Archive for category: Health

Information and stories on health topics.

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The Impact of USAID Cuts on an HIV-Prevention Program in Kenya

HIV-Prevention Program in KenyaDREAMS CONNECT is a project that aims to educate and empower young women and girls in Kenya through a range of programs and group-based activities that promote sexual health and safety awareness, as well as creating awareness of sexual harassment and violence among women. The name ‘DREAMS’ is an acronym for ‘Determined, Resilient, Empowered, AS-free, Mentored and Safe lives.’ Here is information about DREAMS including how USAID cuts are affecting this HIV-prevention program in Kenya.

Vision

Initiated in October 2021, the project was one of many Hope Worldwide Kenya (HWWK) programs in Mukuru informal settlement in Nairobi funded by the U.S. dating back to 2003, with the aim of preventing HIV among thousands of vulnerable youth, particularly adolescent girls and young women, through a variety of care and support programs. In a documentary commissioned by PBS NewsHour in the U.S., journalists spoke to many young women who came through the program. They tell of being educated on simple but potentially life-saving interventions, such as how to use a condom, in addition to compassionate reminders that each of them has inherent value and worth.

USAID Closure

DREAMS, however, despite its proven successes, is facing an existential crisis due to the shuttering of USAID by the Trump administration in early 2025, which left staff suddenly unemployed and vital funding withdrawn, endangering not just DREAMS but thousands of humanitarian programs worldwide.

Both statistical evidence and personal accounts demonstrate the success of DREAMS’s endeavors. Almost all of the 66,000 women and girls who came through DREAMS remained HIV-free during the three-year program. Stacy Njeri, an 18-year-old woman from Mwiki, Kasarani Sub-county in Nairobi, describes how the program introduced her to a Youth Savings and Loans Association which allowed her to start her own nail salon, a decision she says “changed her life.”

With many women’s enrolment cut short due to foreign aid cuts, however, the concern now is that HIV cases among young women may begin to rise again, and that the cuts will discontinue the salutary work that the organization carries out, not only in preventing the deadly disease, but also in caring for young women and girls and equipping them with vitally important life skills and encouragement. PBS NewsHour’s documentary already reported that some women began to turn to prostitution as a means of supporting themselves following the end of DREAMS.

Future

Yet, the three-year stint of this HIV-prevention program in Kenya has shown that the methods used are highly successful and potentially far-reaching; it is only a matter of repairing the broken aid infrastructure. With the decline of USAID, it remains to be seen whether other countries will step in to fill the humanitarian void. Other wealthy nations like the U.K., France and Germany all responded to the U.S. change in policy by cutting back their own foreign aid expenditure, with the U.K. reducing its ODA (Official Development Assistance Budget) from 0.7% to 0.3% of Gross National Income in order to bolster defense spending. 

It may take some time for a viable solution for DREAMS to materialize, but what the scaling back of U.S. foreign aid has shown is just what kind of valuable and quietly empowering programs in Kenya and around the world are being threatened by an increasingly volatile global humanitarian landscape.

– Tomás Quinn

Tomás is based in Glasgow, Scotland and focuses on Global Health for The Borgen Project.

Photo: Wikimedia Commons

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How 3D Printing Can Be a Resource for Developing Countries

3D Printing Can Be a Resource
For educational purposes, healthcare treatments and local production, learn why 3D printing technology is a resource for developing countries.

Across many developing countries, progress can stall when essential systems lack funding, materials, or reliable access to specialized tools. Advanced technology cannot erase those barriers on its own, but it can give communities new ways to act. 3D printing can be a resource when organizations know how to leverage this technology.

Local Production Reduces Delays

Shipping costs, customs delays, limited storage and uneven supplier access can slow a simple repair. Those delays place extra pressure on communities that already stretch equipment and materials across many users.

Instead of waiting for every small object to arrive from far away, trained teams can produce selected parts using a 3D printer and digital designs. A repair component for a water system or a teaching model for a classroom becomes easier to replace once production moves closer to daily life.

Health Systems Gain Practical Tools

Health systems in developing countries often work with limited equipment and long replacement timelines. A rural clinic may not have the tools to print complex medical devices. It may still benefit from basic models, simple supplies or selected lab items that support routine care. 

The National Library of Medicine describes 3D printing as a potential way to produce basic medical supplies, laboratory equipment, anatomical models and prosthetic limbs in developing countries. These uses place 3D printing in a supportive role within existing health systems. The technology expands what trained professionals have available for care, planning and problem-solving. While it cannot replace clinical judgment or formal medical infrastructure, health workers gain a practical resource when supply gaps limit what they can provide.

Rapid Prosthetic Production in Uganda

Children who needed prosthetic support in Uganda faced long production timelines because clinics relied on manual methods and limited specialist capacity. That delay kept patients in the hospital for extended periods and made timely mobility support difficult to provide. 

Through 3D PrintAbility at CoRSU Hospital, clinicians tested a process that used 3D scanning, digital design and 3D printing to produce prosthetic sockets and braces for children. The technology did not replace trained orthopedic professionals. Instead, it gave them a fast workflow that fit the needs of a resource-limited clinical setting.

CoRSU reported that prosthetic socket production time dropped by as much as 70%, from five days with conventional manual methods to 1.5 days with 3D PrintAbility. That improvement shows how 3D printing can strengthen care when local teams receive practical tools that support existing medical work.

Medical Training Improves

Medical education depends on strong instruction, repeated practice and access to clear learning materials. In many settings, students learn anatomy through textbooks or flat digital images because advanced simulation tools cost too much. Those resources still teach important concepts, but they can make depth and proportion difficult to judge.

Printed anatomical models address that gap. A student can study the shape of a bone or organ from multiple angles while connecting structure to function. Then, a clinician can use the same type of model during a patient conversation, so an unfamiliar diagnosis becomes easier to understand.

Education Turns Problems Into Projects

Students and researchers can use 3D printing to connect technical learning with public service. A classroom project becomes more meaningful when it responds to a local challenge. A university lab can test a low-cost teaching tool, then improve the design after a school or clinic explains how it works in practice.

That exchange strengthens both sides. Students learn that design begins with listening. Researchers gain insight from community partners who understand daily conditions better than outside observers. The finished object matters, but the shared process builds people’s problem-solving skills.

Innovations With Global Value

A printer alone cannot overcome weak infrastructure or limited public funding. Strong programs begin with people who understand the setting. Local technicians, educators, clinicians and community organizations should guide decisions about what to print and how to maintain the equipment.

Long-term success also depends on training that fits local capacity. Programs should account for the difficulty level of learning 3D printing before they introduce new equipment. With steady instruction, repair knowledge and realistic goals, 3D printing can be a resource that supports community-led problem-solving instead of creating another unused technology project.

– Kelly Schoessling

Photo: Flickr

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Outbreak of Ebola in the DRC Poses Major Health Risk

Ebola in the DRCA recent Ebola outbreak in the Democratic Republic of Congo (DRC), concentrated in two of the region’s major provinces, poses a major health risk for citizens and aid workers who are striving to contain the virus and combat the spread of the disease. The outbreak threatens to become one of the worst the country has seen, as limited resources, a lack of funding, community resistance and food crises hamper treatment efforts.

What Have Ebola Outbreaks Looked Like for the DRC in the Past?

Ebola was first recognized in the Democratic Republic of Congo in 1976 after an outbreak in the Équateur province– 318 cases were reported, with the majority occurring within 70 km of Yambuku village. The DRC has experienced numerous, periodic outbreaks of the different strains of the Ebola virus. Some strains have a fatality rate of 90%. The current outbreak is the 16th that has plagued the country since it initially arose. The absence of approved medical countermeasures, international aid and lack of robust social services and health care exacerbate the outbreaks.

The outbreak comes as the country faces a humanitarian crisis as 26.5 million people nationwide experience food insecurity, which internal conflict and displacement mainly drive. Indeed, data that the Food and Agriculture Organization of the United Nations (FAO) and the United Nations World Food Programme (WFP) collected shows that the country holds the most individuals facing food insecurity– malnutrition and food gaps run rampant, and the issue is worsened with economic insecurity, conflict and internal displacement. Flooding and the impacts of lean season (September to November) and reduced international aid push vulnerable populations to higher stages of risk. Populations in the country are far more susceptible to contracting the disease in malnourished states.

How Did the Outbreak Start?

The Congolese Health Ministry declared an outbreak of the disease on May 15, and within just under a month, the number of those infected rivals that of some of the largest Ebola outbreaks in the country’s history. The Health Ministry has confirmed more than 1,200 cases. The current death toll stands at 360.

Experts believe that the outbreak started in Mongbwalu, which is a small mining town in the Ituri province. This is due to the high presence of fruit bats, a natural carrier of the disease. Health officials on the ground warn that without urgent intervention, the virus may become the worst outbreak the country has seen.

What Does Treatment on the Ground Look Like?

Individuals in the DRC who suspect they have the virus must wait days for test results to come back from the regional capital, Bunia, as kits are difficult to come by. Many symptoms match those of other more common diseases such as malaria and typhoid, which has been further exacerbating the issue. Hospitals are underprepared to deal with the outbreak at the rate it’s been spreading. Despite warnings and knowledge of the severity of the virus and its contagiousness, caring relatives, neighbors and friends, who are striving to support and save their loved ones, frequent hospitals.

Temporary shelters and structures have emerged in North Kivu and Ituri, the two northeastern provinces where the outbreak has been most concentrated. Despite the fact that the DRC has seen an abundance of Ebola outbreaks in its history, the nature of this particular strain has made the virus extremely difficult to identify and combat. Many locals are infuriated with the way the DRC has handled treatment and have been pushing officials and hospital personnel to act faster and do more to stave off the effects of the illness.

What Has Been the International Response?

Multiple countries and world organizations, such as the United States, South Africa and the European Union Commission, have pledged millions of dollars to work to support the DRC and stop the outbreak, sending equipment, supplies, doctors and health experts. After the initial outbreak, the World Health Organization (WHO) delivered more than 11 tons of medical supplies and equipment to the country. Meanwhile, the United Nations Organization Stabilization Mission in the Democratic Republic of the Congo (MONUSCO) established an air bridge to send supplies from the capital Bunia to the Ituri province.

This Bundibugyo strain of Ebola does not have a cure or vaccine. The Center for Disease Control and Prevention (CDC) considers the risk of the virus spreading to the United States as low at this time. However, multiple countries have established a travel ban to the region. The United States has heavily urged individuals to stop travel to the DRC and neighboring Uganda and South Sudan, with Canada enforcing a 90 day ban.

– Ella Goulet

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

Photo: Unsplash

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3 Diseases Impacting Costa Rica: Ways To Prevent & Treat Them

Diseases Impacting Costa RicaCosta Rica is a country in Central America, located between the Pacific Ocean and the Caribbean Sea, neighboring Panama and Nicaragua. It has a population of around 5,174,564 people, out of all the other Central American countries, many regard Costa Rica’s government as the most stable and democratic and has a beautiful landscape and scenery. It has also been home to quite deadly and common diseases with terrifying effects and symptoms.

These diseases seriously disrupt people’s everyday lives and are dangerous if left untreated. Each one of these viruses is preventable and has treatments that ensure lives are saved, but because the country struggles with poverty, many of its people are unable to safely access medical care and treatment. Here is information about three diseases impacting Costa Rica and the efforts that are addressing them.

1. Hantavirus

Hantavirus is a group of zoonotic viruses that rodents carry and transmit to humans through direct contact with infected rodents or their bodily fluids. Areas at high risk of disease are barns, storage rooms, rustic cabins and poorly ventilated rural buildings due to high rodent activity.

The illness can be quite severe and deadly to people, but it varies depending on the specific type of hantavirus, which includes hantavirus cardiopulmonary syndrome (HCPS) and haemorrhagic fever with renal syndrome (HFRS). It also depends on the geographical location and climate. Now, Costa Rica has not seen a large hantavirus outbreak, unlike their South American neighbors, but the threat is still there and people must be careful. Hantavirus transmits through contact with infected rodents or their droppings.

In humans, the symptoms may vary depending on the type of hantavirus; for example, HCPS causes rapid coughing, shortness of breath, accumulation of fluid in the lungs and shock. Meanwhile, for HFRS, the symptoms are low blood pressure, bleeding disorders and kidney failure.

Diagnosing the illness can be tricky due to it sharing common symptoms with other illnesses like influenza and COVID-19, meaning that extra attention is necessary when symptoms do arise and people must seek medical care as soon as possible. As of now, there are no current specific vaccines available for the disease, but medical care at its early stages can improve the outcomes. To prevent the disease, reducing contact with rodents is a good start. Some effective measures include keeping homes and workplaces clean, sealing any openings that allow rodents to enter buildings, storing food securely and dampening contaminated areas before cleaning,

2. Dengue

Dengue is a viral infection that transmits through mosquito bites, which transfers the virus to a person’s bloodstream. It is common in tropical and subtropical areas where the buzzing critters inhabit. Costa Rica has a history of dengue cases, with it reporting more than 27,000 cases by October 2024 and a decline in cases in 2025 with only 1,802 reported. This reduction in cases is likely due to the increase in vector-control throughout the country. In 2026, dengue remains a common disease, even if it’s on a lower scale than the previous surge, people must still be cautious and aware of this illness.

Symptoms may include high fever, severe headache, pain behind the eyes, muscle and joint pains, nausea and vomiting, swollen glands and rashes. However, in the case a person gets infected with dengue a second time, the illness becomes more severe with symptoms of severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums or nose, fatigue and restlessness, blood in vomit or stool, extreme thirst, pale and cold skin and feelings of weakness. People experiencing these symptoms should seek medical attention immediately.

There is a single vaccine available, QDenga, which is only recommended for people aged 6–16 years. According to the World Health Organization (WHO), several more vaccines are in the development stage, with a few under evaluation for this disease. It is also highly important to avoid bites from mosquitoes in general with the use of mosquito nets at night, along with mosquito repellent and wearing protective clothing. If a person gets dengue, they must rest, drink plenty of liquids, take paracetamol for the pain, but avoid anti-inflammatory medication like ibuprofen and aspirin and be aware if they have any severe symptoms and see a doctor if that’s the case.

3. Chikungunya

Chikungunya is yet another mosquito-related viral disease, particularly the Aedes mosquito. The disease results from the chikungunya virus and passes through mosquito bites into the blood vessels. The name comes from the Kimakonde language of southern Tanzania, meaning “that which bends up,” which describes the severe joint pain those infected with the disease experience.

Its symptoms are sudden fever, muscle pain, severe joint pain, joint swelling, rashes, headache and fatigue. These symptoms can often be mistaken for other illnesses due to overlapping; for example, Zika and dengue have similar symptoms, and as a result, misdiagnosis becomes a large possibility, especially if the joint pain aspect is missing, as it could leave the infection undetected, thus leading to worse conditions.

Not all is hopeless, as blood samples collected in the first week of the illness can easily help detect chikungunya. Treatment includes the use of antipyretics and optimal analgesics for the fever and joint pains, as well as rest and drinking plenty of liquids. As of now, there are two chikungunya vaccines available in several countries, but not yet worldwide. WHO and external expert advisors are currently reviewing the research and progress of more chikungunya vaccines.

The Effects of Poverty on Healthcare Access & NGO Aid

There still remains the issue of poverty as it effects how much access the people of Costa Rica have to all these healthcare options. According to recent statistics, around 24–25% households are below the poverty line, with a large portion of the population struggling to get access to basic necessities, such as healthcare. As a result, many in rural areas are not able to easily receive these treatments against the diseases impacting Costa Rica, leaving them incredibly vulnerable to potential dangers.

A number of organizations and NGOs are trying to help these households. A specific NGO, called Costa Rican Humanitarian Foundation (CRHF), aims to help Costa Rican citizens in these issues. From its founding in 1997, the organization focuses on developing creative and economical solutions for the country’s major challenges. With volunteers from all over the world and donors, it set out to achieve a positive impact in Costa Rica. A few of its achievements include providing urgent medical care and general well-being checks for more than 500 patients in 2025 and supporting more than 800 children and adolescents in the CRHF’s learning centers the same year.

Looking Ahead

These three diseases impacting Costa Rica correlate with the constraints of poverty and a difficult economic situation, which can prevent people from accessing vital medical treatments. Fortunately, NGOS like CRHF are making a difference, helping even those with lower incomes access medical care.

– Michalitsa Kontogianni

Michalitsa is based in Washington, DC, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Unsplash

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Diseases Impacting Bolivia and the Work To Mitigate Cases

Diseases Impacting BoliviaBolivia, a country centrally located in South America, has a population of roughly 12.7 million people. The nation borders other countries such as Brazil, Paraguay, Argentina, Chile and Peru. Its central location in the continent makes it extremely important to contain any diseases that start-up within the country. There have been multiple diseases impacting Bolivia, however, recently, Bolivia has dealt with one outbreak in particular that has caught the eye of international health organizations. There are two other diseases that health officials currently are monitoring with a standard level of caution after a reduction in cases due to health officials and organizations recent efforts.

The Main Outbreak of Focus

Currently, International Health Organizations are focusing on one main Chikungunya outbreak. In recent months, the virus has popped up in the cities of Santa Cruz, the eastern side of Bolivia, and Cochabamba, a central region. Chikungunya is a mosquito-borne and transmissible illness that causes fever and severe joint pain. Symptoms typically begin 3-7 days after an infected mosquito bites. The virus currently has no specific treatment, however, death due to the virus is rare.

The CDC currently has Bolivia’s Chikungunya outbreak listed in the Level 2 Category titled “Practice Enhanced Cautions.” Its main advice for prevention of obtaining the virus is actions necessary to avoid mosquito bites. These actions include using insect repellent, wearing long sleeved clothing and residing in places that have screens on windows and doors. Homeless individuals across the country become more vulnerable to contracting the virus as their access to housing with screens on windows and doors is more limited. Additionally, the CDC recommends the virus-like particle vaccine Vimkunya for travelers visiting chikungunya outbreak areas. Chikungunya certainly stands out as the primary focus for health officials out of the couple of diseases impacting Bolivia currently.

Global Dengue

The CDC lists two other diseases, global dengue and global measles, in the Level 1 Category titled “Practice Usual Precautions.”

Global dengue, like Chikungunya, spreads through infected mosquitoes and is a year round risk to many parts of the world. The virus usually takes up to 2 weeks to develop and causes fever, headache, nausea and vomiting. The CDC placed Bolivia in Level 1 for global dengue due to a couple reasons that include higher reported numbers of dengue than usual in the country, a higher than expected number of dengue cases among U.S. travelers returning from Bolivia and an outbreak that health officials recently mitigated. In order to prevent contracting this virus, health officials recommend avoiding mosquito bites by wearing long sleeved clothing and applying insect repellent. Global dengue popped up significantly in Bolivia in 2024 with close to 60,000 cases appearing in 2024 alone.

PAHO’s Efforts

The Pan-American Health Organization (PAHO) worked with Bolivian authorities to improve the quality of clinical care within the country so that doctors increased their ability to detect the virus early. This assistance from the organization became part of a multi-country program to mitigate the number of cases of dengue that popped up in countries such as Bolivia, Paraguay, Guatemala, Honduras and Panama. The program started wrapping up its work in mid-2025 and the five countries involved jointly saw a 70% average reduction in new cases compared to the previous 5 years.

Global Measles

Global measles is a respiratory illness that is highly contagious. It spreads through coughing and sneezing and typical warning signs and symptoms of the illness include a red bumpy rash, a high fever and red watery eyes. The CDC recommends receiving the Measles-Mumps-Rubella (MMR) Vaccine as the primary way to avoid contracting the virus. Additionally, the CDC advises the vaccination in particular to those who are traveling internationally.

The CDC placed Bolivia in Level 1 for global measles due to both the recent rise in cases in many countries across South America and a recent outbreak that happened in Bolivia itself. The measles outbreak in Bolivia started in April of 2025 eventually leading to a national emergency declaration with health officials reporting around 600 cases across the country.

Bolivia’s Vaccination Efforts

In response, Bolivia ramped up their vaccination efforts and were able to administer 1 million doses to children mostly aged 1 to 20 years old. Coverage for the vaccine expanded in response to this outbreak as 5 to 20-year-olds received the vaccine when previously coverage focused on 1 to 4-year-olds. Unfortunately, coverage for both first and second doses of the vaccine still is below the 95% threshold that helps ensure prevention of outbreaks. Doctors and helpers assisting with vaccination efforts focused on rural indigenous areas in particular as both distance and poverty posed a challenge. Local brigades went door to door while coordinating with local community leaders in order to ensure that the vaccines reach those in the communities who needed it.

The National Vaccination Registry helped assist in efforts as well by helping identify children that had incomplete vaccination schedules. Additionally, the Pan-American Health Organization (PAHO) and the Government of Canada worked to help Bolivia with outbreak control and quick response in order to mitigate the spread of this and other diseases.

Looking Ahead

Ultimately, diseases impacting Bolivia such as Chikungunya, Measles and Dengue have all had surges in numbers in recent years. The outbreaks brought concern to health officials and the key is the continuous work to limit the resumption of breakouts of these diseases. The work up to this point by organizations such as the Pan-American Health Organization contributed massively to a large reduction in cases and it is a positive sign of what is to come in the future.

– Drew Allen

Drew is based in Wilmington, DE, USA and focuses on Global Health for The Borgen Project.

Photo: Wikimedia Commons

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Policy Changes: Estonia’s Mental Health Challenges  

Estonia’s Mental Health ChallengesSince 1990, significant policy changes have been put in place to address Estonia’s mental health challenges. They aimed to create affordable access to mental health services and decrease the length of time people had to spend in psychiatric hospitals. 

Despite this, the need for mental health services is continuously increasing. In 2024, Estonian psychiatrists recorded a 4% increase in mental health and behavioral disorder diagnosis during outpatient visits than the previous year. The biggest increase was among children under 15, according to the National Institute for Health Development (TAI). This is because Estonians still face some challenges when it comes to seeking mental health support.

Challenges People with Mental Health Issues Face in Estonia

Challenges for people with mental health issues in Estonia include:

  • Waiting Lists: People often have to wait several months to be seen by a mental health specialist. In 2007, 13% of people in Estonia felt the need of a psychologist or counsellor but they did not get the help they needed in time due to the long waiting lists.
  • High Costs: Private mental health services are financially out of reach for many people in Estonia, as the costs often range between 50-100 euro.
  • Availability: There is a lack of availability of mental health professionals, which is the most prominent prevention of the national mental health development. Therefore, institutes can only treat patients when their condition is already critical and not beforehand.
  • Shortage in Workforce: The Estonian Qualifications Authority said Estonia is projected to need around 7,700 new health care workers in the next 10 years. However, the current training rate is only expected to produce only around 6,400, which means they will be 1,300 specialists.

Estonia has gradually implemented policy changes which aim to reduce Estonia’s mental health challenges.

How Poverty Affects Mental Health in Estonia

The Estonian government has been placing a large number of orphaned children in state-run institutions that have impoverishing conditions. For example, the children don’t have access to adequate resources or specialized staff. This means the children are at a higher risk of developing mental and behavioral issues because of their economic status. The UN Committee on the Rights of the Child has stated that Estonia needs to implement more open and rehabilitative care strategies to reduce the number of orphaned children with mental health issues.

Reducing Estonia’s Mental Health Challenges

From the early 1990s to 2003, the government closed large psychiatric hospitals and established family medicine as a specialty. It also established the publicly financed benefits package, which expanded mental health care in the region. The purchasing agency (Estonian Health Insurance Fund) provided this.

Furthermore, from 2004 to 2013, the role of mental health in primary health care was established through the development of policy frameworks and clinical guidelines, which allowed more family doctors to prescribe medicine for mental health conditions.

Additionally, since 2014, the government has consolidated and made numerous changes to the mental health services to further tackle Estonia’s mental health challenges. Some changes focused on establishing multidisciplinary primary health care with indirect benefits for mental health care. Others explicitly prioritized mental health care by making changes in how the government finances it.

Addressing Workforce Shortages

The Ministry has worked significantly to improve mental health services in Estonia, said Anne Randväli, the Head of Mental Health Department at the Ministry of Social Affairs in Estonia. They have addressed “workforce shortages” through state funding “residency or induction years for clinical psychologists and psychologist-counsellors since 2021.” The Ministry created “a coherent and sustainable system for training new specialists.” Before, “training largely depended on the personal resources of the professionals.”

Stepped Care Model for Mental Health

In 2024, the Ministry introduced a “stepped care model for mental health.” This model focuses on treating “common conditions such as depression and anxiety” through educating citizens on psychology and mental health and through specialists providing “digital self-help tools” or “low intensity intervention” to those with minor mental issues. This system provides support “at the earliest possible stage and progresses to more intensive services as needed” stated Randväli.

The findings of “the Estonian Human Development Report 2023” were used to create this model. EHDR’s current findings show that the current system resembles an “hourglass shape: relatively strong in terms of self-management and specialist care, but weak at the intermediate levels of community and primary care support.” The stepped care model will use “cost-effective solutions” to improve these intermediate levels, Randväli added.

The Outcomes of These Efforts

The national suicide rate dropped from 15.1% per 100,000 people in 2020 oecd.org to 14% per 100,000 in 2023. This is significantly lower than the suicide rates of countries such as Lithuania, which is at around 17% in 2023, or Korea which is at 24%. However, Estonia’s rate is still higher than many other countries. For example, Chile which is at 11% and Denmark at 9.5%.

Conclusion

The Estonian government has significantly improved their mental health services over the years through their policy changes, which have had a significant effect in extreme cases such as reducing the suicide rate. However, the mental health system is still seen as weak in terms of providing primary care support. The Ministry is working to further improve the mental health services through the stepped care model.

– Bianca Burdulea

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

Photo: Flickr

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How Leaders are Responding to HIV/AIDS in Belize

HIV/AIDS in BelizeAs of 2024, Belize has an HIV prevalence rate of 1.6%. The rate is one of the highest of any Latin American country. Discrimination against people living with the disease hinders efforts to minimize the transmission of HIV/AIDS in Belize.

The History of HIV/AIDS in Belize

AIDS first showed up in Belize in 1986 and is one of the leading causes of death for Belizeans. The disease disproportionately affects gay and bisexual men in the country with people between 15-24 years of age being the largest portion of new infection. Only half of the estimated 3,700 people infected with HIV/AIDS in Belize are receiving treatment.

While new infections have declined 29% since 2010, Belizean deaths from AIDS have risen 14%. People of lower socioeconomic status are more likely to contract HIV/AIDS due to their behaviors around health. Factors correlated to poverty such as food scarcity, lack of economic opportunity and homelessness all increase the risk of HIV transmission.

Low socioeconomic status correlates to low access to HIV treatment. Delays to treatment only decrease the chance of patient survival. In Belize, where 19.1% of the population is multidimensionally poor, organizations see the need to address the issue.

The National AIDS Commission of Belize

The National AIDS Commission of Belize’s goals include keeping Belizeans up-to-date on new information about the disease. The organization, established in 2000, drives a national response to HIV/AIDS in Belize.

The organization also educates citizens on how to prevent infection for themselves and others. It mentions factors like drug and alcohol use, vertical transmission and blood contact. The organization’s leaders are high ranking officials in the country. It also has local and regional partners that assist with education and response.

To overcome barriers associated with a response to HIV/AIDS in Belize, the United Nations in the Caribbean prioritizes the following:

  1. Expansion Prevention: Increasing access to testing and treatment is needed to prevent the disease before and after exposure.
  2. Stigma Management: Training healthcare workers to be sensitive to biases creates comfortable environments for patients.
  3. Strong Health Systems: Collecting data to track progress allows improvements to current systems.
  4. Community Empowerment: Putting more resources in community efforts to be inclusive and provide resources helps citizens with HIV. 

Another priority of the response to HIV/AIDS in Belize is eliminating transmission from mother to child. Belize has created a system where mothers are tested for HIV and syphilis two to three times during pregnancy and before birth. If a mother tests positive, treatment is immediately given to prevent transmission. In addition, women can receive care for 18 months after birth.

In 2023, Belize repealed its law that criminalized exposure to HIV and not disclosing it. The law previously punished an individual that “deliberately or recklessly transmits or spreads HIV/AIDS.” The law did not actually require transmission for penalization. 

Looking Ahead

There is some hope in Belize. In 2025, Belizeans took 49,615 HIV/AIDS tests. As a national standard, treatment is available as well as preventive measures like PrEP, PEP and HIVST.

Since 2023, the proportion of diagnosed, treated and suppressed AIDS cases have all risen. While still below the optimal rates, the numbers show that some progress is being made. In Belize, the limited resources make it difficult to overcome the HIV/AIDS epidemic entirely.

– Hayden Randolph

Hayden is based in Columbus, OH, USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Unsplash

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HIV/AIDS in Uzbekistan

HIV/AIDS in UzbekistanHIV/AIDS in Uzbekistan remains a growing concern, despite the government’s having made notable progress in upgrading its public health system. According to UNAIDS, 60,000 people are living with HIV in Uzbekistan, with new infections continuing to emerge each year. Expanded testing has helped improve detection rates, but structural problems like stigma and unequal access to healthcare still affect the country’s response. Nevertheless, increased funding for treatment and prevention is driving steady progress.

Overview of HIV/AIDS in Uzbekistan

​HIV/AIDS in Uzbekistan transitioned from an illness with a relatively limited prevalence to a more visible public health issue. Data from UNAIDS indicate that 4,000 people are infected annually. At the same time, improved screening has led to more diagnosed cases, mainly due to better surveillance rather than a rise in transmission. Most cases are transmitted through unprotected sexual contact (79%), with parental transmission as the next most common route (12.7%). Urban areas report more cases, whereas rural regions have greater barriers to testing and treatment. According to the IOM, the epidemic mainly affects vulnerable groups, including migrant workers, which consist 13% of all HIV infected people in Uzbekistan.

Key Challenges

One of the main challenges in addressing HIV/AIDS in Uzbekistan is stigma. Reports from UNAIDS suggest that a significant proportion of the population living with HIV experience social discrimination, which discourages them from seeking help and treatment. Around 80% of surveyed women reported that they experienced discriminatory attitudes. As a result, many cases are diagnosed at later stages, reducing the effectiveness of treatment and prevention measures.

Additionally, awareness is not uniform among different parts of the population. Young people and migrant workers often lack the necessary sexual education, increasing their vulnerability. People between 30-39 years are the largest group among the HIV-positive population, with a 28% proportion. Children are also in a vulnerable situation. According to UNICEF, antiretroviral therapy (ART) coverage among children and adolescents has fallen from 89% in 2018 to 73% in 2023. This gap indicates the need for more targeted and inclusive testing and treating strategies.

HIV/AIDS and Poverty in Uzbekistan

HIV/AIDS and poverty in Uzbekistan are strongly intertwined. Despite progress in reducing poverty, low-income families continue to face barriers in accessing healthcare. According to UNAIDS, out-of-pocket healthcare costs can hinder access to HIV testing, treatment and follow-up care. Even with the availability of antiretroviral medications, transportation costs, diagnostic tests and other medical expenses can create additional burdens for people with limited financial resources. Poverty can also increase vulnerability to HIV by limiting access to health information and preventive services. 

Access to healthcare also remains uneven. While antiretroviral therapy is mainly available in major cities, the rural population may face logistical and financial barriers. According to UNAIDS, disparities in healthcare infrastructure continue to affect service quality in remote regions.

As a result, economically disadvantaged individuals are more likely to experience delays in diagnosis and interruptions in treatment, leading to deteriorating health outcomes. Therefore, addressing poverty and access to healthcare is an important part of Uzbekistan’s response to HIV/AIDS.

Efforts and Solutions

​Uzbekistan has expanded its HIV response by adopting national strategies and collaborating with organizations such as UNAIDS and the World Health Organization (WHO). These efforts have improved testing systems and enhanced epidemiological monitoring.

Access to ART has increased in recent years. More than 41,000 people in Uzbekistan were receiving ART in 2024, which is 84.4% of the HIV-positive population, a significant increase from the past few years. ART helps people live longer and reduces the risk of HIV transmission by lowering viral load.

Prevention programs have improved as well. Public campaigns encourage voluntary testing and work to reduce HIV-related stigma. Mobile clinics and community testing now reach more people in rural and underserved areas. Annually, 500,000 people get tested for HIV in Uzbekistan. In 2022, the total number of people tested reached 4 million. 

International funding and technical support have helped expand these programs. Targeted efforts for high-risk groups, such as harm reduction for people who inject drugs, have helped stabilize HIV infection rates.

Conclusion

Although HIV/AIDS remains a serious public health problem in Uzbekistan, the country has made significant progress in expanding testing and treatment services. Partnerships between the government, international organizations and local communities have improved access to healthcare for thousands of people. However, further efforts are needed to combat stigma and healthcare inequities, particularly among low-income populations. By strengthening these initiatives, Uzbekistan can continue to reduce the number of new infections and improve the quality of life of people living with HIV.

– Dias Assan

Dias is based in Rome, Italy and focuses on Global Health for The Borgen Project.

Photo: Unsplash

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Zipline’s Drones and the Future of Health Care in Africa

Zipline’s DronesIn rural Rwanda, a child with severe malaria was transferred through multiple facilities, reaching Kabgayi District Hospital in critical condition after delays that can take hours due to long travel distances. The hospital urgently requested O+ pediatric blood from Kigali, a journey that would normally take about three hours by road in life-threatening cases.

Instead, one of Zipline’s drones arrived within minutes, dropping chilled blood by parachute at the hospital. Doctors began transfusion immediately, and the child stabilized, showing how rapid delivery replaces long transport delays and reduces the time between emergency need and treatment. It reflects a shift in rural healthcare, where distance once shaped outcomes, but fast delivery now bridges the gap between crisis and care.

Barriers to Health Care Access in Africa

Across much of Sub-Saharan Africa, poverty, distance and weak infrastructure constrain healthcare access, with nearly 40% of people living in extreme poverty. In countries such as Rwanda, only about 25% of roads are paved, and heavy rains can isolate entire regions, disrupting ambulances, blood transport and emergency response when time is critical for survival.

These conditions are especially dangerous in emergencies like maternal hemorrhage, severe malaria, traumatic injuries and newborn complications, where rural clinics can diagnose patients but lack essential supplies such as blood, oxygen, vaccines, antibiotics or specialists, forcing transfers that can take hours—sometimes up to five hours for emergency blood delivery.

Healthcare worker shortages, underfunded systems and fragile supply chains further strain the situation, leaving many rural facilities staffed by only a few nurses. WHO recommended doctor-to-population ratios remain difficult to meet, while solutions like Zipline’s drone delivery system aim to reduce these delays by rapidly delivering critical medical supplies to remote facilities. 

Zipline’s Emergency Healthcare Access

Zipline is an autonomous drone delivery company providing on-demand access to critical healthcare supplies. It launched its first national-scale network in Rwanda in 2016, growing from 21 hospitals to about 450 facilities and reaching most of the population. Its mission is to ensure fast, reliable medical delivery regardless of terrain, traffic or weather.

Initially, it focused on delivering blood products to hospitals facing urgent shortages in Rwanda, then expanded to vaccines, cancer medications, insulin, infusion therapies and other essential medicines across thousands of facilities. During the COVID-19 pandemic, it also supported vaccine distribution to underserved communities, improving access and delivery speed.

 Its electric fixed-wing drones fly up to 300 kilometers on a single charge at about 70 mph. Healthcare workers place orders via phone, text, WhatsApp or online, pack supplies into “Zips” at distribution centers, then send them through autonomous aircraft using GPS/GNSS and RTK centimeter-level positioning. Zipline’s drones drop deliveries by parachute into precise zones, with real-time tracking and rapid drone reuse through midair recovery.

Zipline’s Transformational Impact

Founded in 2016 in Rwanda, Zipline has evolved from a single distribution center serving 21 hospitals into one of the world’s largest autonomous medical delivery networks. It now operates across Rwanda, Ghana, Côte d’Ivoire, Nigeria, Kenya and other African countries, fully integrated into national healthcare systems and running routine, large-scale medical logistics operations.

Zipline’s drones system has completed more than 2 million commercial deliveries and flown more than 135 million autonomous miles across multiple countries. In 2023 alone in Rwanda, it delivered 28,754 units of blood, with an average delivery time of 42 minutes from order placement to arrival, demonstrating consistent rapid-response logistics at national scale.

Evidence from health-system studies shows major performance gains: delivery times for critical supplies such as blood, vaccines and emergency medicines are reduced by more than 50%, often arriving in 30 to 45 minutes instead of hours or days. Associated research reports up to a 51% reduction in maternal mortality in Rwanda and 56% in Ghana, around 60% fewer stockouts of essential medicines and vaccines and up to a 37-percentage-point increase in immunization coverage in serviced regions.

Zipline reports impacting more than 458,000 lives by improving emergency access to essential medical supplies, emphasizing that aircraft technology accounts for only about 15% of system complexity, with the core advantage being scalable logistics infrastructure.

In November 2025, Zipline announced a partnership with the U.S. Department of State to expand across Africa, backed by up to $150 million in U.S. funding and up to $400 million in African government utilization fees, scaling from 5,000 to 15,000 health facilities and potentially reaching about 130 million additional people.

Zipline’s Future Impact on African Healthcare

Zipline’s future in African health care focuses on scaling networks powered by Zipline’s drones to serve hundreds of millions of people. Leadership projects reaching up to 130 million globally through centralized hubs integrated into national health systems, enabling rapid delivery of blood, vaccines, medicines and emergency supplies, especially in remote and low-infrastructure regions.

Advances in automation and aircraft performance drive expansion. New drones cut launch time from about 10 minutes to roughly 1 minute and increase capacity from around 50 to up to 500 flights per hub per day. Each hub aims to serve populations of up to 10 million, significantly expanding delivery reach beyond emergency use cases into routine healthcare logistics, diagnostic transport and disaster-response operations, while reducing medical stock-outs and improving healthcare access across Africa.

– Malak Kamel

Malak is based in Amman, Jordan and focuses on Technology and Solutions for The Borgen Project.

Photo: Flickr

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Eliminating HIV in the Bahamas

HIV in the Bahamas HIV in the Bahamas has fluctuated around the 2% marker, making it the highest rate in the Caribbean, due to mother-to-child transmission. Girls and women have a higher rate of living with HIV compared to boys and men. Early prevention efforts from the Bahamian government have caused a decline in rates and have helped ensure treatment is accessible to expectant mothers. As a result, the World Health Organization (WHO) confirmed and certified in April 2026 that the Bahamas has met the elimination criteria.

Meeting the WHO Elimination Criteria

To meet the elimination criteria for HIV, a country must show that pregnant women receive proper treatment and that very few babies are born with HIV. The Bahamas has proved that:

  • The mother-to-child transmission rate of HIV is less than 2%
  • Fewer than five children per 1,000 live births are infected
  • 95% of pregnant women have access to antenatal care, HIV testing and treatment

The Bahamas now joins a group of 12 countries and territories in the Americas certified by the WHO and will continue to maintain its efforts through surveillance and inclusive care for future mothers and their families.

Early Action and Universal Antenatal Care

Beginning in the 1990s, the Bahamas took early action in preventing mother-to-child transmission (PMTCT) by including screening and testing for HIV as part of routine antenatal care.

Working alongside its health care model, the Bahamas provides universal antenatal care for everyone regardless of economic or social background, supported by a strong laboratory network and testing protocol where women are screened at their antenatal appointments during each trimester.

This extensive data collection allows health care professionals to ensure that treatment remains accessible and free to mothers and to monitor how effective the treatment is in continuing to reduce HIV rates.

Integrated Health Programs and PAHO Partnership

Building on the launch of the Pan American Health Organization’s (PAHO) initiative, through which countries integrated HIV and maternal health services into their health care systems, the Bahamas continued to expand access to its residents in 2010.

Integrated into the Maternal and Child Health (MCH) program, the Bahamas coordinates with the National Infectious Disease Programme and oversees the prevention and treatment of HIV. This monitoring ensures continued care and treatment for HIV-positive mothers and exposed infants by providing antiretroviral medicines and other family planning services free of charge.

Looking Ahead

Through sustained surveillance and a commitment to universal health care access, the Bahamas has reduced the risk of HIV transmission and other communicable diseases that pose a risk to health in the Caribbean. Furthermore, its achievement demonstrates that the elimination of mother-to-child HIV transmission is possible and offers a model for other countries working toward the same goal.

– Kianna Phosouvanh-Sythong

Kianna is based in Upper Darby, PA, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Unsplash