Archive for category: Health

Information and stories on health topics.

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3 Organizations Combating Diseases Impacting Northern Ireland

Nurse smiling with elderly patient in hospital room, highlighting care for diseases impacting Northern Ireland.
Noncommunicable diseases (NCDs), such as heart disease, diabetes and asthma, are the primary cause of death in Northern Ireland and impact low-income areas the hardest. The NCD Alliance Northern Ireland, a coalition of health care organizations dedicated to reducing the number of NCDs, reports, citing 2023 Global Burden of Disease data, that more than 15,000 people die from NCDs annually, accounting for around 89% of deaths, and that they disproportionately affect the most deprived communities.

NCDs pose a high risk for those living in poverty, which affected about one in eight people in Northern Ireland in 2024-25. Healthy life expectancy was 13.6 years shorter for males and 14 years shorter for females in the most deprived areas than in the least deprived areas. In 2024-25, approximately 12% of individuals lived in relative poverty and 12% in absolute poverty, measured before housing costs. However, U.K. health organizations work to decrease the number of NCDs in Northern Ireland through prevention and advocacy. Below are three examples of U.K. and Northern Ireland organizations combating the diseases impacting Northern Ireland.

Northern Ireland Chest Heart & Stroke (NICHS)

One of the most common NCDs impacting Northern Ireland is heart disease, but Northern Ireland Chest Heart & Stroke works to change that through prevention, direct care, research and campaigning. Some of its programs include performing Well Checks for individuals and communities, providing education programs, researching NCDs and campaigning for heart care policies. Part of its Well Checks program offers pop-ups for communities struggling in deprived areas.

Another program, Well Schools, offers preventive education about heart health for children. This preventive education can reach children in low-income communities, where “inadequate income can translate into poorer health.” NICHS’s 2024-25 Impact Report disclosed that it supported 2,807 people and provided 4,936 support activities that year.

Asthma + Lung UK Northern Ireland

Respiratory disease is another leading cause of death for those suffering from diseases impacting Northern Ireland. Asthma + Lung U.K. Northern Ireland estimates that “one in five people [in Northern Ireland] have been diagnosed with a lung condition at some point in their lives.” In 2019-23, the standardized respiratory death rate for people under 75 was about 3.3 times as high in the most deprived areas as in the least deprived areas. Air pollution is a risk factor for respiratory illness. Belfast City Council’s Air Quality Action Plan states poor air quality is often found in lower-income communities.

One of Asthma + Lung U.K. Northern Ireland’s main focuses is working to reduce air pollution. In its manifesto, Fighting for Northern Ireland’s Right to Breathe, it calls for preventive policies: the creation of a Clean Air Strategy and a Northern Ireland Clean Air Act, the creation of a Clean Air Fund for local authorities with higher levels of exposure, alongside increased and improved pollution monitoring and investment in public transportation.

Diabetes UK Northern Ireland

Diabetes U.K., the parent organization of its Northern Ireland division, is committed to reducing the number of people with type 2 diabetes and prediabetes through prevention and education. One of the main risk factors for type 2 diabetes is living with obesity or being overweight, which can make it harder for the body to manage blood sugar. The charity also links increased type 2 diabetes risk to consumption of sugary drinks, refined carbohydrates, red meat and salt. For those living in poverty, lack of funds can make access to quality and nutritious food unaffordable.

In 2024-25, approximately 10% of children and 7% of working-age adults lived in food-insecure households, making access to sufficient, varied food harder. However, teams like Diabetes U.K. Northern Ireland work to provide education and care for those with type 2 diabetes, as well as educating people without type 2 diabetes to prevent it. Though they do not provide treatment, their Live Well Hubs offer a variety of communities information and support services from local health care providers and members of the Diabetes U.K. Northern Ireland team.

Looking Ahead

Though NCDs in Northern Ireland are a common risk, these three organizations are a great example of the work to combat noncommunicable diseases. In addition to their own work, all three are a part of the NCD Alliance Northern Ireland, which advocates on the political level for policy changes that reduce NCDs. Northern Ireland Chest Heart & Stroke, Asthma + Lung U.K. Northern Ireland and Diabetes U.K. Northern Ireland are just three of many health care organizations dedicated to reducing the diseases impacting Northern Ireland.

– Brit Allen

Brit is based in Henderson, NV, United States of America and focuses on Good News and Global Health for The Borgen Project.

Photo: Unsplash

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Being Poor in Malta

Being Poor in Malta
The Mediterranean island of Malta is a holidaymakers’ paradise. Increasingly popular since the pandemic, the Malta National Statistics Office estimated that tourism generated €3,904.4 million (about $4.6 billion) in 2025. However, behind the increasing number of hotels, resorts and attractions are many who remain poor. This country is on a path to building a sustainable and prosperous future both for its tourism industry and its most vulnerable residents. Here is information about being poor in Malta.

The Stats – an Enigma

● According to the Central Bank of Malta, Malta’s GDP (Gross Domestic Product) has doubled over a decade and employment has risen from the second lowest in Europe to the second highest.
● Eurostat states that in 2025, the percentage of people at risk of poverty in Malta stood at 16.9%, which is calculated as 60% of the national median equivalized disposable income (after social support).
● The National Statistics Office reported that 19.4% of people were at risk of poverty or social exclusion in 2025.
● The Central Bank of Malta also highlights that Malta performed disproportionately poorly in the percentage AROPE compared to its GDP, with results closer to less economically developed countries.

These points of contradiction provide an interesting case example for being poor in a developed European country. While prospering economically, Malta is home to many who do not reap these advantages. Furthermore, financial thresholds are not the only way to view those who are poor.

What Does Being Poor in Malta Look Like?

Maria is a 51-year-old domestic violence victim who finally gained the courage to leave her home after years of abuse. With no financial independence due to abusive control, she was forced to rely on a homeless shelter run by YMCA Malta.

At the APS Bank 2026 Malta Sustainability Forum (MSF), panelist Christian Okyere Inkum, Residential Service Coordinator at YMCA Malta, shared Maria’s story. APS Bank has held the forum annually since 2019 in response to the UN’s 2015 Sustainable Development Goal 1 (SDG 1), to ‘end poverty in all its forms, everywhere.’ The 2026 forum endeavored to look beyond the statistics, to understand the complex and multifaceted experience of being poor in Malta. Maria’s experience exemplifies how social circumstances, such as abuse, interact with material or financial factors to sustain the conditions of poverty.

Zooming out on the unique position of Malta in the European landscape, the country is especially vulnerable to food insecurity. A small island with a population of more than half a million, it relies heavily on imports. Food supply was severely affected by COVID-19 and the Russian-Ukrainian war, which produced a rise in food costs. As a result, the percentage of Malta’s population suffering from moderate or severe food insecurity rose from 4.3% in 2019 to 9% in 2024 according to the NSO.

Yet, these statistics are complexified by factors beyond inflation. For instance, food insecurity may accompany feelings of shame and social stigmatization. Malta News calls this shame a ‘silent barrier’ to seeking support.

The Impact on Health Care and the Elderly

The World Health Organization found that in Malta, people are more likely to make a catastrophic health care payment than in most other European countries. Although all citizens have access to free health care, dental health and prescriptions are often so significant that they can limit individuals’ ability to pay for other amenities such as food.

The age group with the highest health risks are the elderly – the group with the highest proportion AROPE. In 2025, the NSO found that 28.9% of people aged 65 and over were at risk of poverty. In his study, Brian Gialanzè said that ‘The lived experiences of poverty in old age: a Maltese case’, found that alongside health costs, a rising cost of living and stable pension incomes, older people struggle to engage in an increasingly digitized world and become more isolated. Furthermore, his study highlights the particular struggles of elderly women: historically excluded from the workforce, many are left with no pension and are therefore more at risk of deprivation.

The Impact on Refugees

Another especially vulnerable group are Third Country Nationals (TCNs), in particular refugees and those without legal documentation. Refugees fleeing persecution often enter the country with minimal funds, on top of other barriers such as cultural difference and limited knowledge of the language. This can lead to being AROPE. Undocumented individuals are unable to work legally, meaning they are likely to turn to alternative forms of which frequently pay below minimum wage. Also, on top of having limited access to social services, they may be reluctant to seek support due to their insecure position in the country.

Examples like these demonstrate that poverty statistics fail to scratch the surface of the realities of being poor in Malta. The most vulnerable in Malta are impacted by both material and social factors.

Cultivating a Sustainable Future

As much as being poor in Malta is complex, creating sustainable solutions is far from straightforward. At the MSF, suggestions varied. Increased financial literacy education would mean people could make better financial choices. However, ensuring that all had the basic needs to survive might be a higher priority and reduce victim-blaming. Alternatively, cultivating community-based support systems might be more effective at tackling multifaceted problems. Here is information about what is being done now.

  • Government schemes like the Maltese Housing Benefit Scheme give special support to domestic violence victims, acknowledging the financial barriers to leaving an abusive household.
  • Organizations like the YMCA continue to work with the homeless and roofless in Malta to help them regain independence. Focused on young people, the YMCA claims that ‘education and community participation is the best medicine.’ Setting up schemes such as YMCA Leadership Academies and community centers, the YMCA takes a multifaceted approach to tackling the complex circumstances of those AROPE.
  • Foodbank Lifeline Foundation feeds around 300 families in Malta per week, targeting the basic needs of the materially deprived. Operating on the basis of donations, they offer a six week program of weekly emergency food parcels for families. This organization has existed since 2015 and has six distribution centers across Malta, such as in the capital city of Valletta and smaller towns such as Marsa.
  • The Migrant Women Association Malta (MWAM) helps female migrants to integrate into Maltese society to reduce their social exclusion. Established in 2015 and based in the town of Hamrun, MWAM offers support, advice and community networks. For example, the Sahha Community Kitchen Project empowers migrant women by enabling them to integrate into their Maltese community, gain employment experience, as well as share their native dishes.

How Increased Employment for Maltese Women Could Help

Increased employment among younger generations of Maltese women may improve retirement security over time, although employment trends alone do not establish how future poverty rates will change. The number of Maltese women aged 25-49 in employment has risen from 39.6% in 2005 to 84.7% in 2024. Retiring with their own pensions provides greater financial security and independence. According to the Central Bank of Malta, pensioner couples who are currently retiring will have half as much dependency on one pension compared with 20 years ago.

These are just a few examples of efforts and developments being made to alleviate the pressures of being poor in Malta. From projects to target specific vulnerable demographics, to widespread increased equality amongst the population, a continued culmination of different focuses allow the Maltese people to look towards a sustainable and prosperous future.

– Hattie Murdoch

Photo: Flickr

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Germany’s ODA: A Problem of Fiscal Pressure or Public Perception?

Germany’s ODA
While Germany has long been a global leader in humanitarian aid—ranking as the world’s second-largest donor behind only the United States in total financial volume—its commitment to Official Development Assistance (ODA) is now facing serious fiscal pressure. Between 2020 and 2023, Germany consistently met and exceeded the international benchmark of allocating 0.7% of Gross National Income (GNI) to foreign assistance. However, it now reflects a broader pattern observed across donor nations: federal governments are reducing overseas development spending to manage domestic budgetary pressures and expanded defense priorities that compress discretionary allocations. Here is more information about Germany’s ODA.

From Historical Compliance to Fiscal Squeeze

In the federal budget blueprint, foreign assistance allocations have experienced sustained reductions. Operating under statutory debt-brake rules (Schuldenbremse), the federal government enacted spending limits across multiple departments. Discretionary funding for the Federal Ministry for Economic Cooperation and Development (BMZ)—designated under budget section Einzelplan 23—was reduced to approximately €9.47 billion, marking a consecutive series of funding drops that brought the ministry’s share of the federal budget to an all-time low of 1.7%. Parallel constraints were placed on the Federal Foreign Office, where humanitarian aid remained 50% below 2024 levels alongside a 45% cut to long-term commitment authorizations (Verpflichtungsermächtigungen).

These reductions carry direct operational consequences for international programs. An official policy analysis by the Association of German Development and Humanitarian Aid NGOs (VENRO) notes that shrinking federal allocations directly undermine global food security, climate adaptation and crisis management budgets (the latter reduced from €710 million to €434 million). When major donor contributions decline, multilateral agencies face severe operational shortfalls. Operational assessments from the United Nations World Food Programme (WFP) document that international funding deficits have forced critical relief programs—such as operations in South Sudan and Afghanistan—to drastically scale back emergency response and reduce food distributions by 50% to 70%, leaving millions of vulnerable individuals without vital aid.

Concurrently, public opinion in Germany has shifted, with sections of the electorate questioning Germany’s ODA and international expenditures in light of ongoing domestic infrastructure and fiscal requirements.

The Autumn Window: Debates and Financial Clarifications

Parliamentary discussions are entering a decisive phase in the Bundestag, where members of the Budget Committee (Haushaltsausschuss) are negotiating final ministry appropriations during the autumn sessions.

During these periods of fiscal debate, discussions surrounding foreign assistance frequently focus on headline spending figures rather than project-level structures. A prominent case occurred regarding bilateral development projects in Peru. Public debate and online political campaigns asserted that the German federal government had provided more than €300 million in taxpayer subsidies exclusively to build bicycle lanes in Lima, contrasting this with domestic infrastructure funding levels.

Official documentation released by the BMZ and project evaluations from KfW Development Bank detailed the actual financial breakdown. Non-repayable grants earmarked specifically for sustainable cycling paths and urban transit networks in Lima amounted to approximately €20 million, aimed at reducing urban emissions and connecting lower-income suburban areas. The remaining portion of the referenced €300 million was comprised of low-interest promotional loans extended via KfW. Because promotional loans are repaid with interest by the recipient country, they represent commercial credit mechanisms rather than non-repayable taxpayer expenditure.

Measured Outcomes: Multilateral Health Investments

In discussions regarding public expenditure, policy researchers frequently assess multilateral health initiatives to evaluate tangible returns on development funding.

Germany’s multi-year engagement with Gavi, the Vaccine Alliance, represents a documented example of this financing model. Serving as a core contributor since 2006, Germany provides structured funding through allocations from both the BMZ and KfW. In addition to recurring multi-year pledges of €600 million across operational cycles, Germany allocated more than $300 million to the African Vaccine Manufacturing Accelerator (AVMA), an initiative structured to establish regional vaccine manufacturing infrastructure across the African continent.

Multilateral health data shows that these immunization programs distribute vaccines protecting millions of children against preventable infectious conditions, including measles, pneumonia, and polio. Independent epidemiological studies indicate that maintaining baseline immunization coverage stabilizes local health systems and reduces the cross-border spread of disease, mitigating the likelihood of regional health emergencies expanding internationally.

As the Bundestag concludes its budgetary allocations impacting Germany’s ODA, distinguishing repayable loan instruments from direct grants and reviewing verified outcomes in global health frameworks remain the central parameters used to analyze Germany’s international development commitments.

– Giacomo Ciavarelli

Photo: Flickr

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Cambodia’s National Health Data System Explained

Cambodia’s National Health Data System
On May 15, 2026, Cambodia’s Ministry of Health launched a new electronic Health Management Information System (HMIS) intended for rollout across all 25 provinces, aiming to address gaps in health care data and coverage. The ministry developed this initiative in partnership with the World Health Organization, UNICEF, the Clinton Health Access Initiative and the Vaccine Alliance, representing a shift toward more consistent, data-driven health care services in Cambodia.

What is HMIS?

The Health Management Information System (HMIS) is Cambodia’s national framework for collecting and using health service data. DHIS2 is the software platform on which Cambodia’s national health data system HMIS is built. Based at the University of Oslo, it allows health workers to enter data remotely.

Built on DHIS2, the national system enables data reporting from health centers to decision-makers, increasing both continuity of care and the speed at which it can be administered. The system aims to unify reporting, increasing visibility and allowing health care providers to evaluate who needs care and identify unaccounted individuals.

What Problem is This System Working to Solve?

Cambodia faces struggles with health care coverage due to lack of infrastructure, high out-of-pocket costs, low public funding, understaffing and geographical challenges. According to the World Health Organization (WHO), the kingdom faces challenges primarily in maternal mortality with a ratio of 154 maternal deaths per 100,000 live births and child nutrition with 22% of children under five stunted from malnutrition.

Tuberculosis remains a priority for Cambodia, as the World Health Organization reports that the disease impacts around one in 183 people. Prevention and treatment rely on accessible health care and the distribution of vaccinations.

According to the Cambodia National Immunization Strategy Report, underused health facilities, irregular outreach initiatives and high rates of patient dropout between vaccination doses mean that Cambodia’s immunization system struggles to reach all citizens, particularly zero-dose children. Gavi reports that children remain under-immunized, underscoring the importance of more reliable service data.

HMIS covers routine immunization, primary care and disease surveillance. According to the World Health Organization, Cambodia’s national health data system now allows health care workers to enter and access service and disease data as it becomes available with dashboard monitors to track trends and performance.

What Impact is it Having?

While the implementation of the system is still in early development, it is expected to have positive impacts on Cambodia’s health care system. In September 2026, DHIS2 hosted technical training for Cambodia, including server management training in Ho Chi Minh City. According to its report, this initiative trained participants on installation, security, maintenance and system integration.

According to Cambodia’s National Immunization Strategy 2021-2025, Village Health Support Groups can be unstandardized and often have little or no formal budget, but the new DHIS2-based HMIS gives managers real-time data and dashboards to track service use and trends. This can allow for better targeting of outreach to underserved communities.

What Impact May Occur in the Future?

According to the World Health Organization and Gavi, Gavi is investing more than $2 million to build and adapt the system, train health workers and support nationwide rollout. This initiative marks the commitment of Cambodia’s government to focus on health care and collaboration. The investment aims to strengthen Cambodia’s national health data system, though outcomes will depend on implementation.

UNICEF’s partnership builds a national DHIS2 core team, ongoing training and user manuals so the ministry can manage and expand the system independently to increase long-term national ownership and sustainability. The strategy calls for quarterly tracking of missed children from commune to district to province, and for e-registries with SMS reminders to caregivers.

Cambodia’s health care challenges remain significant, however the launch of the HMIS system with the use of DHIS2 software represents an important update. Cambodia’s national health data system can offer a potential way to reduce unreliable immunization coverage figures and help health managers direct resources toward underserved communities.

– Anna Kubiak

Anna is based in Buffalo, New York/Erie County, United States and focuses on Technology and Solutions, and Global Health for The Borgen Project.

Photo: Flickr

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How Clean Cooking Technologies Can Help Reduce Global Poverty

Clean Cooking Technologies
For millions of families throughout the world, cooking a meal can be more than gathering a few ingredients and turning on the stove. For example, families who cook with wood must find the right wood, build the fire, burn it, manage the smoke at the right point and place the food to let it cook. This process is extremely time-consuming and unhealthy, mainly for families who rely on it for every meal of the day. The World Health Organization (WHO) estimates that around 2.1 billion people worldwide cook using open fire or inefficient stoves that use polluting fuels. Household air pollution contributed to an estimated 2.9 million deaths in 2021.

Clean Cooking

Clean cooking refers to cooking technologies and fuels that meet health-based emissions standards. According to WHO, these include electricity, solar, liquid petroleum gas (LPG), natural gas, and ethanol, while some advanced biomass cookstoves can also qualify when they meet WHO’s standards.

However, easy access to clean cooking remains hard for some families, especially those living in poverty. In 2023, approximately 2.1 billion people still relied on polluting fuels and technologies for cooking. The World Bank reported that global access to clean cooking was 74% that year, but progress has slowed significantly. Many low-income families’ biggest barrier remains affordability.

The Health Effects of Polluting Fuels

When people burn solid fuels inefficiently, the process releases harmful pollutants. These pollutants include fine particulate matter that can travel deep into the lungs and enter the bloodstream. Long-term exposure to this household air pollution is associated with several diseases. Some include:

  • Stroke
  • Ischaemic heart disease
  • Acute lower respiratory infections
  • Chronic obstructive pulmonary disease (COPD)
  • Lung cancer

Women and Children: Effects on Health and Time

In many communities, women and children spend more time on household chores and collecting the cooking fuel or the wood, increasing their exposure to smoke. Due to this reason, they bear a disproportionate share of the health burden from household air pollution. Gathering fuel can cause physical exhaustion and musculoskeletal injuries. For women and children, it can also eat away valuable time that could go toward education, paid work, childcare or other productive activities.

Connection Between Cooking and Poverty

The International Energy Agency reported that Kenya increased clean-cooking access from 10% in 2013 to 31% in 2023. However, 69% of households still relied on polluting fuels. In rural areas, 84% of households used traditional biomass stoves, and 79% of rural households used three-stone stoves. More than 60% of Kenyan households spent at least 7.5 hours per week collecting and preparing fuel. These fuel-collection demands can create a burden for households with limited financial resources, especially in rural areas where access to clean cooking remains low.

Pay-as-You-Go LPG in Nairobi

One approach to this problem comes from Nairobi, Kenya. Pay-as-you-go (PAYG) LPG systems allow households to purchase cooking fuel in smaller increments instead of paying the entire cost upfront.

Making Transition Easier

Nairobi families faced difficulty affording LPG because traditional cylinders need a large upfront payment. PAYG technology allowed families to buy fuels in smaller increments through smart mobile payments.

Results of Pay-as-You-Go LPG System

The PAYG LPG program addresses the high upfront cost that can make clean cooking fuels difficult to adopt for lower-income households. The program has displayed measurable results. Researchers analyzed data from 426 PayGo Energy customers in Nairobi from January 2018 to June 2020. During COVID-19, 95% of customers who were active at the beginning of the lockdown continued using PAYG LPG. LPG consumption among the households increased from 1.12 to 1.22 kilograms per person per month, while the number of daily cooking events increased by 60%. The same WHO report compared these households with a group in Eldoret that did not have access to PAYG meters. Those households, which had to purchase LPG in larger quantities, reduced their average LPG use by 75% during lockdown.

Making Clean Cooking More Accessible

The Nairobi case does not mean that PAYG LPG will work identically in every community. The system addresses affordability by allowing households to purchase LPG in smaller increments. Other communities may require different strategies based on their infrastructure, resources and needs.

A Healthier Way Forward

Clean cooking connects several global development priorities, including health, economic opportunity and poverty reduction. However, expanding clean cooking access requires more than introducing a new technology. Communities need solutions that families can afford, access reliably and incorporate into their daily lives. When the transition is made easier, clean cooking can be a part of every family’s daily lives.

– Lalitha Maddirevula

Lalitha is based in Downingtown, Pennsylvania, US and focuses on Technology and Solutions, and Global Health for The Borgen Project.

Photo: Wikimedia Commons

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An Update on HIV/AIDS in North Macedonia

HIV/AIDS in North Macedonia
Growth trends of HIV/AIDS in Macedonia, later known as North Macedonia, from February 2017, display a consistently low prevalence rate of 0.1% from 2005 to present, and more than 600 people currently live with the disease. Rates are higher for men than women. Transmission commonly occurs through sex or sharing of injections.

Data Challenges

Issues in this area include unreliable data due to social stigma, such as that related to drug use. Consequently, people may not want to participate. Other barriers to data collection include a lack of awareness among vulnerable individuals who may contract it, and financial crises that prevent people from volunteering in trials. Unreliable data makes epidemiological patterns harder to predict. Surveillance also lacks focus on vulnerable populations.

In 2005, Macedonia had a low prevalence of HIV/AIDS, with the main mode of infection being sexual contact. Between 5,000 and 6,000 drug users were registered in Macedonia. Injected drug users (IDU) form the majority of these users, leading to potential increases in the risk of the epidemic concentrating around IDUs in the future.

People most vulnerable include youth, injected drug users, prisoners, juvenile delinquents and the mobile population, such as seasonal workers and commercial sex workers (CSW).

Socioeconomic Challenges

Challenges contributing to vulnerability in Macedonia include poverty, with 21.8% living in poverty. Most impoverished individuals reside in rural areas, where mortality rates are higher compared to cities, and education levels, including regarding HIV/AIDS, are lower.

Past Funding – GFATM

In Macedonia, public health expenditure was around 6% from 1999 to 2003. A foreign grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) of $4.4 million was provided from 2004 to 2006, and Macedonia and Serbia were the only countries that received it. Even then, the resource gap was quite large, by $2 million or more.

Funding was crucial during this time, supporting prevention and treatment efforts. This source suggests the government worked across sectors to implement prevention and treatment effectively. However, this GFATM funding did not cover surveillance, thus more resources are necessary to reach the desired outcome of containing the illness. Nonetheless, the country had a robust plan and funding to aid in the fight against HIV/AIDS nationally.

Recent Funding Cuts

Since June 2017, the Global Fund to Fight AIDS, Tuberculosis and Malaria has ceased funding HIV/AIDS in North Macedonia, leaving the Ministry of Health as the main funding source. The low chance of contracting HIV/AIDS led to substantial budget cuts every year for four years by 40% by the Ministry of Health. Due to early implementation of prevention strategies and other initiatives, North Macedonia has not experienced an endemic for HIV/AIDS.

Not only were rates low for contracting HIV/AIDS in North Macedonia, by 2017, it became classified as an upper-middle-income status, making the argument for budget cuts more robust. Nonetheless, the government worked closely with the Global Fund to ensure links between Civil Society Organizations (CSOs) and the government remained strong.

Need for Increased Funding

Many believe that the budget cuts risk undermining infrastructure and capacities built from 2005 to 2017 funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, which provided over $25 million for HIV nationally. There is a risk of closure of HIV prevention programs that have been effective over the last couple of decades. This may further impact the right to access healthcare if cuts continue.

Companies specializing in HIV prevention and treatment highlight the risk of infections rising with cuts to these services, such as the European AIDS Treatment Group. Almost a quarter of the population now lives in poverty in North Macedonia, which could lead to catastrophe if someone living in poverty acquired HIV/AIDS. Economic constraints already limit access to healthcare. Marginalized people, such as those in rural areas and disabled individuals, already have trouble accessing adequate healthcare, which would project a worse outcome for these people. Additionally, there is a lack of key workers to support HIV/AIDS patients. Each patient has a right to health, and these cuts could take that away from them.

For the last four years, there have been substantial budget cuts toward HIV/AIDS. In 2025, more than 1.46 million euros is allocated for HIV prevention, which is less than what the country needed the previous year.

Proposed Solutions

Some have written to the government and ministry officials. Following the budget cut, 16 Macedonian civil society organizations united to create a joint platform to advocate for sustainable financing of HIV programs. This effort focuses on reversing the government budget cuts.

A social worker believes that it is essential to continue pressing the government and policymakers about the importance of funding in this sector of healthcare, so that people with an HIV diagnosis are never denied treatment.

Focusing on treating patients who have HIV/AIDS is important. “Empowering Patients for a Healthier Society – Annual Work Programme 2025” is funded by the European Union and is a project aiming to increase quality of life by making treatment more accessible and encouraging a more inclusive and beneficial healthcare environment. By doing so, this gives those with HIV/AIDS in North Macedonia more control over their lives and more self-confidence. There is also prevention education, early detection education and a supportive community after receiving the diagnosis. The actual results have yet to be published. However, this is a key type of solution that spreads awareness and makes healthcare more accessible.

When the Ministry of Health took over responsibility for funding HIV/AIDS, positive results emerged two years later, with HIV/AIDS in North Macedonia receiving funding completely internally. North Macedonia is a model example for countries to follow when they cut budgets for good reason.

– Emilia Upton

Emilia is based in London and focuses on Global Health for The Borgen Project.

Photo: Wikimedia Commons

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How UNDP in Sudan is Helping the Country Grow

UNDP in Sudan
Since the outbreak of conflict in 2023, nearly 6.9 million people have been pushed into extreme poverty. Farming communities have collapsed, more than 70% of health care facilities in conflict-affected areas have shut, and diseases such as cholera, HIV and TB have become more prevalent. Children’s education has been disrupted. UNDP reports it plans to continue supporting Sudan in the long term, including through access to services, clean energy, training and livelihood programs that strengthen communities’ self-reliance. Here is information about how UNDP is helping Sudan grow.

Clean and Sustainable Energy

UNDP provides solar-powered energy to ensure farming, health care facilities, and businesses have a cost-effective, clean, reliable, and sustainable source of energy. For example, many of the farms around the River Nile relied on diesel-fueled water irrigation systems. With the state of the economy and conflict in Sudan, this became an expensive and unreliable form of energy. Many farms had to cut back on fuel, which led to failing crops. With UNDP’s help and funding from the Republic of Korea, 300 farms received solar-powered irrigation systems, helping to maintain livelihoods in a clean and cost-effective way.

Helping Communities Grow

UNDP partnered with the UN Interim Security Force of Abyei to provide support for individuals in communities by creating jobs, supporting farmers, empowering women, providing clean water and offering training to ensure conflict resolution and peacekeeping. UNDP set up a local community management committee, giving people a voice and enabling each community to assess needs and assistance priorities. This committee identified the need for home-grown gardens, providing women with seeds, tools and training to produce food for their families while giving them the initiative to sell excess produce. UNDP established the Village Savings and Loans Association to empower women, support small businesses, and provide financial stability for more than 170 women. In one case, the association brought together 25 women from different communities to set up and run a produce business, sharing the capital and profits.

Achievements

UNDP has been working to help the people of Sudan. These efforts have:

  • Reported reaching more than 6.3 million Sudanese people, refugees and migrants.
  • Distributed 150 metric tons of certified seeds to strengthen agricultural resilience.
  • Created more than 200,000 temporary cash-for-work jobs.

The work UNDP does would not be possible without the backing of governments in other countries and funding from supporting partners. However, the need is still growing. UNDP Sudan Resident Representative Luca Renda stated, “To truly match the courage and determination of the Sudanese people, we must do more.” UNDP continues to support the Sudanese people and its communities, helping Sudan grow in its economy, agriculture, clean energy initiative, and peace.

– Shannon Waters

Shannon is based in Middlesbrough and focuses on Business and New Markets for The Borgen Project.

Photo: Flickr

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How Gains in Healthcare in Bhutan Mask Gaps for the Vulnerable

Healthcare in Bhutan
Bhutan has made significant progress in improving healthcare and reducing poverty, but access to essential health services remains uneven for some rural and vulnerable communities. Continued investment in healthcare in Bhutan could help the country build on its health gains while supporting household well-being and long-term poverty reduction.

Bhutan reduced its national poverty rate from 28% in 2017 to 11.6% in 2022, according to the World Bank. However, poverty remains predominantly rural, with 87% of the country’s poor people living in rural areas. These disparities make access to essential services particularly important for communities that may already face economic and geographic challenges.

Bhutan Has Made Significant Health Gains

Bhutan has recorded substantial improvements in health outcomes over the past two decades. According to the World Health Organization (WHO), maternal mortality fell from 255 deaths per 100,000 live births in 2000 to 53 in 2023. During the same period, under-five mortality declined from 84 deaths per 1,000 live births to 19.5.

The country has also maintained immunization coverage above 99%, while institutional delivery rates reached 98.5% in 2023. These improvements reflect Bhutan’s continued investment in health services and efforts to expand access to essential care.

The 2023 National Health Survey also reported improvements in access to health services across the country. These gains provide a strong foundation for continued progress in healthcare in Bhutan, while remaining gaps show the importance of ensuring that vulnerable communities can benefit from these improvements.

Rural Communities Still Face Healthcare Gaps

Despite these improvements, geography can affect access to healthcare in Bhutan. The country’s mountainous terrain and dispersed communities can make travel to health facilities more difficult, particularly for people living in rural areas.

Bhutan’s 2023 National Health Survey found that 72.9% of the population lived less than 30 minutes from the nearest health facility. However, 8.6% lived between one and two hours away, 2.5% lived between two and three hours away and 0.8% lived more than three hours away.

The survey also found differences between urban and rural households in the type of health facility located closest to them. Hospitals were the closest facility for 87.4% of urban households surveyed, compared with 37.6% of rural households. Primary health centers were the closest facility for 52.8% of rural households.

These differences highlight the importance of strengthening primary healthcare and referral services so that people living outside major population centers can access appropriate care.

Healthcare Access Can Affect Household Finances

Access to healthcare can also affect household finances. Illness can create financial pressure through medical expenses, transportation costs and time away from work.

Bhutan’s 2023 National Health Survey found that 46.7% of households incurred health expenditures. Households spent an average of Nu 1,000.8 per month on healthcare-related expenses.

Transportation accounted for 60.7% of health expenditure among rural households. For families living farther from health facilities, transportation can therefore add to the financial burden associated with seeking medical care.

These costs are particularly relevant for households with limited financial resources. When families must spend money traveling to receive healthcare, fewer resources may remain available for other household needs. Improving access to healthcare can therefore help reduce some of the financial and geographic barriers that vulnerable households face when seeking essential services.

Continued Investment Can Strengthen Bhutan’s Progress

Bhutan’s health achievements provide a foundation for addressing remaining gaps. The WHO Country Cooperation Strategy for Bhutan for 2026–2030 focuses on strengthening collaboration with the Royal Government of Bhutan to improve health and development outcomes.

The strategy builds on a partnership between WHO and Bhutan that began in 1982 and identifies continued improvements in health services and health-system capacity as part of the country’s health priorities.

Bhutan is also strengthening its preparedness for health emergencies. In March 2026, the Ministry of Health and WHO convened a consultation to finalize the country’s National Action Plan for Health Security. The process produced a five-year strategic plan and a prioritized 24-month operational plan addressing gaps in health security capacities.

The plan brings together multiple sectors and focuses on strengthening Bhutan’s ability to prevent, detect and respond to public health emergencies. Continued investments such as these can strengthen the country’s health system while improving resilience to future health challenges.

Conclusion

Bhutan has made significant progress in improving healthcare and reducing poverty, but gaps in access remain for some rural and vulnerable communities. Differences in travel time to health facilities and healthcare-related expenses show the importance of continued attention to accessibility. Building on the country’s health achievements while addressing these gaps can help more communities benefit from Bhutan’s development progress and support healthier, more resilient households.

– Adebisi Aliyah Adeola

Adebisi is based in Cairo, Egypt and focuses on Technology and Solutions for The Borgen Project.

Photo: Unsplash

 

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Malaria Education in Madagascar

Malaria Education in Madagascar
Madagascar, an island country east of Mozambique, faces significant poverty and malaria challenges. According to World Bank estimates, 69.2% of its population lived below the international $3-a-day poverty line in 2021, measured in 2021 purchasing-power-parity dollars. Malaria outbreaks have placed additional pressure on communities and health services.

What Works and What Does Not in the Current System?

Geography is crucial when discussing the incidence of malaria infection and why it is harder to contain in Madagascar than in other places with high malaria incidences. Madagascar is an island country heavily impacted by weather events such as cyclones and droughts. Its landscape includes both endemic lowlands and epidemic-prone highlands that create transmission zones, making it very hard to monitor and control the disease. This leads to the necessity of personalized or regionally specific prevention techniques, like malaria education in Madagascar alongside the use of ITNs and residual spraying.

WHO reporting identifies Madagascar as a malaria-endemic country where malaria cases increased markedly in 2024. The risk of malaria differs across communities and transmission settings. The implementation of the highly effective insecticide-treated nets (ITNs), indoor residual spraying (IRS), and seasonal malaria chemoprevention (SMC) have been in effect since the early 2000s and continue to be some of the most useful methods of preventing the disease. Although the CDC notes that indoor spraying lasts about three to six months and does not prevent people from being bitten, it simply kills mosquitoes that land on the sprayed surface.

Malaria-specific social and behavior change communication encourages the use of proven prevention methods, including insecticide-treated nets and indoor residual spraying. Community health workers can explain how to use these interventions and when to seek diagnosis and treatment. Another program for malaria control came from the ACCESS Program and the Ministry of Public Health and National Malaria Control Program partnering to create a community-centered program involving community health volunteers. This program included home visits for early detection and pre-referral treatment for severe malaria in children under five. By the end of ACCESS in 2025, nearly 14,000 community health volunteers were actively delivering malaria prevention and treatment services. ACCESS reports that more than 180,000 people received integrated community services in 2023-2024.

Time to Add Something New?

Although these programs extend prevention and treatment services, malaria remains a serious public health challenge in Madagascar. While the connection to community health volunteers has helped, and there has been some form of malaria prevention education through social and behavior change communication, the programs in place revolving around educating people on general malaria prevention and treatment methods in Madagascar need more investment to reach all villages across the country’s landscape.

A study done in Burkina Faso and Cote d’Ivoire by The Lancet Global Health found that pairing malaria education with the use of ITNs cut disease risk as much as indoor spraying combined with insecticide nets. The research showed a 22% reduction in cases in the following 10 months compared to just using nets alone. This evidence suggests malaria education in Madagascar could help reduce malaria alongside the use of insecticide nets and residual spraying. These findings suggest that targeted malaria education could complement nets, spraying, diagnosis and treatment in Madagascar, although this study in Madagascar has not demonstrated the same result.

Looking Ahead

Strengthening locally appropriate malaria education through community health workers and social and behavior change communication may complement existing prevention, diagnosis and treatment efforts. Reaching remote communities remains essential.

– Lily K. Gibson

Lily is based in Connecticut, USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Wikimedia Commons

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How Solar Water in Rural Malawi is Improving Health

Solar Water in Rural Malawi
Solar water in rural Malawi is helping families get safer and more reliable water. In Karonga District, new solar-powered water systems were built at Chikutu and Thawiro health posts and nearby villages. The systems now provide clean water to more than 2,000 people. Before the project, some families depended on rivers and rainwater for their daily needs. These factors made access to safe water difficult and increased the risk of diseases such as diarrhea and cholera.

Life Before Safe Water

Previously, many families in the area had no easy access to clean water, and in some cases, they had to get it from rivers or use rainwater. This was not always a safe arrangement, particularly for children. The Chikutu Health Post also had difficulties with water supply since the health workers needed clean water both to look after patients and to keep the health post clean. It was therefore important to have a safe source of water close by for the health center.

How Solar-Powered Water Systems Help

The new water systems use solar power to pump water from underground. The water is then stored in tanks and brought closer to the health posts and nearby communities. This gives families a safer source of water and means they do not have to depend as much on rivers or rainwater. The systems also give health workers easier access to the water they need each day. Solar-powered water systems are already in use in various areas of Malawi. The systems use solar power to pump water to places where people need it. This system includes homes, schools and health centers. In 2024, UNICEF-supported solar water systems provided safe water to 48,000 people in Malawi. Around 23,500 of them were children. Similar systems are now being used in different parts of the country, not only in Karonga.

Better Water, Better Health

It is also important to have safe water in order to prevent diseases; in 2023 the Chimaliro Health Centre noted 40 cases of cholera and one death. The health center and the families living nearby had been using water from the same borehole, a source that at times was not safe. Later on a solar-powered water system was set up in the area. Once the new system began to operate, the health center recorded no cases of cholera in 2024 and the health workers also had more water at their disposal for cleaning and looking after patients.

More Time for School

Solar water in rural Malawi can also save time for students. In Machinga District, some students at Mpalangwazi Primary School had to collect water before going to school. Because of this, they sometimes arrived late. Later, six solar-powered water points were built at the school and in nearby villages. Teachers said that students started coming to school on time more often. The school has more than 1,000 students, so having water closer to them can save time before and during the school day.

Water Access in Malawi

For many people in Malawi access to clean water is still a major problem. WaterAid states that about 17% of the population have no access to clean water and that 56% lack proper hygiene facilities. In rural areas people often have to walk long distances to get their water or have to depend on sources that might not be safe. The problem also affects health centers since clean water is needed by patients, the staff and for the daily cleaning. WaterAid has worked with health centers in Malawi to improve their water and sanitation services. This has involved the installation of piped water systems powered by solar energy.

Solar power is useful in rural areas since it allows the water to be pumped without relying on a regular electricity supply. Once the water is pumped, it can be stored and used by the health center and people living nearby. It is also beneficial for families to have a source of water nearby because it saves them time. Rather than spending part of the day searching for or gathering water, people have more time available for going to school, working and looking after other matters. This is particularly important for women and children, who are usually in the position of having to collect water for their families.

Looking Ahead

Many people in Malawi still do not have clean water close to where they live. Having safe water resources that are easy to access could result in less time being spent collecting it and a reduced health risk. It would also make it easier for schools and health centers which need water every day. Solar water in rural Malawi is already reaching communities that once had difficulty finding safe water.

The projects in Karonga and other districts are only part of the work that still needs to be done but the results so far give reason for hope to the people. As more communities receive safe water systems, more families can have a healthier and safer place to live. For families who have spent years worrying about where their next bucket of clean water will come from, having safe water close to home can be the beginning of a better future.

– Mert Sungur

Mert is based in Bursa, Turkey and focuses on Technology and Solutions, and Global Health for The Borgen Project.

Photo: Wikimedia Commons