Archive for category: Health

Information and stories on health topics.

, ,

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

,

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

, ,

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

, ,

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

, ,

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

, ,

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

, ,

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

, ,

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

, ,

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

, ,

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