Archive for category: Health

Information and stories on health topics.

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The Philippines is Addressing Poverty: A Multi-Pronged Approach

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

A Stronger Social Safety Net

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

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

Expanding Access to Education

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

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

Health Care Investment and Risk Protection

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

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

Early Progress

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

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

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

Looking Ahead

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

– Arielle Telfort

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

Photo: Flickr

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Marburg Virus in Ethiopia

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

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

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

The Cause

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

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

Treatment

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

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

Responses

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

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

– Renata Hirmiz

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

Photo: Flickr

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Everything To Know About HIV/AIDS in Bolivia

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

Background on HIV/AIDS

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

The Response

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

Impacts of People in Poverty With HIV

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

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

Addressing Disparities and Prejudices

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

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

Looking Ahead

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

– Sasha Banaei

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

Photo: Flickr

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Fighting Poverty Among People With Albinism in Malawi

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

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

Poverty and Discrimination Among Malawians With Albinism

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

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

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

The Association of Persons With Albinism in Malawi

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

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

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

Standing Voice

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

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

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

Final Remarks

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

– Elysha Din

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

Photo: Flickr

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Typhoid in Bangladesh: A Bold Vaccination Campaign

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

Typhoid in Bangladesh

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

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

Antibiotic Resistance: A Growing Barrier

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

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

The 2025 Nationwide Campaign

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

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

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

Looking Ahead

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

– Nikhil N Kumar

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

Photo: Flickr

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Mutuelle De Santé: Improving Access to Health Care in Rwanda

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

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

Mutuelle de Santé

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

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

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

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

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

Positive Impacts

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

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

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

Challenges and Limitations

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

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

Looking Ahead

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

– Emmanuel Fagbmide

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

Photo: Unsplash

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

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

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

A Hidden Epidemic

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

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

Gender and Youth at the Margins

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

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

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

Poverty and the Global Connection

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

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

Solutions in Action

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

Progress and the Path Ahead

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

– Matt Irwin

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

Photo: Wikimedia Commons

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Providing Health Care to Refugees in Border Countries

Health Care to RefugeesJordan is one of the world’s largest refugee-hosting countries relative to population. It shelters more than 3 million migrants and refugees, including more than 1.3 million Syrians, along with Iraqis, Palestinians, Yemenis and others. This influx has placed considerable strain on Jordan’s national health system, which must balance the needs of citizens with those of displaced populations. The challenge has grown increasingly political, raising questions of equity, inclusion and national identity.

Policy Evolution and the 2019 Reform

Jordan’s refugee health policy has evolved through a complex interplay of humanitarian priorities and national politics. Since 2012, the country’s Ministry of Health has collaborated with international partners, including UNHCR, WHO, UNICEF and bilateral donors, to integrate refugees into existing public health services, rather than establishing parallel systems. This model sought to ensure sustainability while maintaining the state’s control over its health infrastructure.

In April 2019, Jordan introduced a major policy change: Syrian refugees registered with UNHCR were permitted to access public health care at the “noninsured Jordanian rate,” effectively restoring access to government facilities after a period of reduced subsidies. This measure reflected an attempt to balance national cost constraints with humanitarian obligations and international diplomacy.

According to analyses by researchers, this decision was influenced by shifts in both domestic politics and global funding flows. Initial momentum for refugee inclusion, strong during the early years of the Syrian crisis, began to decline as fiscal pressures intensified and political attention shifted. Jordan’s leadership weighed the costs of long-term refugee care against concerns about public resentment and donor fatigue.

Donor Politics and the Multi-Donor Trust Fund

To sustain health-service delivery for refugees and vulnerable Jordanians, the government established the Jordan Response Plan (JRP) framework and a Health Sector Working Group. These bodies coordinate with the Jordan Health Fund for Refugees (JHFR), a multi-donor trust fund managed by the World Bank and the Ministry of Planning and International Cooperation. This mechanism pools donor contributions from the European Union (EU), Canada, Germany and other countries to support public health facilities that treat refugees.

The fund represents a hybrid model where humanitarian assistance and national systems converge, blurring traditional lines between emergency relief and development aid. Such arrangements also reveal how refugee health policy in border-host states is inherently political. International partners influence policy through funding priorities, while Jordan’s government uses refugee-health initiatives to strengthen diplomatic ties and demonstrate regional stability. Researchers argue that this dynamic reflects “policy integration by necessity,” a balancing act between sovereignty and donor expectations.

Equity and Inclusion in Practice

Despite the use of inclusive policy language, access remains uneven. Studies of Syrian and Palestinian refugees in Jordan show that health care equity depends heavily on legal status, registration and location. Refugees registered with UNHCR generally qualify for subsidized public health services. However, unregistered or urban refugees often face high out-of-pocket costs.

Research also finds that gender, chronic illness and camp residency shape who can obtain care. For example, while camp-based refugees may receive consistent primary care from NGOs, urban refugees struggle with costs for hospital care and medicines. The WHO’s 2023 review noted that health service utilization among refugees is constrained by both financial and administrative barriers, even where policies formally allow for inclusion.

This disparity underscores how refugee health is as much a political question of belonging as a technical challenge. When governments define access tiers by citizenship or registration, they reaffirm boundaries of national identity, determining who is seen as part of the social contract and who remains outside it.

Health Care as Diplomacy and Strategy

Jordan’s refugee health policy has also become a form of regional diplomacy. By maintaining access for Syrians and cooperating closely with international agencies, Jordan projects stability and reliability to donors and neighboring states. The World Bank and WHO both highlight Jordan as a leading example of a country “integrating refugees into national systems” within the Eastern Mediterranean Region.

This approach aligns humanitarian and strategic interests: providing health care prevents disease outbreaks, reduces social tensions and supports regional security. It also strengthens Jordan’s leverage in international negotiations, where hosting millions of refugees positions the country as a key partner for the West.

Lessons for Other Border-Host States

Jordan’s effort illustrates that refugee health policy is not solely a humanitarian issue but a political ecosystem involving ministries, donors and citizens. Effective inclusion relies on sound fiscal planning, effective diplomatic management and public trust. When handled strategically, as in Jordan’s integration model, health care for refugees can enhance both human security and state resilience.

For other border-hosting nations, the Jordanian case offers three takeaways:

  1. Integrate refugee care into existing national systems rather than creating separate structures.
  2. Align donor funding mechanisms with government priorities to ensure sustainability.
  3. Recognize that equitable access to health care reinforces social cohesion and prevents instability.

Providing health care to refugees, therefore, is not only a moral responsibility but also a strategic investment in regional peace and long-term system resilience.

– Clara Garza

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

Photo: Flickr

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Abidjan Cholera Outbreak: A Preventable Crisis Fueled by Poverty

Abidjan Cholera OutbreakOn the muddy quay of Vridi Akobrakré, a small fishing village just outside Abidjan, the economic capital of Côte d’Ivoire in West Africa, a Red Cross volunteer pours treated water into the hands of a mother. Her children splash barefoot in a stagnant lagoon, unaware that just days earlier, three of their neighbors died from severe diarrhea. At this moment, the Abidjan cholera outbreak is more than a headline. It is a preventable crisis, driven by poverty and poor sanitation.

The Abidjan Cholera Outbreak and Emergency Response

On June 5, 2025, the Pasteur Institute identified Vibrio cholerae in the water. This bacterium causes cholera, a severe diarrheal disease that can be fatal within hours if left untreated. Health authorities immediately confirmed a cholera outbreak in Abidjan — the first in 15 years. The rainy season had just started, with flooding quickly spreading contaminated water. The dense housing of the most impoverished neighborhoods further fueled the outbreak, resulting in 491 confirmed cases and 20 deaths.

The government executed a swift emergency response. Water trucks delivered clean water to affected neighborhoods and temporary treatment centers opened for rapid patient care. Local health teams collaborated with the World Health Organization (WHO), which provided support for water treatment, chlorine distribution and hygiene education. NGOs such as UNICEF and the Red Cross established hand-washing stations and trained volunteers to monitor symptoms within the community.

Poverty and Neighborhood Vulnerability

Vridi Akobrakré, where the bacterium was first confirmed and similar informal settlements around Abidjan remain highly vulnerable. Homes are built above lagoons and most have no latrines or sewage systems. Flooding spreads contaminated water through streets, schools and marketplaces.

Poverty compounds the risk. Families cannot afford safe water and crowded homes make it difficult to maintain proper hygiene practices. The repeated vulnerability of these neighborhoods shows that emergency measures alone cannot prevent future outbreaks. Without structural changes, cholera will continue to strike the poorest communities.

NGO Response and Preventative Solutions

NGOs play a crucial role in addressing immediate risks and building resilience. The Red Cross distributes chlorine tablets and treats water points. UNICEF runs hygiene campaigns in schools and markets. Médecins Sans Frontières operates mobile treatment centers and trains rapid response teams. Experts report that ongoing monitoring, broader distribution of hygiene kits and public awareness campaigns are essential to prevent future outbreaks.

Preventing another cholera outbreak in Abidjan also requires long-term investment. Governments must build sewage networks, drainage systems, formal latrines and pipe clean water for low-income neighborhoods. Equitable urban planning and continuous hygiene education help communities adopt safer practices. Subsidized access to safe water, community sanitation programs and strengthened health systems, along with the establishment of surveillance and rapid response teams, are crucial.

Since the cholera outbreak began, hygiene campaigns have reached thousands of schoolchildren, teaching proper handwashing and safe water practices. Early signs suggest these interventions are slowing the spread of cholera. However, experts warn that without continued support and infrastructure improvements, outbreaks will recur.

Turning Crisis Into Change

Back in Vridi Akobrakré, the mother dips her children’s hands into treated water and watches volunteers continue their rounds. For families affected by the Abidjan cholera outbreak, clean water remains fragile. But the crisis has sparked meaningful action. Community volunteers are now trained to monitor symptoms, treat contaminated water and educate their neighbors on proper hygiene.

NGOs continue to distribute chlorine tablets, hygiene kits and set up hand-washing stations in schools and markets. If governments and international partners invest in sanitation, infrastructure and poverty reduction, these efforts can become permanent. Safe water systems, drainage improvements and community-led education programs could protect residents from future outbreaks.

What began as a tragedy is turning into a blueprint for resilience, showing that even the most vulnerable communities can lead the way when crisis meets coordinated action.

– Tina Kusal

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

Photo: Flickr

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The Last Mile Against River Blindness in Cameroon

river blindness incameroonIn the rugged highlands of western Cameroon, a silent threat loomed for decades: Onchocerciasis or “river blindness.” Transmitted by the bite of blackflies breeding in fast-flowing rivers, the disease causes severe itching, skin changes and, in its most advanced form, irreversible blindness. For communities living along the valleys of the Meme and Mbam rivers, onchocerciasis did not just affect health; it hampered schooling, work and development in already impoverished areas.

Background

Cameroon has long been an endemic country for onchocerciasis. Indeed, a geospatial modelling study of Africa and Yemen estimated that, as of 2018, national-level infection prevalence in Cameroon exceeded 5% and in some focal regions was much higher.

In response, Cameroon launched community-directed treatment with ivermectin in 1996 under the World Health Organization’s African Programme for Onchocerciasis Control. After APOC ended in 2015, the country continued elimination activities through the WHO’s Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN), which now coordinates regional support.

Mass Drug Administration

At the heart of Cameroon’s strategy has been annual mass drug administration of ivermectin delivered through community-directed treatment. Over 15 years of campaigns in several districts have sharply reduced infection levels. In the Tombel Health District, for instance, after 15 consecutive years of treatment, microfilaria prevalence fell to 1.5% and nodule prevalence to 6%, indicating progress but not full interruption of transmission
Yet, remote mountain villages present persistent challenges. A 2024 study along the Cameroon–Chad border noted that onchocerciasis transmission remains ongoing despite decades of CDTI.

Localised vector habitats, seasonal migration of workers, and gaps in treatment coverage are among the underlying factors. A detailed study in the Meme River Basin highlighted how poverty, farming occupations, housing conditions and limited health seeking behaviour all hamper elimination efforts.

Community-Directed Distributors

Community health volunteers, called community-directed distributors (CDDs), carry the burden of delivering ivermectin and tracking treatments in hardscrabble terrain. But their efforts are constrained by low motivation, logistical bottlenecks and limited training. A qualitative study in three rural districts of Cameroon found that inadequate numbers of CDDs and weak understanding of the disease among health staff hamper progress.

Despite these challenges, when coverage is high and sustained, the health benefits are profound. People treated with ivermectin experience relief from itching, healing of skin lesions and prevention of visual impairment, according to the World Health Organization (WHO). In Cameroon’s Meme River Basin, researchers also found that annual community-directed treatment improved productivity and reduced stigma around the disease.

The Future

Progress in Cameroon against river blindness shows how persistence pays off. National health authorities continue annual community-directed ivermectin campaigns with support from the WHO’s Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN). The country also participates in regional cross-border monitoring with Chad and Nigeria to track transmission and share data.

According to the WHO’s ESPEN program, several health districts in Cameroon have already transitioned to post-treatment surveillance after interrupting transmission, marking key milestones toward national elimination.

– Katie Williams

Katie is based in England, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr