Archive for category: Health

Information and stories on health topics.

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GPEI Funding: $1.9 Billion Toward the Fight Against Polio

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

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

How Polio Affects the World Today

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

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

Successes in the Fight Against Polio

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

About the Funds Against Polio

Pledges to the GPEI came from multiple donors, including:

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

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

– Renata Hirmiz

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

Photo: Unsplash

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Inequality in Isan: Building Economic and Social Equity

Inequality in IsanLocated in northeastern Thailand, Isan is the country’s largest and most populous region, home to roughly 22 million people. Despite national declines in poverty, research from The Asia Foundation in 2019, based on surveys and in-depth interviews with 1,400 residents, shows that Isan continues to face the highest poverty rate and the lowest average income in Thailand. In 2018, the average monthly income in the central region reached 12,818 baht (about $407), nearly double the 6,790 baht ($216) reported in the Isan region.

The study also found that although 87% of households in Isan own land, land ownership alone has not guaranteed stable or sufficient livelihoods.

Budget and Health Care Inequality and Intra-Regional Disparity

Inequality persists in Thailand, particularly in the Isan region, when compared to more affluent areas such as Bangkok. In 2024, the Thai government allocated only 5.54% of its 3.48-trillion-baht (roughly $111 billion) national budget to Isan. In contrast, it allocated almost 10 times that amount, 1.85 trillion baht ($59.2 billion), to Bangkok, despite the capital having less than half of Isan’s population (around 11 million people).

Health care distribution also reflects this inequality. In 2023, Thailand had 37,559 doctors nationwide, but only 8,447 worked in Isan. Inequalities also exist within the region itself. Khon Kaen, one of Isan’s major cities, has a significantly lower doctor-to-patient ratio, with one doctor serving approximately 1,080 people, compared to Bueng Kan, where one doctor serves 5,003 people.

Discrimination

According to Manushya, urban populations in wealthier regions have long perpetuated negative stereotypes about Isan people, mocking them as poor, backward or as “mia farang” (meaning a white foreigner’s wife). The Asia Foundation also notes that some believe “there is no future in Isan,” leading to the assumption that people must migrate to Bangkok for “good prospects.” However, the study shows major shifts in migration patterns.

Young people in Isan are increasingly choosing to enroll in local institutions, such as Khon Kaen University, rather than moving to Bangkok. As a result, students are becoming more interested in pursuing entrepreneurship in Isan rather than seeking work in the capital. These findings show that the negative stereotypes stem from outdated or poorly informed assumptions.

Universal Health Coverage

Thailand introduced the Universal Health Coverage (UHC) Scheme, often referred to as the “30-baht Scheme,” in 2001 to provide health care access for residents not covered by other public health schemes. The Asia Foundation identifies UHC as the most widely used social safety net in Isan, with 97% of surveyed respondents expressing high satisfaction. Before the scheme began, around 80% of the population lacked adequate health care coverage or faced prohibitive medical costs.

UHC has reduced this burden significantly. By 2015, household health care expenditure in Thailand had decreased by 11.8%, easing financial pressure on low-income households and contributing to a reduction in poverty.

Manushya and Advocacy Efforts

Founded in 2017 by Emilie Palamy Paradichit, Manushya is an intersectional feminist organization dedicated to promoting equality and human rights. Manushya worked with several Thai civil society organizations to prepare the Isan UPR factsheet for Thailand’s third Universal Periodic Review (UPR) in 2021. These partners included the Thai CSOs Coalition for the UPR, the Human Rights Violations in Isaan Monitoring Group, the Sai Thong Rak Pah Network, the Amnat Charoen Friend of Women Center and the Isaan Gender Diversity Network (IGDN).

The factsheet highlighted discrimination against Isan residents, such as unequal budget allocation, employment in low-paying jobs and negative stereotypes describing people as “poor,” “backward,” or “lower-class.” Manushya also included these concerns in its shadow civil society report for Thailand’s Convention on the Elimination of Racial Discrimination (CERD) review and participated in two sessions with CERD committee members to ensure that issues affecting Isan were addressed.

Progress and Opportunities in Isan

Efforts to reduce inequality in Isan demonstrate how targeted policies and strong community engagement can lead to meaningful change. Programs such as the UHC have expanded access to essential services, while organizations like Manushya continue to advocate for fair resource distribution and human rights protections. Growing interest in local education and entrepreneurship also reflects a generation investing in the region’s future.

With continued cooperation among government agencies, civil society groups and local communities, progress toward addressing inequality in Isan can accelerate, supporting more secure and sustainable livelihoods.

– Sammi Li

Sammi is based in London, UK and focuses on Good News for The Borgen Project.

Photo: Pexels

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5 Facts About Hunger in Tuvalu

Hunger in TuvaluTuvalu is a small island nation composed of nine islands in the western Pacific Ocean. Because of its history as a former British colony, many of its citizens speak English, even though the native language is Tuvaluan and the native people are Polynesian. Tuvalu is recognized as one of the world’s least developed countries, the fourth smallest independent nation globally and one of the most at risk due to climate change. One-third of the population lives in Funafuti, the main island that is also the most urban. The rest of the population lives a more traditional lifestyle with extended families. Hunger in Tuvalu has been a problem, a direct result of limited access to land or income, and more recently, the impact of climate change. Here are five facts about food and hunger in Tuvalu.

5 Facts About Food and Hunger in Tuvalu

  1. History: For most of Tuvalu’s history, a majority of the population consisted of subsistence farmers who lived off what they grew. Hunger in Tuvalu was a part of life, but there was little famine. Usually, a family could grow enough food to support themselves, and they supplemented their diets with fish caught in the ocean.
  2. Importing Food: As Tuvalu’s connection to the rest of the world has increased, it has begun to import more and more food. Now, 80% of food is imported, mostly from the nearby countries of Australia, Japan, New Zealand and Fiji. This reliance on imported goods has significantly altered the country’s approach to food security and nutrition.
  3. Farming and Fishing: Hunger has decreased due to imported food, but Tuvaluans still face challenges with food security. Before Tuvalu began importing most of its food, local farms and fishing provided food security, but now most fish caught are exported. Even so, many rely on their land or fishing to earn money as the majority of the population is engaged in crop cultivation (69%) and livestock farming (84%). Currently, 26.3% of the population lives below the poverty line. 
  4. Changing Weather patterns: Changing weather patterns pose a major threat to food security because changing ecosystems can hurt people’s food supply. As coral in the ocean dies, fish — a crucial food supply — die as well. Additionally, seawater is slowly becoming acidic, making it an increasingly uninhabitable environment for sea life. More flooding due to rising sea levels and stronger tropical cyclones will also damage farmland and property.
  5. Health Concerns: Despite circumstances threatening food security, hunger in Tuvalu is not the country’s primary food-related problem. Imported foods, highly composed of fat and sugar to reduce spoilage, have increased obesity on the islands. The country ranks seventh in obesity, with an obesity rate of 51%.

Ongoing Efforts to Strengthen Food Security in Tuvalu

In recent years, various stakeholders have been working to address food insecurity in Tuvalu through collaborative initiatives aimed at improving agricultural resilience, promoting local food production and reducing dependence on imported goods.

Tuvalu’s Department of Agriculture, in partnership with the Taiwan International Cooperation and Development Fund, has worked on the development of government gardens. These initiatives introduced composting facilities, heat-tolerant crops and raised garden beds to improve local food production. Alongside these technical improvements, the government has promoted healthier diets by offering nutrition education and local recipes to encourage better use of homegrown produce. A particularly impactful initiative has been the Department of Agriculture’s push for home gardens,  encouraging households to grow vegetables on their own land. These gardens not only help diversify diets and reduce food imports but also promote physical activity and mental well-being. 

Another initiative to address food insecurity in Tuvalu is the one promoted by the NGO Live & Learn Environmental Education (LLEE) through its “Tuvalu Food Futures” project. The project has supported food garden development both in Funafuti and on outer islands like Nukufetau and Nukulaelae. 

While Tuvalu continues to face challenges from the changing climate, economic limitations and a growing reliance on imported food, local and international efforts are helping to build a more food-secure future. By investing in sustainable agriculture, promoting homegrown solutions and reviving traditional practices, Tuvalu is taking important steps toward restoring resilience and self-sufficiency in the face of uncertainty.

– Seona Maskara
Photo: Flickr

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Understanding Hunger in Türkiye

hunger in TurkeyTürkiye is a country with major economic influence in the Middle East, and it is ranked as the 17th most prolific economy worldwide. In 2024, 2.5% of the population was undernourished, a percentage that has remained steady over the last five years. Despite this, the proportion of people living below the international upper middle-income poverty threshold of $6.85 per day decreased from 16% in 2012 to 7.8% in 2022. 

However, a 2023 report from the Turkish Statistical Institute revealed that nearly one in three people in Türkiye faces the risk of poverty or social exclusion.

Persistently High Inflation

Türkiye’s inflation rate remains high at around 70%, significantly impacting the cost of essential goods, including food. In some instances, prices have doubled, with people struggling to afford basic products. 

Moreover, the minimum wage often falls below the hunger threshold, making it difficult for families to meet their nutritional needs. 

Children are particularly affected by the worsening economic conditions. Approximately one-third of Turkish children live in poverty, with many experiencing malnutrition, stunted growth and increased rates of child labor. 

Economic hardship has led to increased child poverty, with many children forced to work to support their families. This not only affects their education and development but also reflects the broader issue of food insecurity within households.

Natural Disasters

Natural disasters, such as earthquakes, have disrupted food production and distribution networks. For instance, the devastating earthquake in February 2023 caused significant infrastructure damage, aggravating food insecurity in affected regions. ​The earthquake resulted in over 50,000 deaths, injured 107,000 people, and either damaged or destroyed 1.9 million homes, leaving 3.3 million people displaced—two million of whom required emergency shelter. The cost of recovery and reconstruction is estimated at $81.5 billion, adding strain to an already fragile situation. 

The Long Term Impact of Refugees 

Türkiye is home to one of the largest refugee populations globally, with over 3.1 million Syrians and nearly 300,000 refugees and asylum seekers from other countries. Since 2011, the country has allocated nearly €10 billion to support both refugees and the communities that host them, with the help of EU funds. 

The long-term presence of Syrian refugees in Türkiye has brought both challenges and benefits, affecting the economy, labor market and society. Syrian refugees, many of whom are employed in the informal sector, have intensified competition for low-skilled jobs—particularly in agriculture and construction—affecting Turkish workers in these fields. However, some studies indicate that their presence has also contributed to the creation of formal, higher-wage employment opportunities. In areas with large refugee populations, rising demand has driven up prices for housing and services. Despite these challenges, refugees have helped boost the Turkish economy through increased consumption and investment, positively impacting GDP in certain sectors, accounting for around 2% of the country’s GDP in 2017. Their presence also led to a production boost of 30.6 billion TL across various sectors, which resulted in about 20.9 billion TL in added economic value—equivalent to 1.51% of GDP.  

Organizations Fighting to Eradicate Hunger in Türkiye

Several organizations are actively working to address hunger and food insecurity in Türkiye:

  • World Food Programme (WFP): WFP provides cash assistance to over 30,000 refugees each month to help alleviate hunger and insecurity.
  • International Fund for Agricultural Development (IFAD): IFAD supports isolated rural communities by helping resource-poor farmers transition from subsistence to commercial farming. Their programs emphasize gender equality, community empowerment, and climate-resilient agricultural practices.
  • Food and Agriculture Organization (FAO): FAO focuses on improving nutrition and social protection for disadvantaged groups, promoting sustainable agricultural development, and strengthening climate resilience, particularly in rural areas. FAO supports smallholder farmers, especially women, with market access and climate-smart practices.
  • Action Against Hunger: In response to the February 2023 earthquake, Action Against Hunger assisted over 80,000 people by providing essential water, sanitation, and hygiene services.

While notable progress was made in reducing poverty and hunger in Türkiye over the past decade, the country continues to face challenges related to hunger, driven by high inflation and natural disasters. Through targeted support, sustainable development strategies, and humanitarian aid, there is a path forward to reduce hunger in Türkiye and help vulnerable communities access the food, resources and opportunities they need to thrive.

– Arianna Distefano
Photo: Pexels

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UHC in Cote D’Ivoire: An Investment in the Future

UHC in Cote D'IvoireHealth is an important factor that can contribute to increased poverty through direct effects and negative feedback mechanisms that can compound this impact. For example, direct health care expenses and, to a greater extent, health-related loss of earnings can significantly damage an individual or household’s ability to maintain net incomes above poverty thresholds. Additionally, lower incomes can incentivize behavior that may result in lower health outcomes, such as consuming lower quality, cheaper food, having more children and experiencing increased stress-related conditions from anxiety over expenses.

Understanding Universal Health Coverage

According to the World Health Organization (WHO), Universal Health Coverage (UHC) is a system that ensures all people have convenient and timely access to the health care services they require at sufficient quality, without financial hardship. UHC can be an important policy measure to create health equity and influence the relationship between health and poverty. Based on data from countries with strong social safety nets and health care systems closest to UHC, the effects of health on poverty are lessened.

Why UHC Matters in Cote d’Ivoire

In West African countries such as Cote d’Ivoire, UHC programs can be vital investments in human capital, especially with a young and fast-growing population. Improving health outcomes can support skills development and productivity, as healthier individuals are able to learn and work more effectively. Increased investment in health care also creates jobs within the sector, which can fuel national economic growth.

Seeing the need for a UHC program, the government of Cote d’Ivoire launched a pilot phase in April 2017 focused on students. After its successful completion, the government introduced its national UHC program, known as Couverture Maladie Universelle (CMU), in 2019. It is funded in part by the National Health Insurance Fund and through contributions from individual workers. To support the rollout, there were efforts to restore and equip hospitals beginning in June 2019.

Ongoing Challenges

Five years after its inception, reports suggested that only around 40% of the population, or about 13 million people, had enrolled in the CMU. One challenge cited was difficulty accessing benefits, such as vouchers provided by hospitals that were not accepted at most pharmacies, requiring patients to pay out of pocket. Additionally, some citizens reported mistrust due to limited information and stories of negative experiences. Covered medications often run out quickly, and substitutes are not yet covered by the CMU. There have also been cases where people pay large premiums for larger families to receive coverage.

Government Efforts to Improve UHC

However, the government has recognized these gaps and is working to address them. In September 2022, enrollment in the CMU became mandatory for all citizens, tied to public services such as passport applications and civil service exam registration.

In February 2024, public-private partnerships were launched with the International Finance Corporation to cover imaging centers and laboratories under the CMU. Mobile enrollment centers are also being rolled out in rural neighborhoods and busy markets to simplify registration and issue health insurance cards on-site. This expansion began in June 2024.

Most recently, in mid-2025, the government announced CMU+, which offers additional cost reductions, including four months of completely free care at rural health centers for enrolled individuals.

Looking Ahead

Overall, Cote d’Ivoire has demonstrated a commitment to improving health outcomes for citizens, especially those with limited income, by working to make an affordable health care plan accessible to all. Although challenges remain, the government continues to expand access to both enrollment and services to strengthen the program’s success.

– Nikhil Kumar

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

Photo: Flickr

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Eliminating TB in Chhattisgarh Through Community Programs

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

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

The Problem

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

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

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

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

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

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

TB in Chhattisgarh

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

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

The Solution

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

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

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

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

Looking Forward

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

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

– Angela D’Avino

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

Photo: Pixabay

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Why City-Level Politics Matter for Health in Maputo, Mozambique

MaputoMaputo, Mozambique’s capital, is a fast-growing coastal city where most residents reside in informal or unplanned areas. Recent analyses estimate that between 75% and 80% of Maputo’s population lives in informal settlements, reflecting a pattern of spatial inequality and weak infrastructure provision. Academic and U.N.-Habitat assessments similarly note that at least 80% of the city is composed of informal settlements.

The municipality also struggles to meet the demand for basic infrastructure, including water supply, sewerage, solid waste management, energy, roads and communications. These deficits pose significant environmental and public health risks, particularly in peri-urban areas with self-built housing and unpaved roads. These conditions make Maputo a clear example of how urban health governance is inseparable from land use, infrastructure and local politics.

In such cities, health outcomes depend as much on municipal decisions about roads, sanitation and land tenure as they do on the formal health sector itself.

Informal Settlements, Infrastructure and Health Risk in Maputo

Studies of Maputo’s informal neighborhoods describe overcrowded, self-built housing, poor drainage and limited formal water and sanitation networks. Research on critical infrastructure in Maputo’s informal settlements shows that water pipes, stormwater drainage, sanitation, waste collection and public lighting are “almost nonexistent” in many areas. Some neighborhoods also still rely on unsafe sanitation and open defecation.

These conditions are explicitly linked to diseases such as diarrhea and cholera. Other studies on Maputo’s informal settlements document the links between socioeconomic status, settlement form and land consumption. They also highlight the exposure of low-income residents to flooding and other environmental risks.

This combination of dense informality and incomplete service coverage makes everyday environmental conditions a central driver of health outcomes. From a global health perspective, this means that interventions limited to clinics and hospitals will miss the root causes of disease burden. Effective urban health governance must therefore link health outcomes to improvements in water, sanitation, drainage, solid waste systems and safe housing in informal settlements.

City Government, Planning and Land

City-level politics are crucial in Maputo because the municipality controls or co-controls, key levers for planning, land management and basic services. Classic work on Maputo’s urban governance reveals that more than half of the city’s population lives in poverty. It also shows that most residents acquire land for housing through informal markets, reinforcing spatial and social inequality.

More recent analyses argue that informality is not an aberration but a dominant mode of urbanization in Maputo and that data on informal areas remain incomplete and outdated. This makes it harder for municipal authorities to plan and manage infrastructure in a way that reflects the realities of informal neighborhoods. U.N.-Habitat’s resilience work with the Municipality of Maputo, using the City Resilience Profiling Tool (CRPT), highlights institutional challenges related to data, coordination and long-term planning.

Recommendations of Actions for Resilience and Sustainability in Maputo focus on improving infrastructure, managing flood risk and strengthening local governance capacities. All of this underlines that urban health governance in Maputo is fundamentally tied to how the municipality regulates land, invests in infrastructure and engages with residents in informal neighborhoods.

Donors, Upgrading Programs and City-Level Investment

Maputo has been a focal point for large urban upgrading and infrastructure programs supported by international donors and development banks. A recent preprint and subsequent journal article on critical infrastructures in Maputo lists several major projects aimed at informal settlements, including:

  • Maputo Urban Transformation Project
  • Mozambique Urban Sanitation Project
  • Maputo Metropolitan Area Urban Mobility Project
  • Other neighborhood-level upgrading initiatives, such as the Chamanculo C and George Dimitrov projects

The World Bank’s Maputo Urban Transformation Project, approved in 2020, aims “to improve urban infrastructure and strengthen institutional capacity for sustainable urbanization in Maputo.” Components include informal settlement upgrading, city-center rehabilitation, sustainable urban growth in peripheral districts and institutional support. Progress reports indicate that hundreds of thousands of residents are benefiting from improved urban infrastructure, drainage, sanitation and roads in informal settlements.

The project also includes performance-based conditions to strengthen land tenure regularization, property tax reform and solid waste management. Earlier programs, such as ProMaputo, also supported by the World Bank and its partners, sought to modernize municipal administration, upgrade infrastructure and regularize land rights in selected neighborhoods. However, analyses note challenges including limited tenure regularization, relocation without secure alternatives and persistent deficits in basic services.

UN-Habitat’s Global Action Plan and Informal Settlement Health

At the global level, U.N.-Habitat has developed a Global Action Plan, titled “Accelerating for Transforming Informal Settlements and Slums by 2030,” which was launched in 2022. The plan is anchored in the Slums and Informal Settlements Network (SiSnet) and the Participatory Slum Upgrading Program (PSUP). It provides a framework for large-scale transformation of informal settlements through improvements in infrastructure, land tenure, community participation and policy reform.

U.N.-Habitat’s urban health work emphasizes that many determinants of health, including housing, transport, water, sanitation and public space, lie outside the health sector and within municipal mandates. It calls for integrated planning that positions health at the center of urban development efforts. Together, these initiatives position informal settlement upgrading and slum transformation as a core pathway for improving health outcomes in cities like Maputo.

They align local infrastructure projects with global frameworks for inclusive, climate-resilient and healthy urban development. This is exactly where urban health governance becomes a practical agenda: coordinating housing, infrastructure, participation and health objectives at the city scale.

Global Health Meets Local Politics

International health agencies are increasingly recognizing that city-level governance shapes health outcomes. The World Health Organization’s (WHO) initiative on Urban Governance for Health and Well-Being (2020–2028) works directly with mayors and city governments to strengthen participatory, multisectoral and multi-level governance, ensuring that health is at the center of decision-making. A companion WHO policy brief on governance and financing for urban health notes that governance structures and funding mechanisms are key challenges to achieving urban health goals.

It emphasizes the need for coordination across government levels and sectors. Maputo’s experience provides a clear, concrete example of these points:

  • Health risks in informal settlements stem from gaps in infrastructure, such as water, sanitation, drainage and waste systems, as well as from land-use decisions.
  • Major improvements rely on the authority and capacity of municipal governments, not just national ministries.
  • Donor programs pass through city institutions and can either strengthen or bypass local systems.

For global health actors, this means that effective strategies must engage directly with municipal councils, planning departments, local utilities and community organizations, rather than focusing solely on national health ministries.

Conclusion

Maputo demonstrates that improving health in the Global South cannot rely on national policy alone. In cities where most residents live in informal settlements, health outcomes depend on urban health governance, which encompasses how city leaders plan, finance and implement infrastructure, as well as how they collaborate with donors and involve informal settlement residents in decision-making.

– Clara Garza

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

Photo: Flickr

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Maternal and Infant Health for the Women of Burkina Faso

Women of Burkina FasoBurkina Faso, a country in West Africa with a population of more than 23 million, has long faced deep-rooted gender inequalities. The women of Burkina Faso, who make up roughly half of the population, have historically faced significant disparities in education and economic opportunity. These barriers have limited their ability to meet essential reproductive health needs, which are directly tied to maternal and infant well-being. While access to maternal and infant health services has not always been readily available, recent years have brought promising improvements that offer hope for continued progress.

Confronting Health Barriers

One of the leading causes of death in Burkina Faso is complications from preterm births — a challenge not unique to this West African nation, but one that poses a serious threat to mothers and babies alike. Several factors contribute to this problem among the women of Burkina Faso, including limited access to prenatal and general health care, young maternal age and a lack of basic information about pregnancy and its risks.

Traditional norms also play a major role in family planning. A cultural preference for large families often leads to short intervals between births, increasing the risk of health complications for the women of Burkina Faso.

Shortage of Skilled Maternal Health Professionals

Burkina Faso faces a shortage of obstetricians and midwives, leaving 63% of women without their maternal health care needs fully met. While West Africa has the highest concentration of nursing and midwifery personnel per 10,000 people on the continent, the region still ranks among the lowest in the world. Burkina Faso has 10.3 nurses and midwives per 10,000 people, compared with 82 per 10,000 in Chile, a country in South America with a similar population size.

To close this gap, several initiatives are underway to expand the pool of qualified maternal health providers. Indeed, four years ago, the Ministry of Health launched a pilot program to train midwives in basic obstetric ultrasound during prenatal consultations. The program targeted eight remote districts and proved highly successful: women no longer had to travel long distances for ultrasounds and midwives could detect and monitor high-risk pregnancies earlier. Building on this success, the Ministry of Health and the WHO plan to expand the program nationwide so that ultrasounds become a routine service for all pregnant women.

Improving Breastfeeding Rates

Currently, 51% of mothers in Burkina Faso exclusively breastfeed during the first six months of their infant’s life. The World Health Organization (WHO) has set a 2030 target of 60%. Although Burkina Faso still has progress to make, it has shown impressive gains over the past 12 years: in 2012, only 38% of infants aged 0–5 months were exclusively breastfed. This is a remarkable achievement and with continued government support and strong advocacy efforts, the country is well-positioned to reach the 60% target within the next five years.

Looking Forward

Social and economic barriers remain, but the women of Burkina Faso are taking meaningful steps toward a more informed approach to family planning and improved access to pre- and postnatal care. With support from local governments and non-governmental organizations, access to family planning services has expanded significantly across West Africa over the past decade.

The Ouagadougou Partnership – which brings together Benin, Burkina Faso, Cameroon, Côte d’Ivoire, Guinea, Mali, Mauritania, Niger, Senegal and Togo – illustrates how regional cooperation can accelerate progress. Through this partnership, participating countries have implemented national plans to strengthen community engagement and enhance the availability and quality of reproductive health care.

Other initiatives like the WHO’s comprehensive implementation plan on maternal, infant and young child nutrition have also contributed to significant improvements in breastfeeding practices. Burkina Faso is a strong example of an African country that has not only adopted this plan but sustained its commitment over time. By prioritizing funding and expanding access to breastfeeding support programs, more than half of new mothers are now able to provide adequate nutrition for their infants.

Burkina Faso’s population is projected to grow rapidly by 2050, underscoring the need to expand access to family planning and safe maternal and infant care. Continued investment in education, community outreach and health care infrastructure will be essential. By promoting local engagement, professional development of qualified health workers and ensuring that women have access to affordable, high-quality medical consultations, the government and its partners can help build a healthier, more sustainable future for the women of Burkina Faso and their families.

– Fernanda Nilson

Fernanda is based in North Charleston, SC, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Pediatric and Neonatal Medical Aid to Niger

Medical Aid to NigerNiger, located in West Africa, is one of the world’s most impoverished countries and is classified by the World Bank as a low-income country. According to the World Health Organization (WHO), Niger has a young population, with 24.8% of the Nigerien population aged between 0 and 14 years. Additionally, the neonatal mortality rate in Niger is 34.15 per 1,000 live births.

Similarly, the mortality rate of children under 5 years old is 117.07 per 1,000 live births, as indicated by WHO data. Therefore, pediatric and neonatal medical aid is crucial to the national public health of Niger. Improving public health is an important aspect of reducing extreme poverty in Niger. Charitable projects that provide pediatric and neonatal medical aid to Niger include those launched by Galmi Hospital, Samaritan’s Purse, CURE International, Médecins Sans Frontières/Doctors Without Borders (MSF) and the African Neonatal Association.

The aid supplied by these charitable organizations encompasses governmental vaccination partnerships and outpatient nutritional rehabilitation services. It also includes surgery for congenital disabilities and untreated trauma, the facilitation of global neonatal research in Africa, as well as the operation of neonatal and pediatric wards.

Pediatric and Neonatal Public Health Programs in Niger

Galmi Hospital is a nonprofit organization hospital in Niger operated by Serving in Mission International. Galmi is located 470 km east of the Nigerien capital city, Niamey. The hospital believes that children are precious to the heart of God. The under-5 clinic at Galmi Hospital provides medical care to approximately 100 infants daily.

Galmi Hospital has a partnership with the Nigerien government to supply vaccinations to children within the regional area of Galmi and its surrounding communities. In addition to this, the outpatient nutritional rehabilitation center of Galmi Hospital cares for infants below the age of 5 who are underweight, stunted or wasted. Malaria, dehydration due to diarrhoea, pneumonia, sickle cell disease, meningitis and malnutrition occur frequently among pediatric in-patients at Galmi Hospital.

Many of these diseases are easily preventable through vaccines against measles and pertussis; however, tragically, due to widespread poverty, medical resources are limited. Galmi Hospital proposes the construction of a specialist pediatric ward to effectively cater to children with illnesses.

The Samaritan’s Purse charity launched a new medical health care center in the Reguou village of Niger in 2021, which has had very high malnutrition rates for many years. The center has a specialist focus on aiding pregnant mothers and malnourished children. A significant decrease in malnutrition rates, an increase in children being vaccinated and improved public health are the successes of the new health care center.

Samaritan’s Purse had been active in Niger before the new launch through the provision of medical treatment for cholera, the opening of nutritional projects and mobile medical clinics. Local medical professionals and the director of Samaritan’s Purse for Niger celebrated the launch of the new health care center.

Neonatal Medical Aid to Niger

The African Neonatal Association is a group of African neonatologists and pediatricians specializing in neonatal care across the continent. Advocacy, education and research by the association help to improve the medical aid available to neonates in Africa. The study conducted by the African Neonatal Association increases opportunities for global neonatal research in Africa and promotes synergy among researchers working with neonates in Africa. It also supplies validated research to support the provision of the best possible neonatal care.

Hypoxic ischaemic encephalopathy or birth asphyxia, sepsis and prematurity are the most common causes of mortality among newborns in Africa. The pharmaceutical medicinal products and medical equipment needed to provide medical aid to newborns in Africa are relatively inexpensive; however, sound logistics are crucial for effectively administering neonatal medical assistance to the African continent, including Niger. According to the African Neonatal Association, the number of neonatologists is limited and neonatal nursing is not yet recognized as a specialty, highlighting the significant need for neonatal medical care in Niger.

Pediatric and Neonatal Surgical Missions to Niger

CURE International is a nonprofit charity founded by an orthopedic surgeon and his spouse to provide high-quality surgical treatment to children in need across developing countries in Africa and beyond. Bowed legs, clubfoot, burn contractures, cleft lip and cleft palate, genu valgum, osteogenesis imperfecta, windswept legs and untreated trauma encompass a range of malformations. CURE International operates pediatric hospitals to provide surgical care for these conditions.

Three sisters who received surgical treatment from CURE Niger for the genetic congenital disability osteogenesis imperfecta suffered from fragile bones that broke frequently, resulting in mobility difficulties and an inability to walk. More than 12 surgical operations and months of recovery were required before the sisters were able to walk following treatment. CURE Niger is the only hospital in Niger that offers specialized surgical medical care for children with treatable physical disabilities.

Obstetric Medical Aid for Neonates and Infants

MSF provides obstetric medical aid through a maternity ward in an MSF-operated hospital in the Madaoua district of Niger to decrease the mortality rate of newborns. The MSF hospital in Madaoua also operates an inpatient therapeutic feeding center, in addition to neonatal and pediatric wards. In the Dungass district of Niger, MSF launched a 200-bed pediatric unit and supported the coordination of other pediatric units nationwide.

Final Remarks

The provision of pediatric and neonatal medical aid is a vitally important part of reducing extreme poverty in Niger. Improvements in overall national public health boost the country’s economic development. Many international aid projects by charities and other organizations have helped facilitate pediatric and neonatal medical aid in Niger.

– Deborah Asante

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

Photo: Flickr

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Ethiopian Highland Malaria Exposure

Ethiopian Highland MalariaRising temperatures are changing where malaria is transmitted in Ethiopia. Multiple studies show that as the climate warms, thermal thresholds suitable for malaria shift upward in elevation, increasing risk in places that were previously considered lower risk. This trend is directly relevant to Ethiopian highland malaria exposure.

A landmark analysis of long-term data from the highlands of Ethiopia (and Colombia) found that interannual temperature variability drives upslope movement in malaria incidence, providing clear evidence of altitudinal change. Complementary climate work using Ethiopia’s enhanced national climate dataset (ENACTS) identified statistically significant increases in the elevation of key temperature thresholds linked to transmission suitability, reinforcing concerns about such risks. Ethiopia’s malaria risk has traditionally been determined by altitude and temperature.

Program profiles identify “malaria-free” areas above roughly 2,500 meters—or above 2,000 meters where average annual temperatures stay below about 16 °C, highlighting how climate historically restricted transmission at higher elevations. As those conditions change, the boundary of receptivity can move, with implications for surveillance and response in fringe highland districts.

National Strategy and Health System Planning

Ethiopia’s National Malaria Elimination Program (NMEP) operates under a five-year strategic plan (2021–2025). It aims to consolidate gains, further reduce malaria burden and interrupt transmission in selected areas. The plan emphasizes evidence-based stratification, vector control (long-lasting insecticidal nets [LLIN]/Indoor Residual Spraying [IRS]), case management and surveillance, pillars that can be calibrated as malaria exposure changes.

Ethiopia’s recent malaria situation highlights the stakes. The World Health Organization (WHO) reported more than 7.3 million malaria cases and more than 1,100 deaths between January 1 and October 20, 2024, a reminder that national systems must plan for surges and geographic shifts. While these figures are national (not highland specific), they frame the operational urgency for climate-informed malaria control.

Climate-sensitive planning is already embedded in Ethiopian research and practice. Recent analyses link El Niño and other climatic drivers to epidemic risk in Ethiopia and programmatic efforts have piloted integration of climate information with disease surveillance to strengthen early warning and response.

Donor Financing and Policy Frameworks

The Global Fund and Ethiopia have launched three new grants totaling more than $441 million for 2024–2027 to sustain progress against HIV, TB and malaria while strengthening health and community systems. This funding can also support climate-aware targeting, improved surveillance and vector control, aligned with national health priorities. Globally, the Global Fund’s 2023–2028 Strategy and subsequent guidance explicitly encourage integrating climate considerations into malaria programming, including grant reprogramming to address climate-related shifts in risk.

These frameworks offer a pathway for aligning budgets and activities with evolving transmission zones. Partner inputs extend beyond financing. Program profiles from the U.S. President’s Malaria Initiative (PMI) detail Ethiopia’s stratification and intervention mix, a baseline that can be recalibrated if Ethiopian highland malaria risk zones expand.

Compounding Factors: New Vectors and Urbanization

In addition to climate-driven altitudinal shifts, the emergence of Anopheles stephensi, an invasive urban malaria vector, has complicated control in the Horn of Africa. WHO has issued an alert on its spread and peer-reviewed studies from Ethiopia have implicated the vector in outbreaks, underscoring the need for expanded entomological surveillance and tailored control in urban and peri-urban settings.

Actionable Recommendations

  • Continuously update high-elevation risk maps by adopting climate-informed micro-stratification that uses high-resolution temperature data and surveillance information to identify newly receptive highland areas. Reassess historical altitude thresholds (for example, the 1,750–2,000 m guidelines) where warming has increased thermal suitability for malaria transmission.
  • Strengthen climate-informed early warning systems by integrating meteorological drivers (rainfall, temperature anomalies, El Niño) with routine case data for predictive action; deploy tools and workflows documented in Ethiopian pilots and international reviews.
  • Target vector control to shifting zones. Prioritize LLINs/IRS and larval source management in highland districts where suitability has increased; expand entomological surveillance along elevation gradients, including monitoring for Anopheles stephensi in at-risk urban corridors.
  • Use flexible financing to adapt grants by leveraging Global Fund climate and malaria reprogramming guidance. Adjust budgets and activities mid-cycle as risk maps evolve, for example, by increasing procurement of nets and IRS supplies, adding surveillance sites or deploying rapid response teams.
  • Protect equity in access. As highland communities confront new exposure, ensure case management, outreach and supply chains reach newly affected areas to prevent delays in diagnosis and treatment.

Conclusion: Health, Equity and Stability

The evidence is clear that warming can shift malaria suitability to higher elevations, challenging historical assumptions about Ethiopian highland malaria. By aligning national strategy, donor financing and climate-informed surveillance, Ethiopia and its partners could anticipate and respond to highland malaria risk before outbreaks take hold. Doing so is not only a public health imperative but a matter of equity and system resilience in a changing climate.

– Clara Garza

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

Photo: Flickr