Archive for category: Health

Information and stories on health topics.

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The Progress of HIV/AIDS in Azerbaijan

HIV/AIDS in AzerbaijanHIV is a communicable disease that attacks the human immune system. It destroys CD4 cells, otherwise known as white blood cells. As time goes on, it weakens the immune system. As a result, it causes opportunistic infections such as fungal infections, tuberculosis and some cancers. Many patients do not feel symptoms of HIV for a few months after infection, and as a result, do not realize they have the disease. Compared to Europe, HIV/AIDS in Azerbaijan is comparatively low, but it is still a significant problem. The rate of new HIV infections increased by 0.09 per 1,000 uninfected people from 0.01 in 1990 to 0.1 in 2024.

Treatments for HIV/AIDS

Antiretroviral treatment (ART) prevents HIV transmission from mother to child through breastfeeding. Patients who use ART can also prevent HIV transmission to their sexual partners. However, patients must take ART every day for life. Moreover, reducing HIV transmission connects to harm reduction approaches, which specifically involves the provision of sterile injecting equipment. It proves that harm reduction services include not only needle and syringe programs but also the provision of opioid agonist treatment (OAT).

The Causes of HIV/AIDS in Azerbaijan

On August 3rd, 2016, there were 4,955 HIV-infected people in Azerbaijan; 73.2% of them were men while 26.8% were women. The most significant cause of HIV/AIDS in Azerbaijan was the use of drugs, accounting for 47% of cases. Meanwhile, the second-highest cause was heterosexual contact at 42.1% and the third-highest cause was unknown causes at 7.8%. Finally, the fourth-highest cause was homosexual acts at 1.8% and the fifth-highest cause was mother-to-child transmission, affecting 1.8%.

In Azerbaijan, HIV infection is a serious problem with many cases being connected to people who injected drugs. According to the official statistics of 2021, injection drug use caused 14% of new HIV infections in the country. Of 690 HIV infections, 97 people were people who injected drugs (PWID).

Treating HIV/AIDS in Azerbaijan

Of the 26,894 people in prison in Azerbaijan, 7,979 people were in prison because of illegal drugs on January 31st, 2023. In prison, HIV prevalence was 1.7% in 2020. ART has been available in prisons resulting in 91.8% prisoners receiving treatment in 2019. However, NSP and opioid substitution therapy (OST) were not accessible.

Access to treatment can be challenging for people in Azerbaijan. For example, the needle/syringe program (NSP) covered only 33.9% for each client, providing 55 needles and the unit cost was approximately €33. Meanwhile, OAT coverage was about 1% in 2024 and the price of it was about €133 per client in a year. However, the unemployment benefit proxy was just €1,245. In prison, imprisonment costs about €3,008 per person per year. A simple community package including NSP and OAT and the unemployment benefit were about €1,411 per person per year.

Women’s Challenges and Barriers to Health Care

According to a Eurasian Women’s Network on AIDS study in 2022, Azerbaijan’s National HIV Program did not particularly support women. The overall plan did not include information on addressing stigma, discrimination and human rights for women experiencing HIV, working as sex workers or using drugs.

Additionally, as the Republican AIDS Center mentioned in May 2025, 10,324 respondents living with HIV/AIDS in Azerbaijan mentioned that they faced stigma and barriers to accessing health care and testing services. According to HIV/AIDS patients, access to stigma-free, confidential testing and treatment services need to be a priority for Azerbaijan’s public health strategy in addition to addressing discrimination.

Progress Addressing HIV/AIDS in Azerbaijan

For the voluntary licensing agreement between the Medicines Patent Pool (MPP) and ViiV Healthcare in late 2020, Azerbaijan was able to access dolutegravir (DTG) based on the regimens in upper-middle-income countries, which included Azerbaijan, Belarus and Kazakhstan. In addition, ViiV Healthcare and MPP developed the first-of-its-kind agreement to increase access and affordability to DTG-based HIV treatment plans. As a result, Azerbaijan was able to reduce the price by more than 90% through efforts of communities, procurement agencies and others. The government of Azerbaijan began the actions concerning the import of specific syringes to prevent HIV/AIDS in Azerbaijan.

In 2025, the Ministry of Health mentioned that it will allocate $431,000 for the procurement of these specific syringes. As a component of the “Harm Reduction” project, the government will buy the syringes with a “low dead space.” They expect that these syringes will help prevent HIV.

The Azerbaijan Parliament adopted a new law on HIV/AIDS. It concentrated on human rights and the universal accessibility of HIV-related services, including services targeted at drug users who are both in and out of prison. With the support of United Nations Office on Drugs and Crime (UNODC) and national experts, it could develop these recommendations.

As mentioned by Ali Hassanov, Deputy Prime Minister of the Republic of Azerbaijan, National legislation and policy had to consider the interests and needs of people who injected drugs and prisoners. He also mentioned that efforts to address the social and economic risk factors for HIV infection were an important part of an efficient strategy to reducing the spread of HIV in the years to come. The social and economic factors meant that they deprived individuals of the power to protect themselves against HIV infection.

In addition, Hadi Rajabli, Chair of the Social Policy Committee mentioned that the new law included the prohibition of discrimination and stigmatization. It contained programs to prevent the contraction of HIV among at-risk groups and prison inmates.

Looking Ahead

The issue of HIV/AIDS in Azerbaijan is still challenging. However, Azerbaijan’s efforts have helped reduce the price of treatments by 90% and it expects that HIV prevention plans will improve. Furthermore, the parliament accepted a new law on HIV/AIDS with the aid of UNODC and national experts.

– Yunjae Lee

Yunjae is based in Vancouver, Canada and focuses on Global Health and Politics for The Borgen Project.

Photo: Unsplash

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Addressing Syphilis, Hepatitis B and HIV/AIDS in the Maldives

HIV/AIDS in MaldivesIn October 2025, the World Health Organization (WHO) officially declared that the Maldives had become the first country in the world to accomplish ‘triple elimination’ of mother-to-child transmission of HIV, syphilis and hepatitis B. As a nation, the Maldives has demonstrated a dedication to targeted, all-encompassing health care, providing a blueprint for the rest of the world to follow in its footsteps towards a collective aim of eliminating preventable disease transmission. This milestone holds the promise of a protected generation born free of infection, making it more than just a medical triumph. The reduction of HIV/AIDS in the Maldives serves as a reminder worldwide that even smaller nations can spearhead global change with the right commitment and focus.

The Meaning of Triple Elimination

Essentially, in global health terms, “triple elimination” marks one of the highest standards a country can achieve: a victory against three life-threatening diseases. It represents an implication that mothers are no longer infecting their offspring with hepatitis B, syphilis or HIV, three diseases that took the lives of countless newborns. Although the diseases have not completely perished, their transmission has dropped to the point that they are no longer a concern to public health. Although these infections still exist, transmission rates fall below strict WHO thresholds. To receive recognition, a country must:

  • Test and treat nearly all pregnant women
  • Provide prompt newborn interventions, including the hepatitis B birth dose within 24 hours
  • Maintain consistent outcomes over several years

Triple elimination fundamentally demonstrates what can be achieved when governmental, medical and scientific efforts come together to provide every baby with an optimal start in life.

Mother-To-Child Transmission on the World Stage

Globally, an estimated 1.3 million women and girls living with HIV become pregnant each year. Congenital syphilis is the second leading cause of preventable stillbirth globally, preceded only by malaria. Hepatitis B, on the other hand, is a liver-attacking virus that can infect a newborn and cause chronic illness in later life. However, early detection, treatment and prompt vaccination—especially the hepatitis B birth dose within 24 hours of delivery—can prevent these diseases.

According to UNICEF, new HIV infections among children under five dropped by 62% between 2010 and 2024. However, to meet the 2030 goals that UNAIDS and its partners established as part of the UNAIDS Global Strategy to End AIDS, progress needs to be made at a much faster rate. To eradicate new infections in children and cut the number of HIV-related deaths among expectant mothers in half, treatment for all pregnant and nursing women living with HIV must be accelerated.

Where Poverty Fits In

Poverty increases vulnerability to mother-to-child transmission because families with low income often face:

  • Limited access to antenatal care
  • Delayed or missed screening
  • Higher rates of untreated infection
  • Less access to protection during intercourse
  • Difficulty affording transport or follow-up appointments

The Elimination of Mother-To-Child Transmission (EMTCT) Initiative

To assist nations in achieving these objectives, the World Health Organization (WHO) developed the Elimination of Mother-to-Child Transmission (EMTCT) initiative. Numerous countries have made strides with some succeeding in ‘dual elimination’ status for syphilis and HIV. However, no nation had ever successfully eliminated all three at the same time until the HIV/AIDS in the Maldives confirmation this year.

This makes EMTCT efforts essential for reducing inequality across countries, especially in regions with limited health care infrastructure. The Maldives became an active participant in the WHO South-East Asia Regional EMTCT Initiative in 2016. In 2018, due to the regulation provided by the EMTCT initiative, they implemented the ‘Agenda for Integrated Service Delivery’ and started a systematic data collection for HIV, syphilis and hepatitis B. The progress seen with HIV/AIDS in the Maldives highlights how strong public health systems can help overcome poverty-related barriers. 

In the Maldives, poverty and geographic isolation have historically increased the risk of mother-to-child transmission of infections like HIV, syphilis and hepatitis B. Dr Catharina Boehme, Officer-in-Charge at the WHO South-East Asia Regional Office, affirmed the significance of “equitable care across its dispersed islands.” The nation’s numerous outer islands have historically had lower income levels, fewer job prospects, and less access to social services than the capital region. Families in these islands were more likely to miss early screening or timely newborn vaccination due to reduced household income and inadequate health infrastructure, underscoring the connection between health risk and economic disadvantage. Acknowledging these disparities, the government structured its maternal health system on universal access: all islands now offer free testing, treatment and birth-dose vaccination, and the WHO’s EMTCT framework supports this model.

Maldive’s Methods

  1. Early and Universal Screening: By the mid-2010s, the Maldives integrated first-trimester HIV, syphilis and hepatitis B screening into routine antenatal care, ensuring that even women in remote islands received early diagnosis.
  2. High Antenatal Care Coverage: The government invested heavily in island-level health posts and trained midwives, increasing antenatal care coverage and reducing disparities between wealthier households and families experiencing poverty.
  3. Strong Vaccination Systems: The Maldives maintained hepatitis B birth-dose coverage above 95%, a key requirement for EMTCT validation. Skilled birth attendants on smaller islands received training to guarantee newborn vaccination within 24 hours.
  4. Free Access to Treatment: All testing and treatment for HIV, syphilis and hepatitis B were free of charge, removing financial barriers that typically disproportionately affect low-income families.
  5. Data-Driven Monitoring: Through support from the EMTCT initiative, the Maldives strengthened its data systems, enabling accurate tracking of infections, treatment uptake and birth outcomes.

Looking Ahead

Proving itself a leading agent in maternal and antenatal care, “The Maldives’ triple elimination stands as a powerful example of how sustained investment in health systems, innovation and community-based care can change the trajectory of public health,” said Ms. Payden, WHO Representative to the Maldives. The HIV/AIDS in the Maldives’ progress began more than a decade ago, long before triple elimination was in sight. Because its population is dispersed across more than 1,000 islands, the government prioritized a decentralized, community-based health care system to ensure equal access regardless of income or geography. As stated in the WHO’s South-East Asia update, the Maldives’ feat is credited to long-term, systemic investments that have sustained high antenatal care coverage and integrated first-trimester screening for all three infections across scattered island communities. For the children of the Maldives, the future now begins infection-free.

– Prubleen Bhogal

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

Photo: Pexels

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Digital Pharmacy Platforms Make Medicine in Nigeria Affordable

Medicine in NigeriaIn Nigeria, the struggle to access affordable health care remains one of the most pressing challenges in the fight against poverty. Millions of Nigerians, especially those in rural areas, face unaffordable health care and counterfeit medications that threaten their lives and drain their resources. However, recent technological advancements are beginning to change this situation.

The rise in digital pharmacies introduces a clearer path to affordable and quality health care. Through the intervention of companies such as DrugStoc, Drug-IT Solutions and Pharmagateway, technology now authenticates supply chains, reduces the presence of counterfeit drugs and lowers costs for patients. These platforms not only improve health care access but also stimulate the economy by creating digital jobs and supporting local pharmaceutical businesses.

Background and Challenges

Nigeria, often referred to as the “Giant of Africa,” is a country located in West Africa with a population of more than 230 million people, the largest in Africa. Known for its ethnic diversity, large entertainment industry and major oil and gas production, Nigeria holds an important position in Africa. However, the country continues to face several challenges, including poverty, insecurity, corruption and lack of access to affordable health care.

Among these issues, the state of the health care system remains one of the most urgent ones. Health care in Nigeria suffers from inadequate funding, with leaders allocating only about 4.27% of the nation’s GDP to this sector. Other factors that affect Nigeria’s health system include poor infrastructure, a high disease burden and limited access to vaccines and other essential medications, which further weaken the system.

A particularly concerning issue involves the widespread prescription of counterfeit and substandard drugs, often sold through poorly trained “street chemists.” Many innocent civilians fall sick or require hospitalization because these “chemists” sell fake drugs. According to the National Primary Health Care Development Agency, around 70% of the drugs circulating in Nigeria are fake.

Poverty fuels this crisis. Many people in rural Nigeria cannot afford basic health care, so they turn to these street pharmacies as a source of cheaper medicine. This urgent need for change creates an opportunity for online technologies, particularly digital pharmacy platforms, to alleviate the financial and health burdens associated with poverty.

The Rise of Digital Pharmacies

Digital pharmacy platforms in Nigeria have emerged as a transformative solution to this challenge by combining traditional pharmacy systems with modern digital tools to improve the ordering, verification and delivery of quality medications. In Nigeria, several notable health-tech platforms, including DrugStoc, Pharmagateway and Drug-IT Solutions, have made significant progress in addressing the issue of counterfeit medication distribution.

  • DrugStoc: Launched in 2017, DrugStoc is a cloud-based platform that helps health care providers easily access affordable, high-quality pharmaceuticals and medical products. It ranks among Africa’s top health-technology innovators. DrugStoc provides authenticated medications to hospitals and clinics through thorough quality checks and real-time supply analytics. This way, it ensures the reliability and transparency of the medications it distributes.
  • Pharmagateway: This is another digital pharmacy platform in Nigeria that works to ensure that quality medication reaches consumers. Founded in 2020, Pharmagateway developed a system for pharmaceutical professionals to manage and pay industry-related dues while ensuring compliance with professional standards. The platform also provides access to job opportunities within the pharmaceutical sector.
  • Drug-IT Solutions: This is another Nigerian technology-powered pharmaceutical distribution company that offers a digital platform that helps health facilities safely and efficiently restock medical supplies, while also providing consumers with a convenient prescription refill service. The company aims to transform Nigeria’s pharmaceutical supply chain using innovative technology. By improving distribution processes, reducing waste, combating the spread of counterfeit drugs, lowering costs and increasing access to medicines, Drug-IT enhances health care access for people nationwide.

By utilizing the specialized Matrix-36 software, Drug-IT Solutions connects manufacturers, wholesalers, retailers and consumers, thereby creating a fully integrated pharmaceutical supply chain.

The rise of digital pharmacies in Nigeria improves access to safe and affordable medicine by using technology to strengthen the drug supply chain.

Looking Ahead

Digital pharmacy platforms in Nigeria provide access to safe and affordable medicine, offering a promising path toward stronger health care and reduced poverty. Companies like DrugStoc and Drug-IT improve medication quality and accessibility. However, these platforms still face challenges, including limited internet access in rural areas, inconsistent regulatory enforcement and low digital literacy among certain communities.

With continued innovation, stronger government support and sustained investment in technology and public education, Nigeria can overcome these obstacles. Moving forward, digital pharmacies have the potential to support a more reliable, affordable and accessible health care system for all Nigerians.

– Emmanuel Fagbemide

Emmanuel is based in Winnipeg, Canada and focuses on Technology and Global Health for The Borgen Project.

Photo: Unsplash

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The Philippines is Addressing Poverty: A Multi-Pronged Approach

Philippines is addressing povertyThe Philippines is addressing poverty with a three-tier strategy that combines cash transfers, education reforms and expanded health care coverage, officials say, as policymakers aim to transition short-term relief into sustainable progress.

A Stronger Social Safety Net

At the core of the country’s effort is the flagship conditional cash-transfer program known as the Pantawid Pamilyang Pilipino Program (4Ps). The program provides regular cash payments to low-income households that meet specific criteria, including regular school attendance for children and regular preventive health care visits. The idea is to provide an immediate buffer from extreme hardship while encouraging families to adopt behaviors that build human capital.

Government planners identify poverty reduction, universal health care and quality education as the three key “socioeconomic goals” driving this agenda.

Expanding Access to Education

On the education front, the Philippine government passed the Universal Access to Quality Tertiary Education Act (RA 10931) in 2017. It provides free tuition and certain school-fee subsidies at state universities and colleges and offers a “tertiary education subsidy” (TES) for students in private institutions under particular conditions. The policy has benefited more than two million students.

Officials say that free higher education is a vital means of equipping low-income households for stable employment, thereby helping to break the cycle of poverty. For example, 4Ps households are being encouraged to tap the student-aid schemes. Yet analysts note that participation among the most impoverished deciles remains lower than among wealthier peers; in 2019, only about 6.1% of students came from the neediest households versus higher shares in better-off ones.

Health Care Investment and Risk Protection

The Philippines is also addressing poverty by working to fortify health care access through its Universal Health Care (UHC) law. It aims to reduce financial risk from illness and to expand service delivery, especially for people experiencing poverty. According to the World Health Organization (WHO), high out-of-pocket spending and health-service gaps have been drivers of poverty in the country.

A study by the Philippine Institute for Development Studies (PIDS) identified major geographic coverage gaps: while most major regions have national health insurance enrollment rates above 90%, conflict-affected provinces in Mindanao reported coverage levels as low as 52%.

Early Progress

According to the Philippine Statistics Authority, the national poverty rate dropped from 18.1% in 2021 to 15.5% in 2023. This translates to a decline of roughly 2.4 million individuals living under the official poverty line. It suggests the multi-pronged strategy is yielding results. However, officials caution that inflation (especially food price inflation) and regional disparities remain serious headwinds.

Despite the framework, key challenges remain. In health care, enrollment is still concentrated among formal-sector workers, making it difficult to extend equitable coverage to informal and rural populations. In higher education, low-income households continue to be underrepresented, raising concerns about whether subsidies are reaching those who need them most.

Finally, in cash-transfer programs, persistent inequalities, service-delivery bottlenecks and local government capacity gaps mean full reach has not yet been achieved.

Looking Ahead

For the Philippines’ approach to translate into enduring poverty reduction, policymakers will need to deepen the linkages among welfare, education and health interventions. That means ensuring vulnerable households are not only stabilized by cash grants, but that their children benefit from quality schools and are shielded from catastrophic health-care costs. If effectively implemented, the integrated model offers a pathway from relief to resilience.

– Arielle Telfort

Arielle is based in Purchase, NY, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Marburg Virus in Ethiopia

Marburg Virus in EthiopiaMarburg virus is a rare disease that can be spread between humans via contact with bodily fluids from another infected individual. The disease is severe and in 80% of cases fatal. The virus causes symptoms such as fever, headaches, muscle aches, rash, vomiting and more. 

The virus is most commonly found in sub-Saharan Africa. Multiple countries in this region have been affected in the past, with the most recent outbreak reported in Ethiopia. Ethiopia is a country located in the Horn of Africa, with the second-largest population on the continent.

The country has already battled multiple viruses, such as yellow fever, hepatitis, HIV and more. On November 12, 2025, a new outbreak of Marburg virus was detected in Ethiopia. This strain is reportedly the same strain that had broken out in other African countries. There are at least nine cases of Marburg virus in Ethiopia, with six confirmed deaths.

The Cause

The virus spreads to humans from infected Egyptian rousette bats. According to scientists, there is an increased risk of outbreaks as “climate [instability], as well as deforestation and urbanization, is steadily destroying the habitats of the fruit bats that harbor diseases like Marburg and Ebola…” Once the virus has infected humans, it can be transmitted to others through contact with infected bodily fluids.

To prevent transmission, experts recommended that those working in or visiting areas inhabited by bat colonies take protective measures, such as wearing gloves and masks. They also advised avoiding contact with individuals who are already infected.

Treatment

Treatments and vaccines for the virus currently do not exist. However, some vaccines are under investigation and early supportive care has also been shown to improve the survival rate of those infected. Nonetheless, multiple other countries, such as Rwanda, Tanzania and the Democratic Republic of the Congo, have experienced Marburg outbreaks but managed to control the virus in a short period through several effective methods.

This was achieved through community engagement and intervention practices, such as case management, reducing the risk of human-to-human and bat-to-human transmission (through isolation, masks and other measures), surveillance, contact tracing and more. These methods may be implemented to combat the virus in Ethiopia.

Responses

Multiple responses have been implemented to aid those who were infected, prevent transmission and eliminate the virus from the country. Various health organizations have carried out these measures:

  • Ministry of Health: The Ethiopian Ministry of Health has taken multiple measures to fight Marburg virus in Ethiopia. This includes establishing a National Task Force to aid in decision-making and resource mobilization, along with a three-month response plan. It has also been informing the public about the outbreak and conducting surveillance and response activities.
  • The World Health Organization: The WHO has also been supporting Ethiopia during this time. The organization has deployed a team of expert responders and provided the necessary medical supplies and equipment.
  • Africa CDC: Ethiopia’s molecular diagnostic and genomic surveillance capacity was immediately put to use during the outbreak. Africa CDC supported these efforts by providing sequencing equipment, PCR detection kits with Marburg-specific assays, extensive training and other resources.

– Renata Hirmiz

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

Photo: Flickr

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Everything To Know About HIV/AIDS in Bolivia

HIV/AIDS in BoliviaHIV/AIDS in Bolivia affects less than 1% of the population. The U.S. Agency for National Development reports that this puts the country at the lowest in HIV prevalence within Latin America and the Caribbean region. Officials reported the first diagnosis of HIV in 1985. Although HIV prevalence has remained low, it disproportionately affects marginalized populations. Two populations that are disproportionately affected are men who have sex with other men (MSM) and transgender women. Societal stigma and prejudice against these groups have resulted, necessitating a response that addresses these specific issues. According to UNAIDS, infection rates have steadily declined since 1993 and reached about 0.16 per 1,000 people as of 2024. Death rates have also steadily declined since 2011. As of 2024, the death rate is about 0.04 per 1,000 people.

Background on HIV/AIDS

According to the World Health Organization (WHO), HIV is a virus that targets the immune system by attacking white blood cells. Bodily fluids from an infected person can spread HIV. This can include blood, breast milk, semen and vaginal fluids. Antiretroviral therapy treats HIV. Without treatment, HIV can develop into AIDS.

The Response

The United Nations developed UNAIDS, the Joint Programme on HIV/AIDS, to lead the global effort to eradicate it. UNAIDS’ main focus is to advocate for affected communities, provide technical support, collect data on the illness and assist countries that are most affected. The joint program in Bolivia has carried out various efforts to address HIV through prevention, testing and treatment. Community-based programs, supported by the Joint Programme, have provided access to HIV prevention packages in 2023 to MSM and transgender women. Furthermore, the Triple X (Xpressa, eXplora and eXige) campaign has run a social media initiative aimed at increasing condom usage. It has reached 111,000 young people and resulted in a 12% increase in condom distribution within the public health system in one year. Additionally, the government has developed national guidelines for pre-exposure prophylaxis with support from the World Health Organization (WHO) following its adoption of the preventive drug regimen.

Impacts of People in Poverty With HIV

People who live with HIV/AIDS in Bolivia face conditions conducive to poverty, such as food insecurity and unstable livelihoods face major obstacles in managing their treatment, indicating a connection between economic struggle and HIV-related health outcomes, according to a study performed by Palar and a team. The Pan American Health Organization (PAHO) states that more than a third of Bolivia’s population lived below the national poverty line in 2021, indicating economic strain that reflects the hardships patients described in the study.

Palar’s team determined that time conflicts with their jobs prevented many participants from getting their doses, the stigma of HIV caused the loss of jobs and that many HIV patients struggled to balance their treatments with expectations from informal or unpredictable employment. The study observes that these conditions directly impact antiretroviral adherence, especially for those who lack a stable income or consistent access to food. The team also notes that a food-assistance pilot program has helped ease these pressures through improving patients’ nutritional stability. This has helped patients take their medication correctly.

Addressing Disparities and Prejudices

Fighting HIV/AIDS in Bolivia importantly involves addressing the disparities within the populations it affects and the prejudices surrounding the disease. Capacity-building training and catalytic funding have supported civil society organizations in Bolivia to strengthen the HIV response, address stigma and discrimination and protect human rights. As UNAIDS reported, the Bolivian Network of People Living with HIV and the Ministry of Health have introduced a pulsometer, a pilot stigma and discrimination self-assessment tool, to gather data on stigma and discrimination directed toward people living with HIV and key populations within the healthcare system. This aims to address barriers to accessing services.

In 2022, officials created an essential care standard for vulnerable communities and integrated it across 3,000 health facilities. As UNAIDS outlined, this protocol includes guidelines that prevent stigma, ensure adherence to care and diagnosis standards for HIV and promote condom use. In an effort to decriminalize HIV transmission, REDBOL and the community-centered organization Asociación Un Nuevo Camino have created a project to modify the 2008 HIV law. Advocates organized social dialogues to pressure Congress.

Looking Ahead

Although HIV is not an epidemic among the general population in Bolivia, it is prevalent within concentrated communities. The government and external organizations have made consistent efforts to address and treat this disease. HIV carries significant societal stigma and prejudice; as such, the response has acknowledged discrimination against marginalized groups. The response has addressed the disease itself and has also worked to undo prejudice and discrimination toward marginalized communities.

– Sasha Banaei

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

Photo: Flickr

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Fighting Poverty Among People With Albinism in Malawi

People With Albinism in MalawiMalawi has one of the highest rates of albinism in the world; an estimated one in 130 people is born with the genetic condition, more than 134,000 in total. Albinism causes a lack of melanin pigmentation in the skin, hair and eyes, significantly increasing the vulnerability to sun damage and, therefore, skin cancer. Yet for those living with albinism in Malawi, health risks are only a fraction of the struggle.

Harmful superstitions have fueled discrimination and ritual attacks, with some erroneously believing that some body parts of people with albinism bring wealth or good fortune. These dangers leave individuals with albinism isolated and economically vulnerable. Growing advocacy efforts are helping to challenge stigma, improve access to protection and build safer, more inclusive opportunities for Malawians with albinism.

Poverty and Discrimination Among Malawians With Albinism

Of the 134,000 Malawians with albinism, 53,000 are primary and secondary school age. From an early age, many Malawian children with albinism face bullying and discrimination at school. Social exclusion, alongside misinformation about their condition, causes many to withdraw or drop out entirely.

Without a full education, opportunities for higher-paying or skilled employment become limited, increasing the likelihood of lifelong poverty. Those who struggle to find work are often pushed toward low-wage, outdoor labor, such as farming or manual jobs, which places them under direct sunlight for long hours and heightens health risks.

Health concerns further compound these economic barriers. As melanin helps protect the skin from ultraviolet exposure, people with albinism are highly susceptible to severe sunburn and skin cancer. Access to sunscreen, protective clothing and dermatology services is limited, particularly in rural areas. Both medical challenges and threats of violence trap individuals with albinism in a cycle where discrimination and poor health drastically narrow opportunities for mobility and economic participation.

The Association of Persons With Albinism in Malawi

The Association of Persons with Albinism in Malawi (APAM) is the country’s leading grassroots advocacy group for the rights, safety and economic inclusion of people with albinism. APAM documents attacks and human-rights violations, presses police and government to act and, through engagement with local communities, demands better protection and services. In recent years, the group has shifted its focus from emergency response to long-term inclusion.

It now implements school outreach programs to reduce stigma, supports leadership and entrepreneurship training to help members transition into safer, higher-quality work and advocates for policy measures. APAM also partners with health-focused NGOs to expand sunscreen distribution, vision care and dermatology referrals, recognizing that health protection and socioeconomic well-being are interlinked. By combining case documentation, public education and policy advocacy, APAM has helped place albinism on Malawi’s national agenda.

It has prompted the government and donors to commit to sustained funding for protection programs, a vital step in breaking the cycle of discrimination and poverty.

Standing Voice

Standing Voice is an international nonprofit working in Malawi (and across Africa) to deliver long-term, scalable solutions for people with albinism. Rather than focusing only on crisis response, the organization operates programs that prioritize individuals’ safety, attending school and participating confidently in public life. In the health sector, Standing Voice establishes clinical networks and provides access to sunscreen, dermatology and low-vision services.

These are critical interventions that enable people with albinism to participate in school or the world without being sidelined by illness. On the education and livelihoods front, the organization works to reintegrate children into schools and provide vocational and livelihood support. This enables adults with albinism to access safer and more sustainable employment rather than outdoor, high-risk labor.

Additionally, like APAM, Standing Voice undertakes advocacy to break cycles of stigma, violence and exclusion by amplifying the voices of people with albinism and influencing policy. Its holistic strategy links protection with economic empowerment, addressing both root causes and outcomes of poverty for Malawians with albinism.

Final Remarks

People with albinism in Malawi continue to face preventable dangers and barriers that limit both their safety and socioeconomic participation. Yet, the progress led by advocacy organizations, health initiatives and community education shows that these challenges are not inevitable. With continued investment in protection, accessible health care and inclusive employment, Malawians with albinism can build secure, independent futures.

– Elysha Din

Elysha is based in Guildford, UK and focuses on Good News and Politics for The Borgen Project.

Photo: Flickr

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Typhoid in Bangladesh: A Bold Vaccination Campaign

Typhoid in Bangladesh: A Bold Vaccination Campaign to Counter a Drug-resistant Menace Typhoid is a highly contagious infection that typically causes high fevers of up to 39-40 degrees Celsius, along with symptoms such as headache, cough, extreme fatigue, constipation, loss of appetite and diarrhea. If left untreated, there are risks of intestinal and neuropsychiatric complications. The cause of the disease is the bacteria S. typhi, and the primary mode of transmission is through food or water that is undercooked or contaminated from contact with an infected individual.

Typhoid in Bangladesh

Typhoid in Bangladesh is endemic. In fact, there were approximately 477,518 cases of typhoid, with 7,998 deaths in 2021. According to a 2017 study, Bangladesh is one of the top five countries worldwide in terms of clinical incidence, deaths and disability-adjusted life years due to typhoid fever. Typhoid is closely linked to poverty; the highest clinical incidence occurs in poorer communities with limited access to clean water, uncontaminated food and hygienic environments.

Based on the national poverty line, Bangladesh’s poverty rate was 18.7% in 2022, according to the World Bank. Data shows that this rate has risen in recent years, with estimates projecting an increase to 21.2% in 2025. Factors contributing to this include weak labor markets, high inflation and depressed wages. Children face a disproportionately high impact. Studies in Dhaka have shown that children under 15 are at an abnormally high risk for typhoid, with elevated clinical incidence rates. This has driven the government of Bangladesh to prioritize child-focused prevention efforts.

Antibiotic Resistance: A Growing Barrier

One major factor complicating typhoid control initiatives is antibiotic resistance. S. typhi continually evolves, developing resistance to medications that were once highly effective. As of 2022, the newest strain—extensively drug-resistant (XDR) typhoid—could resist both first- and second-line treatments. Few medications remain effective, posing significant challenges for countries with limited health care infrastructure, fewer resources and higher poverty rates.

To address this, the government of Bangladesh proposed introducing typhoid conjugate vaccines (TCVs) to prevent typhoid among children. Compared to live vaccines, TCVs offer increased efficacy, stronger immune responses and the ability to be administered to children as young as 6 months. A 2024 study assessing cost-saving strategies for vaccine administration found that any rollout strategy would be cost-saving compared to current conditions.

The 2025 Nationwide Campaign

In October 2025, Bangladesh launched a nationwide vaccination campaign to protect children from drug-resistant typhoid. The monthlong campaign aims to vaccinate 50 million children between the ages of 9 months and 15 years with one dose of a TCV. The vaccine offers five years of protection, helping slow transmission among children.

The campaign specifically targets low-income areas such as urban slums and poorly connected rural regions due to the elevated clinical incidence and associated risks in these settings. Once the campaign ends, the TCV will be integrated into the national vaccination schedule in 2026 for children under 1, ensuring continued protection.

The campaign, supported by Gavi, the Vaccine Alliance, United Nations International Children’s Emergency Fund (UNICEF) and the World Health Organization (WHO), has already led to the vaccination of 38 million children across Bangladesh, despite interruptions caused by misinformation and vaccine hesitancy. As the campaign approaches its end date, some field officers and parents have voiced interest in extending vaccination deadlines to ensure broader coverage.

Looking Ahead

Overall, this vaccination campaign is a significant step toward the eradication of typhoid in Bangladesh and improving the standard of living for not only children but for the nation at large.

– Nikhil N Kumar

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

Photo: Flickr

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Mutuelle De Santé: Improving Access to Health Care in Rwanda

Mutuelle De SantéAccess to affordable health care remains one of the greatest challenges in African countries, where poverty and limited medical resources prevent millions from receiving essential treatment. However, Rwanda has made remarkable progress through its community-based universal health insurance system, also known as “Mutuelle de Santé.” Primarily introduced in 2004, this system was designed to ensure that every citizen, regardless of income, had access to quality health care without the issue of financial hardship. This system has helped to prevent out-of-pocket spending in health care, especially for those in rural and low-income communities.

Supported by the Rwanda Social Security Board (RSSB), the system combines community contributions, government funding and donors to create a sustainable system of universal health care. This article will explore how Mutuelle de Santé has improved access to affordable health care in Rwanda, the economic impacts of the program and the challenges that still need to be addressed to ensure lasting success.

Mutuelle de Santé

Rwanda, also known as “the land of a thousand hills,” is a developing country located in East Africa, with a population of about 13.8 million people. This nation is often recognized for its progress in technology, unique landscape, environmental sustainability and gender equality in politics.

However, due to the devastating effects following the genocide that occurred in 1994, the health care system was severely affected, leading to the spread of multiple waterborne diseases such as cholera and malaria due to the high rate of interaction between civilians. Several infrastructures, including hospitals, were also destroyed and many doctors fled the country prior to that time.

As a result, many Rwandans, especially those in the rural areas, were deprived of access to affordable health care. That crisis created an urgency for a new and inclusive system that could make health care accessible and rebuild trust for all the citizens in Rwanda.

To address these challenges, the Ministry of Health launched a universal health insurance system known as “Mutuelle de Santé.” This system was designed to make health care affordable and accessible for all citizens through contributions from the government, local communities and health care providers. Mutuelle de Santé is primarily funded through donor support, member premiums and national taxes. Initially introduced in 1999 as an optional community-based insurance system, it gave citizens the option not to contribute. However, after its early successes in 2004, the government officially implemented the program nationwide and increased public funding to reduce hospital costs for patients.

Mutuelle de Santé has experienced remarkable growth and an increase since 1999; currently, around 91% of the population in Rwanda is now insured, making it one of the highest in Africa.

Positive Impacts

The implementation of Mutuelle de Santé has played a vital role in reducing poverty and protecting families from financial hardship caused by medical expenses. Due to the coverage by insurance, out-of-pocket spending on health care has drastically declined and because of this, citizens have a chance to think about other expenses such as food, water and rent.

This has improved economic stability at both the family and community levels, allowing families to save and invest more effectively. Moreover, healthier citizens are more productive and able to participate actively in the workforce, which in turn contributes to national economic growth and development. This program not only protects individuals from medical debt but also strengthens Rwanda’s overall economy by creating a healthier, more resilient population.

Another benefit involved with the introduction of Mutuelle de Santé is the three-tiered scaling program called “Ubudehe.” This is a system which groups households into six categories based on income and assets. The government fully covers insurance premiums for the lowest-income groups, while middle-income households pay an annual premium of approximately RWF 3,000 ($2.68), and higher-income groups pay RWF 7,000 ($6.24). Around 83% of Rwandans fall into the middle categories and pay their own premiums, while those living in extreme poverty, old age or with disabilities have their costs fully subsidized. This structure ensures that even the most vulnerable citizens have access to essential health care services.

Challenges and Limitations

Despite its many successes, Mutuelle de Santé continues to face significant challenges. Since 2011, Rwanda has suffered due to financial problems, which have raised concerns about the insurance system’s sustainability. In 2001 and 2012, the deficit was recorded at 3,896 million Rwandan francs (RWF), and by 2014/2015, it had exponentially increased to RWF16,149 million. Although it declined slightly to RWF 12,837 million in 2015/2016, the deficit increased again to RWF 17,670 million in 2017/2018. This ongoing fluctuation has forced the Government of Rwanda to intervene each year to cover community-based health insurance (CBHI) debts owed to health facilities.

Other challenges associated with Mutuelle de Santé include broader governance and structural issues that affect its sustainability. The program’s heavy reliance on government support can create financial strain and raise concerns about long-term stability. Additionally, Rwanda’s strong sense of community solidarity has been essential to the success of the insurance system. Whereas in countries where trust in public institutions is weaker, a lack of community engagement and confidence among recipients can hinder the implementation of a similar model.

Looking Ahead

Despite these challenges, Mutuelle de Santé has continued to thrive in a nation once devastated by conflict. Its success demonstrates Rwanda’s resilience and commitment to affordable health care for all citizens. With continued reflection, adaptation and innovation, this community-based health insurance model has the potential to inspire and guide other African nations to universal health coverage.

– Emmanuel Fagbmide

Emmanuel is based in Winnipeg, Canada and focuses on Technology and Global Health for The Borgen Project.

Photo: Unsplash

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Behind The Numbers: The Story of HIV/AIDS in Niger

HIV/AIDS in NigerNiger has one of the lowest HIV rates in sub-Saharan Africa – but experts warn that low prevalence does not mean low risk. Behind the calm statistics lies a fragile health system, deep gender disparities and poverty that magnifies every infection.

According to the Joint United Nations Program on HIV/AIDS (UNAIDS), as of 2020, about 31,000 people in Niger live with HIV, with roughly 1,200 new infections each year. While Index Mundi cites adult prevalence remaining steady at just 0.2% as of the same period, only 68% of those infected were on antiretroviral therapy (ART), leaving nearly a third untreated. In a country where more than 40% of citizens live in extreme poverty, these gaps carry steep social and economic costs.

A Hidden Epidemic

Health officials warn that Niger’s low HIV rate masks deeper weaknesses in detection and prevention. In an interview with the University Research Co, a company focused on international development and health, Halima Mainassara, Chief of Party for the U.S. Department of Defense HIV/AIDS Prevention Program (DHAPP) in Niger, reinforced the urgency of the disease, “Every new HIV case detected is important – their contacts also need to be tested,” says Mainassara, “This ensures that all individuals who test positive will receive treatment and that the virus cannot spread further.”

Despite gains – such as the integration of HIV and tuberculosis care in 262 treatment centers – resource shortages, long travel distances and stigma over HIV/AIDS in Niger still limit testing and follow-up, according to the World Health Organization – Africa (WHO AFRO). Per the same report, mortality among TB/HIV co-infected patients fell from 21% in 2019 to 14% in 2022, but coverage remains uneven between cities and rural areas.

Gender and Youth at the Margins

Women and young girls carry most of the burden. UNAIDS data from 2021 shows they account for just under 55% of HIV cases in Niger, reflecting social inequalities that restrict education, health care access and decision-making. Early marriage, gender-based violence and limited reproductive services heighten vulnerability.

“When a woman is divorced as a result of her HIV status, it is difficult for her to keep her children,” said Sona Soumaré Conté, President of an NGO working with HIV-positive women in Niger. “Their husbands are afraid their children will not be well taken care of or will become contaminated.”

A report by the Journal of the American Medical Association (JAMA) stated that adolescents are also at risk. Knowledge about HIV prevention among young people remains low, and misconceptions persist, especially in rural communities where sexual health education is scarce.

Poverty and the Global Connection

HIV and poverty form a vicious cycle. Illness limits productivity, weakens households and deepens food insecurity. A report that UNAIDS and the World Food Programme (WFP) did in 2022 found that for families already surviving on less than $2 a day, one untreated infection can mean lost income and school dropouts.

The link extends beyond Niger. Global efforts to end extreme poverty rely on stable, healthy populations. In the same report, the World Food Programme and UNAIDS launched a joint cash-transfer project that provides small stipends (≈ US $76 per quarter) to people living with HIV to improve treatment adherence, underscoring the inseparable link between health and development.

Solutions in Action

One organization leading change is Solthis, an international Non-Governmental Organization (NGO) partnering with Niger’s Ministry of Health to strengthen HIV prevention and care. Through its Lahiyata project launched in 2023, Solthis works in Maradi and Niamey to improve sexual and reproductive health among adolescent girls, offering education, counseling and access to HIV and STI testing. In addition, Solthis technical support program helped train health workers, upgrade laboratories and expand treatment access nationwide. According to data from UNAIDS, between 2022 and 2023, more than one million pregnant women in Niger received voluntary HIV counseling and testing, linking many to lifesaving antiretroviral therapy.

Progress and the Path Ahead

Niger’s progress is real: ART coverage has grown from 26% in 2011 to 68% in 2020, likely attributed to the increase of foreign aid between 2015 and 2020 and Niger’s adoption of UNAIDS’ “90-90-90” prevention framework, and nationwide awareness campaigns are improving testing uptake. But sustainability is fragile. Most funding comes from international donors, and local programs risk collapsing if aid declines, per UNAIDS. To secure its future, Niger must expand ART coverage for HIV/AIDS in Niger, target key populations, and confront stigma through education and inclusion.

– Matt Irwin

Matt is based in Brooklyn, NY, USA and focuses on Global Health for The Borgen Project.

Photo: Wikimedia Commons