Archive for category: Health

Information and stories on health topics.

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Maternal Mortality in the KP Region

Maternal Mortality in the KP RegionConditional cash transfers (CCTs) are a common tool used by governments to alleviate poverty. It involves direct cash transfers to individuals or households to help families manage expenses. In exchange for these grants, there are stipulations of required health check-ups or testing, educational enrollment or other factors that can broadly reduce poverty and improve standards of living.

Based on current evidence, CCTs are most effective in health care-related initiatives, often improving health outcomes and encouraging increased utilization of health care offerings. The studies that provide this evidence also note that despite the clear positive impact, the efficacy of these initiatives remains ill-defined. This is due to disparate health care systems and the quality of services offered between the countries and communities where CCTs have been implemented.

Maternal Mortality in the KP Region

In Pakistan and in South Asia generally, the maternal mortality rate is significantly high. Although there has been a significant drop in the maternal mortality rate of around 60% between 2000 and 2017, the region still accounts for around 20% of maternal deaths worldwide. The 2006-07 Pakistan Demographic and Health Survey was the first effort to collect information on maternal mortality in the country.

The survey revealed that during those years, there were 276 maternal deaths for every 100,000 live births in Pakistan. In 2007-08, in the Khyber Pakhtunkhwa (KP) region, the maternal mortality rate was 275 deaths for every 100,000 live births in the region. These numbers indicated severe deficiencies in the delivery of adequate health care to expectant mothers, which the local governments of Pakistan sought to address.

The Chief Minister’s Special Initiatives

In the KP region of Pakistan, the Chief Minister’s Special Initiatives are a set of poverty alleviation measures created by the local government. These initiatives aim to improve living standards by offering financial incentives to individuals who take advantage of local services focused on education, employment and health outcomes.

For example, grants were provided to female students above grade 5 to encourage them to continue their education. Stipends were also offered to young people enrolled in government-sponsored vocational training programs. These incentives were significant because they represented key examples of CCTs used as a poverty alleviation tool in Pakistan.

In 2014, recognizing the urgent need to address maternal mortality rates and in line with a national push to improve health care for mothers and children, the government of KP launched the Chief Minister’s Special Initiative for Mother and Child Health. This conditional cash transfer program provides fixed cash stipends to marginalized mothers for attending prenatal checkups, delivering safely and completing postnatal visits.

A 2024 study evaluating the program found a substantial increase in the total number of health-seeking hospital visits, indicating that the intervention successfully achieved its intended behavioral change. Additionally, the cash incentives improved household purchasing power and supported the incomes of vulnerable families. The findings provided strong evidence for expanding the use of other CCT programs in Pakistan.

Maternal Mortality Declines in KP

In the years that followed, the maternal mortality rate declined significantly. The 2019 Pakistan Maternal Mortality Survey collected updated national and regional data, showing trends since the 2007 survey. Nationally, maternal deaths fell from 276 to 186 per 100,000 live births.

In the KP region, the figure dropped from 275 to 165, representing a slightly higher percentage reduction than the national average. This suggests that local initiatives and conditions, including the CCT programs, may have contributed to reducing maternal mortality rates.

Final Remarks

The conditional cash transfers program in the KP region has already shown promising results for improving maternal health outcomes and alleviating poverty. It could be a model for the rest of Pakistan to follow and bring down its alarming maternal mortality rates.

– 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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Dependency on Foreign Health Care Workers in Ireland

Health Care Workers in IrelandIreland has long been a source of high net emigration, with an estimated 10 million emigrants leaving the western European island since 1800. However, the past two decades have seen an unprecedented increase in the number of foreign health care workers in Ireland. The Irish health care system has experienced notable growing pains in its attempts to retain domestically-trained doctors, who often follow a decades-long trend of looking abroad to Australia, Canada and the U.K. for hire.

As Irish doctors continue to move abroad, internationally trained medics bridge the gap. Here is a look at the path ahead as Ireland copes with shortages in professional health care and works toward a more accommodating workplace for Irish doctors.

Brain Drain: Doctors Leave Ireland Behind

A telltale shift in the Irish health care industry came in the late ’90s, when rapid economic growth and demand for nursing services outpaced Ireland’s supply of workers. Since 2000, Irish doctors, most of whom depart from Ireland during or after their training, have remained similarly scarce. This period of economic expansion marked an inflection point in Irish health care, where Ireland’s historical role as a major exporter of Irish nurses reversed.

Ireland’s trend in poor doctor retention seems to mirror a similar trend affecting northern and western Europe as a whole.

Unstable Working Conditions Disillusion Doctors

Most doctors born and trained in Ireland intend to work domestically. Yet, various factors keep these workers looking for work abroad. Notably, a 2018 survey of Irish training doctors found that only 45% intended to find work domestically, hinting at an underlying push factor in the Irish medical field. A 2021 study accredits Ireland’s exodus of domestically-trained doctors to short staffing and poor training, which catalyze stressful conditions in the workplace.

The fulfillment that Irish doctors don’t find in their work environment at home, they pursue abroad. About 72% of emigrant Irish doctors prefer employment in the U.K., Canada and Australia. Naturally, international recruitment programs call on foreign-trained health care workers to compensate for Irish staffing shortages.

Foreign health care workers in Ireland must bridge the gap that Irish emigrant doctors leave behind. Nevertheless, recent assessments of Ireland’s health care system indicate that this international recruitment practice is neither sustainable for foreign-trained workers nor the communities they serve.

Challenges for Foreign Health Care Workers in Ireland

A 2025 World Health Organization study assessing nine European countries (including Ireland) found that the number of foreign-trained nurses increased 67% in these regions from 2014 to 2023 alone. Higher wages and more benefits than are available in a foreign health care worker’s home country incentivize such high immigration trends. However, a significant disconnect exists between foreign workers’ expectations and the working conditions they receive upon arrival in Ireland, perpetuating brain waste in the Irish medical field.

This occurs as foreign doctors trained in a specific setting are assigned arbitrarily to any position lacking staff, thus depriving both their origin country and their receiving country of their talent. A study interviewed foreign health care workers in Ireland and found such instances of dissonance between the position to which individuals apply and the actual role to which they are called. Due to the costly financial and emotional investment of choosing to migrate, many cannot withdraw their commitment in pursuit of a better opportunity.

Thus, many foreign doctors bear the brunt of the poor working conditions that prompt Irish-trained doctors to go abroad.

Local Implications of Sending and Receiving Health Care Workers

Local communities, either on the sending or receiving end of foreign doctors, become more vulnerable as professional health care access is redistributed across international borders. Subsequently, Ireland’s understaffed health care force leaves marginalized and low-income communities, domestic and abroad, under strain. In attempts to compensate through international recruitment, the community in Ireland outsources for doctors and the spread is thin.

Foreign health care workers in Ireland become more vulnerable to poverty as they pay the exorbitant costs associated with migration. Consequently, individuals seeking health care may not have the financial means to compete for a spot in their health care provider’s overbooked schedule. Ireland has introduced noteworthy doctor retention programs, seeking to break this cycle, with varying results.

The Path Forward for Strong Doctor Retention in Ireland

To promote universal access to quality health care, Ireland has to sustain an equitable, stress-reduced working environment for its domestically trained doctors. A shift away from brain drain in Irish health care is an uphill battle. This is largely due to systematic flaws such as hostility from or poor connections with mentors and coworkers, which weakens a newly trained doctor’s support system.

Noteworthy doctor retention efforts began in 2015, when Ireland’s Strategic Review of Medical Training and Career Structures oversaw adjusted working conditions and training opportunities for doctors training domestically. However, a 2021 study revisiting the success of these doctor retention programs found them ineffective and out of proportion to the problem’s scale. Going forward, it will take increased investment in strong mentorship for Irish training doctors and more compatible training programs to see the Irish health care industry draw a greater appeal to its workers.

Fortunately, a successful doctor retention policy, such as Romania’s, provides a hopeful template as Ireland pursues an equitable health care system benefitting workers and patients alike.

– Isla Hansen

Isla is based in Spokane, WA, USA and focuses on Good News and Politics for The Borgen Project.

Photo: Wikimedia Commons

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Progress and Possibility Behind HIV/AIDS in Guatemala

HIV/AIDS in GuatemalaGuatemala has made significant progress in its fight against HIV/AIDS. While it may not make headlines every day, Guatemala’s advancements are persistent and deeply human. The country is steadily moving towards the UNAIDS target of 95% of people knowing their virus status, 95% of people on treatment and 95% achieving viral suppression. Tucked between mountain roads and the Caribbean coast and once overwhelmed by stigma, unequal health care infrastructure and limited access to treatment, Guatemalans now have expanded access to treatment, information and community. The trajectory of meeting these 95–95–95 targets is palpable.

At a time, those numbers felt out of reach. Today, however, the change is measurable. Approximately 33,000 Guatemalans are living with HIV, with an adult prevalence rate of just 0.2–0.3%, among the lowest in Latin America. Since 2010, AIDS-related deaths have fallen by nearly 40%, thanks to wider access to antiretroviral therapy (ART) and strong community-driven advocacy. About 78% of people with HIV are now receiving treatment, and two-thirds have achieved viral suppression, signaling significant and lasting progress in care accessibility. Yet, this progress also underscores how deeply health outcomes are tied to economic inequality. Poverty continues to limit access to testing and treatment, especially in rural areas where clinics and transportation remain scarce. The progress of HIV/AIDS in Guatemala reflects not only medical advancement but also the broader effort to close the gap between health and opportunity.

Confronting Stigma With Inclusion

Progress rarely comes without resistance, a major barrier for Guatemala’s HIV response being stigma. It lingers in small towns, classrooms and suppressed conversation. In a national survey, 57% of adults said they would not buy food from someone with HIV, and only 22% of youth accurately understood prevention methods. Lurking behind those numbers is a deep cultural fear. Still, the response has been just as powerful. 

Local organizations and youth-led campaigns now promote inclusive education, normalize testing and support open conversations around sexual health. Across Guatemala, people are bringing HIV education to light, and what once kept people in the shadows out of fear of judgment is slowly being replaced with visibility and open dialogue.

Although ART is free through Guatemala’s public health system, discrimination once kept many people from seeking it out. A study found that only 35% of those living with HIV were engaged in care, and just 16% achieved viral suppression at that time. In response, Guatemala has expanded mobile testing, integrated HIV services into community health centers and strengthened privacy protections for patients. While these changes may sound procedural, local testing means local recovery and accessibility. These reforms are especially important for low-income communities, where poverty and stigma often intersect.

Local Activism Leading the Fight Against HIV/AIDS in Guatemala

Change often begins with one voice. Guatemalan advocate Alma de León from the International Treatment Preparedness Coalition–Latin America and the Caribbean has shown how activism can drive national reform. Her coalition helped lower the price of dolutegravir, a key HIV medication, from $240 to $7 per patient, while also simplifying treatment options from more than 200 combinations to fewer than 65. These changes make treatment affordable and sustainable, and allow the fight against the stigma of HIV/AIDS in Guatemala to reach communities and families facing economic hardship who may otherwise lack access to consistent health care.

Multi-month ART refills have also redefined accessibility for rural workers who may have once spent an entire day traveling to refill their prescriptions. This approach, paired with peer-led outreach and telehealth mentoring for rural doctors, is creating practical changes to create a flexible, efficient and human health care system.

A Future Built on Collaboration

This progress is not happening in isolation. Partnerships with international groups like the U.S. Centers for Disease Control and Prevention (CDC) have strengthened infrastructure through programs like Project ECHO, which links local clinicians to specialists for real-time mentoring. Other initiatives like the multi-month prescriptions and pharmacy fast-track refills are easing that daily burden on patients.  

These strategies altogether create a true ripple effect to better training, fewer barriers and stronger communities. Efforts show that treatment is not a sole indicator of success, but proof of a shared effort over time.

Hope on the Horizon

Guatemala’s HIV response is a story of persistence and partnership. Deaths are falling, access is expanding and education and empathy are replacing stigma. Emerging outcomes are indicators of collaboration, local activism, global outreach and most importantly, communities refusing to be defined by fear. The fight against HIV/AIDS in Guatemala has deep ties to the nation’s fight against poverty. By improving access to care and breaking down economic barriers, Guatemala is showing how public health progress can also strengthen economic resilience.

Continued investment in local leadership, youth empowerment and international cooperation will ensure this fight not only meets but exceeds global goals. Guatemala is proving that ending HIV is not just possible, it’s already happening.

– Ella Bogdan

Ella is based in Denver, CO, USA and focuses on Global Health for The Borgen Project.

Photo: Unsplash

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$28 Billion Pledge Boosts Childhood Anemia Prevention

Childhood Anemia PreventionIron deficiency anemia is the most prevalent, yet preventable, nutrient deficiency-related disease in the world. According to the World Health Organization (WHO), 269 million children younger than 5 are affected, primarily those in low-income countries. At the 2025 Nutrition for Growth (N4G) Summit, global leaders addressed childhood anemia prevention, pledging nearly $28 billion to address the crisis. This investment could change millions of lives; however, the challenge is turning commitments into actions that reach children who need it the most.

Childhood Anemia: Effects on Health, Education and Poverty

Iron deficiency anemia is primarily caused by inadequate nutrient intake. Children in poverty-stricken countries are most at risk as food insecurity prevents balanced meals. Excessive blood loss associated with malaria, a disease currently found in 83 countries, is also a compounding factor of anemia in children. The link between poverty and anemia highlights why it is essential to understand its impact on children’s health, education and future potential.

Anemia causes fatigue, weakness, compromised immunity and, if left untreated, heart problems. Beyond health issues, affected children struggle with attention and memory problems, impacting learning as well as social interactions. The result is poor school performance and increased absenteeism, which affects their access to future educational and career opportunities, further perpetuating the cycle of poverty.

Why Previous Efforts Fell Short

Previous N4G Summits prioritized malnutrition and childhood anemia prevention. Global leaders pledged $23 billion in 2013 to address global malnutrition and $27 billion in 2021 to invest in anemia and food fortification. Sadly, these pledges fell short as a result of weak monitoring, insufficient funding and implementation delays. COVID-19 disruptions additionally prevented 2021 programs from fully reaching target communities.

Based on previous tracking reports, the 2025 Summit has new priorities. With a historic investment of $28 billion, the WHO and global leaders aim to turn commitments into tangible results. The efforts emphasize accountability, targeted interventions and measurable outcomes, supported by data systems to track progress. These changes set the stage for this initiative to make a real difference.

How $28 Billion Supports Childhood Anemia Prevention

Building from previous frameworks, the WHO, in partnership with UNICEF and the Anemia Action Alliance, has developed a comprehensive strategy to address childhood anemia. Their four primary areas for intervention include:

  • Addressing root causes: Programs are being implemented to address the nutritional and infectious causes of anemia. Comprehensive care tackling iron deficiency, malaria and parasitic infections is paramount in reducing the prevalence of childhood anemia.
  • Supplement distribution: In collaboration with national ministries and outreach programs, the WHO and UNICEF will increase women and children’s access to iron and folic acid tablets.
  • Food fortification: Countries are enacting policies mandating the fortification of staple foods such as wheat, rice and salt, which make up the bulk of diets in low-income countries. Fortification with iron helps address the widespread deficiency that contributes to childhood anemia.
  • Health system improvements: The WHO and UNICEF are working with ministries of health to integrate anemia testing into routine health services, provide training to health workers and improve the delivery of supplies.

These efforts aim to create lasting systems that prevent childhood anemia rather than only treating it. When sustained, such progress improves health and boosts education, productivity and economic stability, helping break the cycle of poverty.

Turning Promises Into Progress: Why Transparency Matters

The impacts of anemia go beyond health; it impacts national growth, too. According to the World Bank, anemia in children reduces productivity and learning potential, costing low-income countries up to 4% of their GDP each year. To truly make a difference and reduce poverty across generations, commitments to improving health need to become actions.

That’s why the 2025 N4G Summit emphasizes trust and transparency. Past pledges faltered due to weak data collection and limited accountability. Organizations such as the U.N. and Global Nutrition Report are calling for stronger monitoring systems to ensure this doesn’t happen again. New tracking dashboards are in place to measure outcomes and ensure real progress is being made.

If governments and partners uphold their commitments, this unprecedented $28 billion pledge for childhood anemia prevention could finally create lasting change. It offers a once-in-a-generation opportunity to break the cycle of malnutrition and poverty for generations to come.

– Tina Kusal

Tina is based in Montrose, CA, USA and focuses on Good News for The Borgen Project.

Photo: Pexels

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HIV in Zimbabwe

HIV in ZimbabweZimbabwe is a country located in southern Africa. It shares its borders with South Africa to the south, Zambia to the north, Mozambique to the east and Botswana to the west. Harare, the largest city and at the same time the capital, lies in the northeastern part of the land.

Zimbabwe’s population is about 17 million, with the average age of a citizen being 18. The political system is a constitutional democracy and most of its population practices Christianity. Despite its vast size, natural beauty and rich cultural heritage, HIV in Zimbabwe remains a significant public health challenge.

The Prevalence of HIV

HIV in Zimbabwe is becoming an increasingly serious problem. In 2024, about 1.3 million people were living with the virus, most of whom were adults. Notably, women made up a significantly larger share of those affected, with 740,000 cases compared to 490,000 among men.

Despite the progress made in prevention and treatment, economic instability and limited public health funding continue to threaten the country’s response to HIV. The national currency’s devaluation and rising inflation have reduced health care budgets and led to shortages of medicines in some regions.

In early 2025, cuts and freezes in international funding, including a temporary suspension of economic support, took effect. As a result, several HIV clinics closed and the ARV supply was interrupted, leaving thousands without help. Experts and health organizations have warned that such disruptions could reverse years of progress in HIV control and treatment adherence.

Key Populations

In Zimbabwe, key populations, especially female sex workers, bear a substantially higher burden of HIV than the general population. About half of female sex workers have HIV in Zimbabwe. The prevention is difficult because many in the key population don’t even know their HIV status, spreading the illness further.

Women and girls, despite progress in some areas of education, remain underrepresented in formal employment and are more exposed to poverty. Many women rely on the informal sector for income, such as street vending and odd jobs, which often yield irregular earnings, making it difficult to afford health care, clinic transport or consistent treatment. In some cases, the urgency to provide for dependents leads to “survival sex” or informal transactional relationships.

Fighting HIV

Zimbabwe has made significant progress in combating HIV, with strong backing from the Global Fund, PEPFAR, UNDP and local civil society groups. According to recent reports, about 93% of people living with HIV in Zimbabwe know their status, 98% of those diagnosed are receiving antiretroviral therapy (ART) and 95% of those on ART have achieved viral suppression. However, sustaining these gains remains a challenge.

Despite substantial external support, Zimbabwe faces a funding gap of about $133 million in 2024 to fully meet the resource needs outlined in its strategic HIV plan. Recent freezes and reductions in donor funding, including from USAID, have raised serious concerns about maintaining services, clinics, ART supply and outreach, particularly for vulnerable and marginalized groups.

With continued, focused commitment from international partners and increased domestic investment, Zimbabwe aims to maintain and strengthen HIV prevention and treatment services. Key elements include expanding local funding sources, ensuring that services for key populations remain prioritized, sustaining supply chains for ART and scaling up testing, prevention and care innovations.

– Julia Skowrońska

Julia is based in Wrocław, Poland and focuses on Global Health for The Borgen Project.

Photo: Flickr

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COPD Underdiagnosis in Latin America: Challenges and Solutions

COPD Underdiagnosis in Latin AmericaThe PLATINO and PUMA studies from 2002 and 2016 outlined the rate of Chronic Obstructive Pulmonary Disease (COPD) underdiagnosis in Latin America. The data highlighted the importance of early intervention in minimizing the economic and social fallout associated with this respiratory illness.

COPD is caused by damage to the lungs. It can be a consequence of smoking or exposure to air pollutants from biomass fuels. According to the World Health Organization (WHO), the overwhelming majority of deaths of people aged 70 and younger from COPD take place in low- and middle-income nations.

Who Is at Risk?

In Puno, Peru, on the shore of Lake Titicaca, women’s risk of developing respiratory issues due to daily use of biomass fuels is 55%. In Colombia, older men who smoked or were exposed to wood smoke for more than 10 years were more likely to develop COPD. The findings of the 2016 PUMA study, which focused on primary care in Argentina, Colombia, Venezuela and Paraguay, revealed underdiagnosis of COPD in more than 70% of cases. The most affected group included younger men with low educational levels and no prior testing.

Consequences of COPD Underdiagnosis in Latin America

The burden created by the underdiagnosis of COPD in Latin American countries can turn into an even heavier burden that those already struggling with poverty cannot afford:

  • Productivity and work gaps decrease the earning power of people affected and their employers, placing most of the economic burden on the families of the sick.
  • A person whose COPD is more severe due to a lack of early treatment can expect higher health expenses due to the need for hospitalization. In Brazil, the cost of treatment rose from $5,891 in 2010 to $13,181 in 2015.
  • The rate of in-hospital mortality due to COPD in Mexico, Brazil and Argentina continued to rise significantly through the ’80s and ’90s. However, in Brazil, the mortality rate decreased by more than 25% from 2000 to 2019 thanks to local efforts.

The Challenges

In a survey by Vital Strategies and Umane, up to 62.3% of Brazilians did not seek medical attention due to several reasons. The surveyees stated long wait times, difficulties accessing specialists or underestimating the health issue. Up to 40.5% of those who did attempt to visit a doctor could not, due to extensive waiting times, lack of available doctors or proper equipment.

However, starting in 2024, the Breathe Well South America program has a plan to investigate access to primary care for people with COPD. It is being funded by the National Institute for Health and Care Research (NIHR). It’s driven by the work of the Institute for Clinical Effectiveness and Health Policy (IECS) in Argentina and several international universities.

Diagnostic Tools

Spirometers are a vital tool for the diagnosis of COPD. The test measures airflow and volume. In Latin America, it is often underused by primary care providers because of limited access to spirometers, short appointment windows and insufficient training to perform and interpret tests.

Throughout 2022 and 2023, the Brazilian Ministry of Health, in conjunction with the Hospital das Clínicas of the Federal University of Minas Gerais, began putting into place the Telespirometry System Brazil (TS-BR). The initiative aims to provide training and spirometers to specialists. As of 2024, 147 municipalities had participated in the program.

Pharmaceutical giant AstraZeneca launched Smart Spiros in Panama to improve the rate of diagnosis of COPD. Around 7,500 tests are expected to be performed by the end of 2025, which could help diagnose nearly 50% of COPD cases.

Increasing Awareness

The survey by Vital Strategies discovered that 34.6% of Brazilians questioned avoided seeking care because they assumed their health issue wasn’t serious enough to merit a visit. To combat this, World COPD Day takes place worldwide on the third Wednesday in November. It encourages health organizations to educate people about symptoms and possible treatments regularly.

In 2017, Paraguay’s Health Ministry dedicated an entire week to training, education and testing patients. This work is important because early diagnosis is crucial to preventing exacerbations that can result in costly, lengthy hospital stays.

From Underdiagnosis to Action

As of 2024, COPD was the fourth-leading cause of death globally. COPD underdiagnosis in Latin America has been a major issue that national and international organizations are working to quantify and resolve. For people living in poverty, illness and loss of income can become a crippling situation that further diminishes their earning capacity or entirely prevents them from earning a livelihood.

Despite challenges, such as a lack of education, spirometers and trained professionals, universities, international organizations and governments have come together to put into motion programs that bring much-needed solutions to the public.

– Johanna Lorena Arredondo Gonzalez

Johanna is based in Pittsburgh, PA, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Pexels

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Fighting the Silent Killer: Hypertension in Sub-Saharan Africa

Hypertension in Sub-Saharan AfricaHypertension, often called the silent killer, is surging across sub-Saharan Africa as cities expand and diets change. The World Health Organization (WHO) says more than one-third of adults in the region live with high blood pressure. Yet, many do not know they have it until they suffer a heart attack, stroke or kidney failure.

Unlike infectious diseases with obvious symptoms, hypertension can go undetected for years. Rural clinics may be miles away and often lack reliable blood pressure cuffs. Even in cities, routine screenings are rare outside hospitals. Poverty deepens the problem.

Many patients skip checkups because of travel costs or lost wages and medication can be hard to find or too expensive.

Community Health Workers Take the Lead

Governments and aid groups are training community health workers to screen residents where they live. In Kenya and Ghana, mobile teams set up at markets and churches to check blood pressure for free. When they discover hypertension in an individual, health workers give lifestyle advice and connect patients to inexpensive generic drugs.

These programs are low-cost and easy to expand, often costing only a few dollars per patient each year.

Medicine matters, but prevention depends on wider change. Public campaigns urge people to cut salt, eat more fruits and vegetables and exercise regularly. In Tanzania, radio programs and text-message reminders promote healthier cooking and daily walks. Urban planners in Nigeria and South Africa are adding walking paths and parks to make physical activity safer and easier.

Partnerships and Policy Momentum

The WHO’s HEARTS Initiative has been deployed in several low- and middle-income countries to standardize hypertension care protocols and strengthen primary care delivery systems. Similarly, regional bodies such as the Pan African Society of Cardiology (PASCAR) have collaborated with the WHO to produce the “Roadmap to Achieve 25% Hypertension Control in Africa by 2025,” guiding national hypertension policies.

National governments have adopted task-sharing and guideline frameworks under pressure from global advocacy groups. In Africa, the Innovative Epidemiology and a Vibrant Ecosystem (ACHIEVE) strategy outlines 10 strategic actions for integrating hypertension control into health systems policy. Furthermore, donor agencies and international NGOs, including Resolve to Save Lives, support the procurement of affordable medications, provide training and provide technical assistance to governments launching hypertension control programs.

Within Africa, the Centers for Disease Control’s (CDC) strategic plans emphasize strengthening partnerships, workforce development and institutional coordination across member states. These efforts aim to embed noncommunicable disease (NCD) control—including hypertension—into broader health systems.

A Vital Step Toward Stronger Health Systems

Controlling hypertension in sub-Saharan Africa strengthens health services overall. Routine blood pressure checks create chances to spot diabetes and other chronic diseases. Reliable supply chains for hypertension drugs improve access to other essential medicines. By fighting a silent but deadly disease, sub-Saharan Africa can prevent countless premature deaths and build a healthier, more productive population. This shows that tackling chronic illness is as important to development as battling infectious disease.

– Katie Williams

Katie is based in the United Kingdom and focuses on Global Health for The Borgen Project.

Photo: Unsplash

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HIV in the Central African Republic

HIV in the Central African RepublicThe Central African Republic (CAR), located in the heart of the continent, has long faced a severe HIV epidemic. While HIV has largely dwindled in threat in the West, it remains the primary cause of mortality in the CAR. In 2019, there were 4,800 deaths and 110,000 people overall living with the disease in the nation.

This epidemic has been declared a national crisis, one intensified by the lasting and prevalent stigma shadowing HIV. This fatally impacts treatment access for people living with HIV (PLHIV) in the Central African Republic. To understand and combat this situation, initiatives in the CAR piloted by Médecins Sans Frontières (MSF) and UNICEF focus on eradicating stigma-based prejudices through community-based aid. Their programs validate the significant impact of providing psychological support to PLHIV, especially in a situation that may feel hopeless.

HIV-Related Stigma

The 2018 PLHIV Stigma Index found that 87% of PLHIV experienced discrimination that affected their daily lives. The health care sector in the CAR is severely underfunded, resulting in insufficient (or sometimes zero) government-led ethics training being delivered to workers.

As a result, these professionals develop inaccurate beliefs about transmission causes and harbor fear-based prejudices against PLHIV. Hence, incidents such as humiliating comments, disclosure of HIV status and alienation from health care professionals affect PLHIV, with 12% avoiding health centers because of their status.

PLHIV in the CAR not only fear discriminatory professional care, but also fear being “found out” by their peers — an exposure that can lead to consequences such as social marginalization, family rejection or even violence from intimate partners. This double barrier creates a deep-seated fear, resulting in fatal disengagement from care, a challenge foreign aid organizations are working to address.

Antiretroviral Treatment

Campaigns across the CAR focus on utilizing community support groups to improve adherence to antiretroviral medicine (ARV) treatment plans. This medication can reduce levels of HIV to an undetectable level and protect the immune system. Thus, without access to it, PLHIV may experience numerous fatal complications and a risk to their quality of life.

However, MSF reported that, in 2016, only 18% of PLHIV in the CAR were actively undergoing ARV treatment provided by the CAR government. It found that by the time the majority of patients begin treatment, their immune systems are too badly compromised and they are already suffering from advanced and unmanageable AIDS. Chillingly, this is the case for two-thirds of PLHIV in the CAR.

Community Groups

The E Bata Guigui (Let Us Protect Life) group, initiated in 2018 by UNICEF in the CAR’s capital city, Bangui, promotes treatment through offering empathy and reassurance for PLHIV. The campaign consists of 2,000 young people offering peer solidarity, encouragement for testing and accompaniment through treatment appointments and journeys.

Results show that more young people aged 0-14 with HIV in the CAR have access to treatment, even after being deterred by their local clinics. Evidently, treating PLHIV with humanity can often be life-saving.

In 2019, MSF launched its Community Groups initiative across West Africa. The program allows one member to collect drug refills on behalf of the group, improving adherence and access to long-term treatment. Its stigma-sensitive approach — centered on self-management and peer support — has led to an increase in viral suppression and patient follow-up rates. Within a year of implementation, more than 1,800 patients had begun HIV treatment and 558 new cases were diagnosed.

Positive Changes

The milestones achieved by Community Group programs surrounding early diagnosis, medication uptake and treatment adherence show valuable strides toward a brighter, healthier future for PLHIV in the CAR. While challenges remain, the progress made in tackling widespread discrimination, through greater acceptance and enhanced psychological support, has already bettered both physical and mental health outcomes, delivering hope to those who once felt there was none.

– Emily Wooster

Emily is based in Birmingham, UK and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Disability and the Struggle Against Poverty in Gabon

Poverty in gabonPeople with disabilities in Gabion face widespread poverty and barriers to employment, education and health care, despite legal protections. Although the country has abundant natural resources and a relatively high gross domestic product (GDP) per capita, unequal income distribution leaves vulnerable groups — including people with disabilities — at greater risk of poverty. 

Expansion of Social Programs

The United Nations International Children’s Emergency Fund (UNICEF) is working with Gabon’s Ministry of Social Protection and the National Fund for Social Action to strengthen social safety nets and expand protection programs for the country’s most marginalized communities and to help reduce disability and poverty in the country.

UNICEF Representative Stephen Grieb said the goal of the income-generating program, which residents such as Thecle are receiving, is to help households in the present areas gain access to education, health coverage and social protection for their children. 

One of the pilot communities in Zoula, where the initiative aims to encourage revenue-generating activities. By boosting income, organizers say the program will help disadvantaged households assert their rights and receive essential social services. Thecle and other participants hope the effort will allow them and their children to break free from poverty. 

Improving Youth Skills

The World Bank Board of Executive Directors on Tuesday approved a $100 million loan to help Gabon improve skills training and create jobs for young people. The Development and Employability Project aims to reduce disability, poverty and unemployment while supporting faster growth in the Central African Nation. 

The project will expand vocational training in key growth sectors, promote skills development for unemployed graduates and school-leavers, and provide entrepreneurship training. It seeks to address the mismatch between the skills of young people and the needs of the labor market. 

Gabon’s National Development Plan

Gabon had launched the Emergency Community Development Program (PUDC) with national funding to be carried out across the country’s nine provinces in partnership with the United Nations Development Program (UNDP). The initiative is part of the President Brice Clotaire Oligui Nguema’s national development plan: The Rise Toward Prosperity. Overseen by the Ministry of Planning and Forecasting, the program aims to reduce socioeconomic and regional inequities by strengthening local governance, expanding economic opportunities, improving infrastructure and increasing access to essential services. 

The Future of Poverty in Gabon

Gabon is launching multiple initiatives to tackle poverty and inequality, particularly for people with disabilities and disadvantaged communities. Efforts include income-generating programs supported by UNICEF and a $100 million World Bank-backed project to expand vocational training and job creation. These programs aim to improve social protection, education, health care access and local economic opportunities, helping vulnerable households break the cycle of poverty.

– Joshua Pettis

Joshua is based in Houston, TX, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Aid Cuts Deepen Lesotho’s Health Crisis

Lesotho’s Health CrisisLesotho is a small landlocked nation in Southern Africa that is rarely in the headlines. The country is facing one of the world’s most severe humanitarian and health crises. Preexisting food insecurity, driven by repeated droughts, crop failures and rising prices, is now colliding with one of the highest HIV rates in the world.

These combined struggles leave families, especially young children, on the brink of survival. Aid cuts from international donors are worsening, forcing organizations like the World Food Programme (WFP) and World Vision to decrease their critical contributions. Without more support, Lesotho’s health crisis risks falling deeper, which could have long-term consequences for its people.

Food Insecurity Collides with HIV

Lesotho’s location in Africa, as well as its climate, makes it very vulnerable to drought. According to the WFP, nearly one in three people face food insecurity during the lean season when harvest numbers are low. Therefore, food prices increase. Families often skip meals, sell their livestock or pull their children out of school to work to cope with these circumstances. These cycles deepen the cycles of poverty.

On top of the food insecurity, Lesotho now has an HIV epidemic. The nation has one of the world’s highest HIV rates, with more than 20% of adults living with the virus. For children, exposure to both HIV and malnutrition creates a deadly combination. If they do not have adequate nutrition, antiretroviral treatment becomes less effective. This leaves the children more prone to infections and reduces their chances of survival.

Clinics across the country are reporting rising numbers of malnourished children who are unable to respond to HIV treatment because their bodies lack the strength. The double burden of food insecurity and HIV is creating an emergency that rarely makes global headlines; however, it devastates families daily.

Aid Cuts and Shrinking Safety Nets

For a long time, international aid programs provided critical support to the country. The WFP’s food distributions and World Vision community outreach programs supported thousands. Recent shifts in global funding, though, have forced cutbacks. The WFP warned in 2023 that it may have to reduce assistance due to shrinking donor contributions. This left tens of thousands without aid. These cuts come when inflation and climate are already straining many households.

Without funding, local programs have been unable to keep up. Families have to walk miles to health centers that no longer stock needed supplements. Those who once relied on emergency food services are left alone.

Innovative Local Solutions

Despite the challenges, Lesotho has developed several initiatives to fight back. One of those efforts is the establishment of nutrition corners in health facilities. The centers provide integrated care from food support to growth monitoring to HIV treatment, all in one place. According to the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) Lesotho, these facilities have been especially effective for children living with HIV, improving both their nutrition and survival rates.

Another initiative is the use of cash-transfer programs, such as the Emergency Food Assistance Project. Instead of distributing food directly, these programs provide families with money or food vouchers to buy what they need locally. This approach helps households access nutritious meals and supports local farmers and markets.

The Maximum Intervention Programme (MIP) is a government-led partnership backed by the U.N.’s Renewed Efforts Against Child Hunger (REACH). It has made nutrition a national priority. By aligning itself with multiple agencies, it aims to provide food, health, social protection and security in one strategy.

Looking Ahead

Lesotho’s health crisis is not without hope. The solutions are known and are showing progress. Scaling up health and nutrition services, expanding monetary assistance and investing in climate-resilient farming can reduce reliance on unpredictable rainfall. What remains missing is steady international support.

Lesotho may not dominate headlines, but it illustrates the consequences of aid budget cuts on those who need help most. When donors focus elsewhere, vulnerable nations risk being left on their own. In a country where food insecurity and HIV intersect, continued global support is imperative. With sustained commitment, there is still hope for overcoming Lesotho’s health crisis.

– Brody L. Gates

Brody is based in Fort Worth, TX, USA and focuses on Good News and Politics for The Borgen Project.

Photo: Flickr