hit by HIV/AIDS, with adult prevalence rates among the highest in the world. Yet, through committed public health efforts, the country has demonstrated that even in high-prevalence settings, eliminating new pediatric HIV infections is achievable.

The WHO’s Gold Tier status is awarded to countries that meet rigorous criteria for the elimination of mother-to-child transmission, including maintaining transmission rates below 2% and sustaining this achievement over time. Botswana’s attainment of this status is a testament to its effective health policies, strong political will and dedicated community programs.

Keys to Success: Universal Treatment and Comprehensive Care

Central to Botswana’s success has been the provision of universal free antiretroviral treatment (ART) to all pregnant women living with HIV. This policy ensures that pregnant women receive the medication necessary to suppress the virus, drastically reducing the chance of passing HIV to their babies.

Moreover, Botswana boasts high rates of antenatal care attendance and widespread HIV testing among pregnant women. Early diagnosis and continuous monitoring throughout pregnancy enable timely intervention and care adjustments, maximizing the chances of a healthy, HIV-free birth.

Complementing clinical care, robust community-based health programs have played a critical role. These programs provide education, support and follow-up services, ensuring that women stay engaged in treatment and adhere to prescribed regimens.

A Model for the World

Botswana’s achievement in reducing mother-to-child HIV transmission not only saves countless children from HIV but also offers a blueprint for other countries facing high HIV burdens. It challenges the notion that eliminating vertical transmission is unattainable in resource-limited, high-prevalence environments. The country’s success underscores the power of integrating free, accessible health care services with community engagement and strong political commitment. It also highlights the importance of sustained investments in maternal and child health programs.

While Botswana’s milestone is cause for celebration, continued vigilance is essential. Maintaining low transmission rates requires ongoing support for pregnant women, access to ART and community outreach. Indeed, Botswana’s experience demonstrates that with the right strategies and resources, the goal of an HIV-free generation is within reach, even in the most challenging settings.

As global health organizations and countries worldwide strive to eliminate pediatric HIV, Botswana stands as a beacon of hope, proving that with determination and comprehensive care, vertical transmission of HIV can be stopped.

– Meagan Beaver

Meagan is based in Zephyrhills, FL, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr