Archive for category: HIV/AIDS

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HIV/AIDS in Mali: ARCAD Santé PLUS Makes Care Accessible

HIV/AIDS in MaliHIV/AIDS remains West Africa’s most pressing health challenge. Mali’s HIV/AIDS prevalence rate of 1.1% is quite high for West Africa and the country is one of the few African nations where new infections are rising. Mali is both one of the 10 poorest countries in the world where they are on a list of 37 very poor and very indebted countries. It relies heavily on foreign aid. Many Malians struggle to access HIV/AIDS testing and treatment due to stigma and discrimination. Other challenges are difficult access to health facilities and scarcity of follow-up at community level. Yet, amid these challenges, a homegrown organization is working to address HIV/AIDS in Mali, one community at a time.

A Crisis of Access and Awareness

Approximately 62% of Malians living with HIV/AIDS know their status. Among those who test positive in Mali, 56% are on antiretroviral therapy (ART), with 48% on ART achieving viral load suppression. It helps people living with HIV/AIDS stay healthy, live longer and reduce the risk of transmitting the virus to others.

On February 28th, the U.S. decided to suspend funding to FHI360, a global nonprofit organization that is based in North Carolina. The Joint United Nations Programme on HIV/AIDS (UNAIDS) Country Office and the Executive Secretary of the High National Council for the Fight against AIDS organized this meeting and made this decision. To this, the Malian government went on to distribute 120 million CFA francs ($212,000) to associations to help them continue their activities and reduce the drawbacks of the suspension.

ARCAD Santé PLUS: A Community-Focused Response

ARCAD Santé PLUS is an NGO founded in 1994 in Bamako. Led by Dr. Aliou Sylla, ARCAD Santé PLUS (formerly ARCAD-SIDA) focuses on community resilience and access to health, providing technical support, community research and advocacy. This is particularly for people living with HIV/AIDS and vulnerable populations.

The services they offer include prevention and care initiatives, including capacity building for community leaders on sexual health and rights. ARCAD Santé PLUS seeks to bring communities together to identify and address their health needs, contributing to a world free of HIV/AIDS.

The organization runs CESAC, otherwise known as the Centre for Listening, Care, Activities and Advice. It originated in 1996 which was Mali’s first dedicated HIV clinic. It receives support from the Global Fund which ARCAD Santé PLUS leads. HIV/AIDS prevention, treatment and care and programs specifically for children, adolescent girls and women are some of the health services they provide.

More specifically, ARCAD Santé PLUS’ clinics provide prevention kits and PrEP, testing for HIV/AIDS, treatment of opportunistic infections, initiation and monitoring of ARVs, community-based ARV distribution, self-support groups, harm reduction, research and advocacy.

A Major Step Forward in 2024

In March 2024, The Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund), the government of Mali, ARCAD Santé PLUS and Plan International Mali signed three new €102 worth of grants. These grants support the fight against AIDS and tuberculosis (TB) and strengthening health systems over the 2024-2026 period. 

About 96,600 people will receive HIV/AIDS and TB treatment through grants by 2026 to prevent significant numbers of new HIV/AIDS infections, including mother-to-child transmission.

The grants will also be used to improve testing coverage and success rates, focused on decentralized care for drug-resistant TB between 2023 to 2025. This will scale up prevention activities for hard-to-reach populations and strengthen the capacity of community-focused organizations.

Progress Is Possible

Naturally, the path to ending HIV/AIDS in Mali is not without obstacles. Funding disruptions, conflict and persistent stigma continue to challenge the national response. However, organizations like ARCAD Santé PLUS reflect that community-focused, patient-centered care can make a meaningful difference despite these difficult circumstances. ARCAD Santé PLUS is proof that continued investment in local solutions can fight against HIV/AIDS in Mali.

– Joy Kohol

Joy is based in Muncie, IN, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Unsplash

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Treatment Access and Awareness for HIV/AIDS in Guyana

HIV/AIDS in GuyanaIn 2024, 40% fewer people acquired HIV and 54% fewer died from AIDS-related causes than in 2010. Many countries around the world have invested extensively in combating the HIV/AIDS epidemic, with one country making notable progress despite the many obstacles it faces: Guyana.

Guyana is a country in the northeast region of South America, with a population of 878,674 as of 2022, largely centered on and around the Caribbean coastline. It was until the recent discovery of offshore oil reserves one of the poorest countries in South America, a socioeconomic effect which still impacts the country today in regard to government resources and public health.

Medical hospital infrastructure for instance was, until the most recent decade, a costly and difficult expense. Accessing necessary health treatment required a challenging trip to the capital city, Georgetown, often taking more than half a day to complete and having a disproportionate impact on low-income patients in terms of health and accessibility. Here is more information about HIV/AIDS in Guyana and what some are doing to address it.

International and Governmental Efforts

Recent strategic investments by the Government of Guyana, the Pan-American Health Organization (PAHO) and the World Health Organization (WHO) have helped expand the region’s health care network. These ongoing efforts from international support organizations will, by 2027, open five more “smart” hospitals in the country which will provide far more expansive and high-quality healthcare access than ever before.

Similarly, the Universal Health Voucher Programme (UHVP) was a 2025 initiative by the Government of Guyana through the Ministry of Health, aimed at improving healthcare service accessibility to all of Guyana’s citizens by providing each member of the public a $10,000 health voucher and reduced costs for valuable medical tests. The current president of Guyana, President Mohamed Irfaan Ali, launched the UHVP with the goal of improving Guyanese healthcare and especially through improved health monitoring and early addressing of health conditions.

Critically Affected Populations

Research shows that HIV is still among the leading public health challenges in Guyana and the Caribbean, largely due to the combination of HIV/AIDS solutions lacking full accessibility and awareness in everyday life in Guyana.

There are an estimated 11,000 HIV/AIDS cases in Guyana, a prevalence of 1.5% among the population, and new cases have risen by 19% since 2010. This is compared to the global average of HIV/AIDS, which among adults aged 15–49 sits at around 0.7%, or less than half of Guyana’s HIV impact.

In 2017, the Global Fund approved an HIV grant of $4,539,985 to the Guyana Ministry of Health, lasting from the beginning of 2018 to the end of 2020. The proposed grant program targeted an epidemic of diverse and vulnerable populations, those being “men who have sex with men (MSM), female sex workers, transgender people, miners and loggers,” according to the Global Fund Technical Review Panel (TRP). The program worked to assess and implement a coordinated variety of strategies to address these populations and treat any and all HIV/AIDS cases more broadly, building upon recent efforts by Guyana on aiding key populations and with the goal of eliminating HIV/AIDS and addressing detrimental social and economic impacts the epidemic creates.

Eliminating HIV/AIDS in Guyana

Guyana has made significant progress in its efforts to eliminate HIV/AIDS, though has not managed to meet its optimistic 95-95-95 targets completely. These goals mean for 95% of persons living with HIV to know their disease status, for 95% of persons with HIV/AIDS to have active treatment, and for 95% on treatment to have viral suppression aid. As of the National AIDS Programme 2023 Annual Report, Guyana has reported 94%, 72%,and 87% respectively, showing substantial improvement from a decade prior but without the 95% benchmarks being met which would signal an effective and complete eradication of the epidemic.

However, HIV infections are certainly not yet a settled case in the country. The year 2024 saw almost 500 new HIV infections recorded, with many of them being preventable, according to Guyana’s Health Minister Dr. Frank Anthony. Guyana provides free nationwide testing and treatment services for HIV/AIDS, which is why this increase is so hard to explain by conventional resource explanations.

Studies assessing young people’s knowledge of HIV/AIDS and their views on sexual behavior and contraceptives in Guyana may help explain why. Almost a quarter of teenagers ages 12-14 years old were sexually active, jumping to more than one-third of teenagers for ages 15 or older. Just two out of every five of these groups utilized condoms and other measures, reflecting attitudes toward HIV/AIDS prevention affected by a lack of public knowledge and importance due to age and educational and religious teaching on these contraceptives. Guyanese cases ages 15-24 accounted for 14% of the 580 new HIV/AIDS infections recorded in 2023, and HIV prevalence for the age group rose from 0.2% to 0.3%, suggesting the problem is increasing despite measures being taken.

Actions by the Guyanese Ministry of Health

Rates of HIV/AIDS have stayed constant throughout the country as well, suggesting that the increased health accessibility reforms by Guyana’s government have not had the intended effect in the country. The Government of Guyana already funds every test, HIV tablet, ARV and viral load test, in contrast to most other developing countries which tend to rely on international financing for HIV/AIDS healthcare support.

The Government of Guyana additionally introduced PrEP (pre-exposure prophylaxis) pills in 2019 through the Ministry of Health and the National AIDS Programme Secretariat (NAPS), pills which are highly effective in treatment for HIV/AIDS, but which have been largely ineffective due to a lack of public awareness. Research shows that PrEP awareness in Guyana exists largely through media sources, whereas PrEP access is significantly less commonly prescribed by a health care provider. 

Many are concerned about limited access, side effects, and inadequate provider engagement in PrEP and other HIV/AIDS treatments, illustrating a lack of success in providing sufficient awareness efforts by the Guyanese government. However, more than half of the research participants also expressed a willingness to use PrEP, and more than three-quarters expressed a willingness to recommend it to their peers.

Final Thoughts

HIV/AIDS efforts in Guyana have been moderately successful, particularly in expanding healthcare access and treatment potential. Continued problems exist with spreading accurate information and reducing the systemic barriers present to current health care inaccessibility in Guyana, yet greater provider training, routine PrEP integration into medical spaces and targeted community outreach to improve public perception and access can combat it.

– Matthew Hecomovich

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

Photo: Wikimedia Commons

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Addressing HIV/AIDS in Bahrain

HIV/AIDS in BahrainAs a country with a mix of Islamic and Western influences, Bahrain finds itself in a unique position. This blend is a result of a large migration of foreign nationals into the country. More than half of the country’s population is made up of foreign nationals. 

HIV/AIDS in Bahrain

According to a report, 237 cases of HIV were recorded in the Kingdom of Bahrain. Transmission through sexual contact was more common in foreign nationals, accounting for 45.7% of cases, while drug abuse was the predominant cause for Bahraini citizens, making up 38.8% of cases of HIV/AIDS in Bahrain.

There is also a large, underreported sex trafficking industry in Bahrain. While sex workers exist in almost every country, their legality in some nations makes it easier to do HIV testing. However, in a country like Bahrain, where sex work is illegal, and authorities arrest women for participating in sex work, it becomes rather difficult. 

Currently, sex workers receive testing for HIV/AIDS in Bahrain only after authorities arrest them, which means that there is probably a huge number of untested HIV-positive individuals. Additionally, there might be many sex workers who do not receive testing out of fear of arrest, and many people who have contracted the disease without knowing it.

Public Attitudes About HIV

According to a study that Janahi et al conducted, which includes the knowledge, risk perceptions and attitudes of 1,038 Bahraini adults, misconceptions towards HIV do exist in the region. 

About 60% support patient isolation and 52.4% see HIV as a divine punishment. Meanwhile, 84.4% of people believe that religion plays a role in limiting the spread of disease. These misconceptions require attention to create a society that makes people less hesitant to get HIV testing, as people fear their family and friends shunning them just for being HIV positive.

A report by the Journal of Bahrain Medical Society states that “The HIV-related stigma and discrimination in the health care sector has not been studied in Bahrain, most probably due to the low prevalence of HIV and AIDS in our country.”

Efforts That Bahrain is Making

The National AIDs Programme, which has been a GCC-sponsored health initiative since 1987, provides free antiretroviral therapy, which is commonly known as ART, for patients who are recorded as positive with HIV. Before the National AIDs Programme, the government did not have a central plan to combat AIDs as there was no approved drug back then. Treatment back then mostly relied on palliative and supportive care. The free therapy has seen success with 68% receiving free healthcare in the year 2021, a notable increase from 33% in the year 2015. However, Bahrain must make efforts to create a population that is ready to undergo HIV testing, to make steady improvements in the crisis.  

The Free ART treatments has been a success with many patients receiving free healthcare, and this is the reason why HIV/AIDs in Bahrain doesn’t lead to poverty. The Kingdom of Bahrain also claims that the global definition of global poverty does not apply to the country, as there are no people living below the poverty line, but a United Nations report ranks Bahrain third in poverty among GCC countries, making one doubt everything the country claims.

Concluding Thoughts

Public attitudes and laws make it difficult to record and diagnose cases. However, the National AIDs programme has been successful in treating patients, although more progress is needed to address widespread ignorance.

– Adil Sayyad

Adil is based in Mumbai, India and focuses on Global Health for The Borgen Project.

Photo: Unsplash

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5 Facts About the Fight Against HIV/AIDS in Suriname

HIV/AIDS in SurinameLocated on South America’s Northern coast, the small country of Suriname holds a diverse population. While its public health landscape faces challenges in 2026, the country has emerged a regional leader in integrated care, bridging the gap between remote interior communities and urban centers. According to the World Bank, almost 26% of the population lives below the poverty line. These rates increase in the more interior regions with limited basic infrastructure.

Poverty is often a driver that increases vulnerability to HIV/AIDS infection, simultaneously creating significant barriers to accessing treatment. Despite this, the fight against HIV/AIDS in Suriname continues, with the understanding that social stigma can be as much a hurdle as access to medical care.

1. Expansion of Treatment Coverage

A steady growth in antiretroviral therapy (ART) access turns the tide of the fight against HIV/AIDS in Suriname. According to UNAIDS, it allows the treatment coverage rate to reach 70% of people living with the condition in Suriname by 2026.

Data from the HIV/AIDS Industry Outlook indicates the treatment coverage by the nation achieves an average year on year increase of 1.6 points. Continuing on this path upwards, the Ministry of Health has reaffirmed the commitment to meet the UNAIDS global targets for HIV care through decentralized testing and community based clinics.

2. Progress in Pediatric Health

In 2026, the HIV/AIDS prevalence rate for those aged 10-14 is expected to drop to 60 people, an 8% decrease compared to 2021 according to the Suriname HIV/AIDS Industry Outlook. Since 1995, the rate has had a staggering 13.1% year-on-year decline in pediatric prevalence. Health experts have attributed this success to the integration of prenatal HIV screening and improved preventions of mother to child transmissions (PMTCT) services.

3. Community-Led Support Systems

Poverty often acts as a barrier for those in rural Suriname. Treatment requires consistent clinical visits and access to pharmacies, and limited household income can make the cost of travel to centers prohibitive. The fight against HIV/AIDS in Suriname continues in community-led organizations like the Double Positive Foundation. The provision of psycho-social care and “peer buddy” support, and ensuring treatment reaches impoverished populations is led by advocates such as Ethel Pengel. 

This acts as a beacon of light within socioeconomic barriers such as family rejection and social stigma. Walking beside young women and girls ensures that they remain in the healthcare system following a diagnosis.

4. State-Sponsored Medication Access

The Suriname Ministry of Health has provided HIV inhibitors at no cost to patients since February 2005. It sustains this through a financial partnership with the Global Fund, a worldwide partnership providing 26% of all international financing for HIV programs. In 2026, “person-centered care” is at the forefront of medical health; ensuring the treatment of other chronic conditions alongside HIV.

5. The 95-95-95 Path to Recovery

The recovery of Suriname relies on reaching the UNAIDS global targets: 95% of people living with HIV know their status, 95% of those diagnosed receive ART, and 95% of those on treatment achieve viral suppression. 

Looking Ahead

While funding remains a challenge, Suriname is ensuring regional Caribbean partnerships to maintain a steady supply of biomedical interventions. By prioritizing long-acting preventions, HIV/AIDS no longer defines this nation’s future. 

– Celine Dib

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

Photo: Wikimedia Commons

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Lenacapavir’s Introduction in Zimbabwe

Lenacapavir’s Introduction in Zimbabw Zimbabwe’s Human Immunodeficiency Virus (HIV) epidemic has been among the most severe globally, shaped by decades of social, economic and structural pressures. At the turn of the 21st century, the country faced one of the highest HIV prevalence rates worldwide, with an estimated 1.3 million people living with the virus. The epidemic has strained families, eroded the workforce and pushed public health services to their limits. Although sustained national efforts and global partnerships have driven major progress, the Joint United Nations Program on HIV/AIDS (UNAIDS) Global AIDS Update 2022 warns that prevention gains are now faltering, with inequalities continuing to fuel new infections in high-burden countries.

Lenacapavir’s Introduction in Zimbabwe

In February 2026, Zimbabwe became one of the first countries in Africa to introduce Lenacapavir, a long-acting injectable HIV-prevention drug developed by Gilead Sciences. Administered only twice a year, Lenacapavir’s introduction in Zimbabwe marks a major milestone in the region’s response to HIV. The rollout positions Zimbabwe at the forefront of next-generation prevention strategies, offering a discreet and highly effective alternative to daily oral pre-exposure prophylaxis (PrEP).

Health officials and global health bodies have welcomed the introduction. Zimbabwe’s Health Minister Douglas Mombeshora described Lenacapavir as a new approach, noting that it offers a less complicated method compared with daily oral PrEP.

While daily oral PrEP has been available for years, its impact has been limited by stigma, partner suspicion, unpredictable schedules and social scrutiny. A survey conducted by The Lancet found that 51% of participants held discriminatory attitudes toward HIV and reported shame of association.

A discreet biannual injection removes many of these barriers. As one early recipient explained, clients often misinterpreted PrEP pills as HIV treatment, leading to stigma and lost income, a challenge that the injection avoids.

Constance Mukoloka, one of the first recipients, said the injection makes her “feel safe” and able to “work with confidence,” explaining that daily PrEP pills often created tension with clients and were difficult to take consistently.

A Tool for High-Risk Groups

Lenacapavir’s introduction in Zimbabwe is significant for vulnerable communities, particularly adolescent girls, young women, sex workers and other high-risk groups who face disproportionate vulnerability to new infections. Its introduction signals a shift in HIV prevention strategy, particularly in regions where incidence remains high despite decades of progress. Early evidence from large-scale trials shows that more than 99% of participants remained HIV negative while on the twice-yearly regimen, underscoring its potential to overcome adherence challenges that have previously undermined daily oral PrEP uptake.

Although national HIV prevalence has declined significantly over the past two decades, women and girls continue to bear a disproportionate share of new infections, driven by structural inequalities, gender-based violence and economic precarity.

The rollout has also sparked public debate, as some community voices celebrate the new treatment while others raise concerns about access, affordability and the need for transparent communication to build trust in long-acting biomedical prevention. As global partners such as the U.S. government and the Global Fund frame this as a landmark in innovation and health system strengthening, Zimbabwe may become a critical test case for how long-acting PrEP can be scaled equitably across Sub-Saharan Africa.

Early Evidence and Implementation

Early pilot programs indicate that Lenacapavir’s introduction in Zimbabwe has seen strong uptake, with clinics reporting that the simplified regimen is easier to manage, reduces drop-off rates and integrates smoothly into existing reproductive health services. These findings mirror broader regional trends, as early adopters across Africa have seen strong interest in Lenacapavir even before full national rollout. Public health experts argue that the injection could significantly reduce new infections if scaled nationally, especially in rural areas where clinic visits are infrequent and transport costs are high. Several states are already exploring similar pathways.

Looking Ahead

Zimbabwe’s decision to move early on long-acting PrEP signals a broader shift in global health leadership. Rather than waiting for donor-driven adoption cycles, the country is asserting itself as a regional pioneer in HIV-prevention innovation. The rollout is supported by partnerships including the President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund, but Zimbabwe’s strong HIV-response infrastructure, having already met the UNAIDS 95-95-95 targets, has enabled rapid integration of the new technology.

In a region where HIV remains a leading cause of mortality, the introduction of a discreet, effective and user-friendly prevention tool represents a meaningful step forward. It offers new autonomy to individuals who face stigma or safety risks when using visible prevention methods, strengthens health system efficiency and demonstrates African leadership in adopting public health technologies.

– Max Kenway

Max is based in London, UK and focuses on Technology and Politics for The Borgen Project.

Photo: Flickr

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Poverty and Healthcare in Kenya

Healthcare and Poverty in KenyaThere are many health factors that contribute to the approximately 3.6 million orphaned children in Kenya: sickness, malnutrition, healthcare access and gender disparities. Poverty is woven through each of these areas that has significant effects on women and orphan children that reside in Kenya, leaving many vulnerable to developing health risk behaviors. The lack of accessible healthcare is clear in Kenya with the prevalence of diseases and many barriers that women and children face in order to be able to receive care. This has now also become a socioeconomic issue as the healthcare system shows extreme disparities within the major communities of Kenya.

Navigating HIV/AIDS in Poverty

HIV/AIDS affects 1.4 million people in Kenya, and 32% of orphanhood stems from HIV/AIDS. This happens due to how widespread HIV is within families, and how it will directly affect the families labor force and overall income. HIV also plays a major role in the health of parents in the family, causing deaths of either one or both parents, leaving more children orphaned. Poverty directly impacts access to antiviral drugs (ARVs) as
the citizens of Kenya rely heavily on donors. In January 2025, the U.S. shut down its USAID, reducing its programs to Kenya from 149 to 30. This massive exit from humanitarian aid has caused many healthcare workers to experience lay offs and forced healthcare facilities to close.

Vitamin Deficiencies in Pregnant Women

In Kenya, many pregnant women have vitamin deficiencies which are due to the limited amounts of nutritional products for maternal health along with overall nutritious foods required during pregnancy. In Kenya, 26% of pregnant women suffer from iron deficiency, creating an anemia rate of 42.6%. Kenya as a whole is facing a drought which is not only affecting their resources, but also the ability for families to have stability which leads to a lot of children in orphanages. Many of the orphans in Kenya have living relatives but widespread poverty leaves them without substantial resources, leading to children being placed in orphanages with the idea that they will live a better life.

Gender Disparities

Only 6% of women have titles to land in Kenya. Although it is a legal right for them to own property, societal norms of discrimination against women have long been the driving factor of them being unable to obtain and keep property. Kenyan women are at risk of being victims of land grabbing, usually in the way of their husbands running them off or abusing them causing them to have to flee. These women are put in vulnerable situations, feeling forced to abandon their children to orphanages, and pushes women to make less than ideal choices, such as prostitution. This can lead to a higher mortality rate, and ultimately leaves many children orphaned.

Available Resources

To help combat these issues, many organizations and campaigns, such as Stand for Her Land and Kenyan Peasants League have started garnering support and finding these depleted resources to help the community. Stand for Her Land has worked on advocacy for women of lesser status and income to exercise their rights on gaining legal access to land. Along with this, the Kenyan Peasants League gathers community-based funding to purchase land for women who had their lands usurped during major land-grabbing times.

Policy Action

The government has now also taken a stronger stance on these issues, one main way being by creating the National Care Reform Strategy for Children in Kenya. This specific act focuses a lot on family based care in society and ensuring that they are provided with the resources to continue in society. However, to break this cycle of poverty as a whole, national and international organizations need to prioritize things such as accessibility to healthcare, enforcing a woman’s right to own land, and overall strengthening child-welfare programs. Changes like these can likely help the livelihoods of not only the children in Kenya, but also the community that exists around them.

Conclusion

In summary, poverty in Kenya has shown to have lasting effects that have caused severe damage to especially the orphaned children of the country. Studies show that there will be long term effects on their overall developmental issues that will likely follow them into their adulthood. In order to properly address these matters, more accessible resources need to be implemented.

– Mansi Sampda, Jessica Norman, Melissa Kronblat and Kalea Mailangi

Mansi, Jessica, Melissa and Kalea are based in Bothell, WA, USA and focus on Global Health for The Borgen Project.

Photo: Unsplash

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3 Reasons for Elderly Poverty in Eswatini

Elderly Poverty in EswatiniNearly 60% of the Eswatini population lives below the national poverty line. While poverty affects much of the population, studies consistently find that older persons are overrepresented in these poverty rates. One can trace elderly poverty in Eswatini back to three structural factors: limited social protection, rural economic dependence and long-term effects of the HIV/AIDS epidemic. These structural factors continue to affect elderly poverty in Eswatini, and people across the country.

Weak Social Protection and Limited Pensions

Eswatini spends about 1% of its GDP on its social protection programs. This is the lowest share of GDP to social protection expenditure in the region. Social protection programs include the Old Age Grant, which gives a monthly stipend of E500 to Eswatini people age 60 and over. This amount, which translates to roughly $26 or €24, must stretch across multigenerational households. 

According to the International Fund for Agricultural Development (IFAD), more than 70% of the Eswatini population depends on small-scale agriculture for income and subsistence. This means that workers do not contribute to formal pensions. Because of this, many elderly Eswatini people rely solely on the Old Age Grant. 

Rural, Low-Productivity Economic Structure

About 75% of the Eswatini population live in rural areas, where poverty is highly prevalent, and depend on subsistence farming. Agriculture in Eswatini is vulnerable to drought and adverse weather, and the country ranks 128 out of 187 countries on the ND-GAIN climate vulnerability index. For older adults, this rural economic structure means income is often tied to physically demanding, climate-sensitive work. 

Beyond income limitations, access to services also plays a role in elderly poverty. Rural communities often face limited access to healthcare facilities, transportation and formal employment opportunities. For older adults, traveling long distances to clinics or markets can add additional financial strain. 

At the same time, high unemployment rates among younger generations reduce the likelihood that elderly parents will receive consistent financial support from adult children. In a country where generations often share household resources, economic instability affects not only working-age adults but also older family members who depend on collective income.

Long-Term Economic Effects of HIV/AIDS

Though Eswatini’s reported HIV prevalence has declined as treatment coverage expands, the epidemic continues to affect the population. UNAIDS data show roughly 27% of adults between the ages of 15 and 49 are living with HIV.

Earlier waves of the epidemic led to high mortality among working-age adults. This reshaped household structures and shifted caregiving responsibilities to grandparents and older relatives. 

A United Nations report on the impact of HIV/AIDS on generational roles found that older adults in heavily affected countries often assume primary caregiving roles for orphaned children. In Eswatini, where many elderly already rely on limited social grants, supporting younger dependents continues to strain household income and contribute to persistent poverty.

Although Eswatini has made progress in expanding HIV treatment coverage and increasing the reach of its Old Age Grant program, structural pressures continue to affect elderly poverty in Eswatini. In response, new community based initiatives have emerged. The Philani Maswati Old Age Home, established in 2017 and 2018 as the country’s first residential care facility for older persons, was created to provide housing and daily support for elderly individuals who face neglect or extreme poverty. The facility offers stable living environments for older adults who may not have reliable family support. This facility indicates recognition of the need for formal care services. While challenges persist, initiatives such as Philani Maswati signal gradual efforts to strengthen protections for older citizens and address elderly poverty in Eswatini.

Looking Ahead

Elderly poverty in Eswatini is shaped by limited pensions, a rural economy built around subsistence farming and the long-term effects of the HIV/AIDS epidemic. Programs like the Old Age Grant show that the country is beginning to address these challenges. Continued efforts to expand support for the elderly is important as Eswatini works to reduce poverty across generations.

– Kale Overton

Kale is based in Ames, Iowa USA and focuses on Good News and Politics for The Borgen Project.

Photo: Unsplash

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Positive Work To Address HIV/AIDS in Georgia

HIV/AIDS in GeorgiaGeorgia has historically reported low rates of HIV, and new infections are concentrated among the most at-risk groups, such as men who have sex with men (MSM) and those who inject drugs. In 2024, Georgia passed legislation that limits queer individuals’ access to essential health services and therefore threatens the progress made to raise awareness, testing, treating and preventing HIV/AIDS. This important work now falls to community organizations such as Equality Movement and Tanadgoma, who are supported by the United Nations Population Fund (UNFPA), and continue their life-saving work to treat and prevent HIV/AIDS in Georgia among vulnerable and impoverished groups.

7 Key Facts About HIV/AIDS in Georgia

  1. UNAIDS classifies Georgia as having a low-level HIV epidemic.
  2. As of 2023, approximately 9,100-10,500 people are living with HIV/AIDS in Georgia, which is about 0.3% of the general adult population.
  3. Among the MSM population, the prevalence of HIV is 21.5%, which suggests current methods do not reach the most at-risk groups.
  4. The number of new HIV infections has been decreasing gradually since 2019.
  5. Concerningly, around 36% of those living with HIV are not aware of their HIV-positive status; individuals can remain symptom-free for years.
  6. About 2,492 people have died as a result of HIV/AIDS in Georgia since 1989.
  7. Around 71% of those with HIV are receiving Antiretroviral Therapy (ART), which suppresses the virus and enables them to live long, healthy lives as well as reducing the risk of transmission

HIV/AIDS and Poverty in Georgia

HIV/AIDS and poverty are deeply and complexly intertwined. Those who deal with food insecurity, housing instability and/or are in poverty are significantly more vulnerable to getting an HIV infection. This is especially true if they rely on sex work to raise money for basic necessities, and where this power imbalance may not allow them to purchase and/or negotiate the use of condoms.

Similarly, those who live with HIV in their household are more at risk of falling into and remaining in poverty. Symptoms of HIV/AIDS can mean people are unable to work for long periods of time, or experience isolatio due to stigma, which can result in the loss of jobs, food security and housing, and in some places make them unable to pay for HIV/AIDS treatment and prevention healthcare.

This is a difficult cycle to break out of. Some treatments, such as ART drugs, must be taken every day with food, and therefore, a lack of adequate food resources and consistent medication places people further vulnerable to severe symptoms of HIV/AIDS. This means they are likely to be out of work for longer, making it even more difficult to raise funds for food and/or medication.

Although steadily declining, in 2024, 9.4% of the population of Georgia was below their national absolute poverty line. The proportion of the population living below the international poverty line at $3.00 a day, and therefore at a higher risk of contracting HIV/AIDS in Georgia was 4.2%.

Community Work 

Organizations such as Tanadgoma and Equality Movement recognize this threat and have a commitment to their mission of reducing the number of new HIV/AIDS diagnoses as well as changing social attitudes to the infection.

Tanadgoma, a UNFPA partner, are working to increase the HIV testing service uptake by providing access to HIV information and services to young people to counter the issue of more than 50% of new HIV diagnoses occurring at a late stage. A key effort of this is to ensure that their environment is free of stigma and discrimination surrounding HIV/AIDS, and other contributing factors such as safe syringe procedures and sex work, despite the recent legislation. People such as Tamar Gakhokidze, a woman who is HIV positive after being infected during a dental procedure in jail, work with these organizations to break down misconceptions and stigma and hope to offer an example to others of someone living with HIV/AIDS in Georgia, but without fear or shame.

Equality Movement have developed a self-testing online platform to help popularize testing for HIV among at-risk groups such as MSM. These tests are free and individuals can complete them at home, allowing them to complete them anonymously with no need to visit community centers. They are also accessible to those in poverty. Also included in these self-test packages are condoms and lubricant that can help prevent the spread and new diagnoses of HIV/AIDS in Georgia; so far, Equality Movement have distributed more than 170,000 condoms and 45,000 lubricants through this project. As an organization, it has also provided Pre-Exposure Prophylaxis (PrEP), an effective daily pill to prevent contracting HIV, to more than 500 people for free.

Looking Ahead

In response to the continued work of organizations such as Tanadgoma and Equality Movement, the Georgian Anti-Corruption Bureau has been persecuting and pressuring civil society and non-governmental organizations to cease their activities. This has not swayed Equality Movement from its mission, and they state, “despite the unlawfully initiated monitoring, we continue our activities and legal efforts to stop the enforcement of repressive laws. We will use all available legal means to protect our rights and the rights of the citizens of Georgia.”

– Stephanie Gable

Stephanie is based in Wales, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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The Proactive Fight Against HIV/AIDS in the Solomon Islands

HIV/AIDS in the Solomon IslandsThe Solomon Islands, a vibrant archipelago of nearly 1,000 islands in the South Pacific, continues to demonstrate remarkable resilience in public health management. While the nation faces geographic and economic hurdles — ranking 156 out of 193 on the Human Development Index — the rate of HIV/AIDS in the Solomon Islands remains one of the most stable in the region.

For decades, the archipelago has maintained a low HIV prevalence rate. Data shows that since 1994, only 0.1% of the population aged 15-49 lives with HIV/AIDS in the Solomon Islands. Between 1994 and 2016, health officials recorded only 30 cases, a testament to the nation’s early intervention and cultural protective factors. 

While the historical numbers remain low, recent years have seen a slight uptick in reported cases of HIV/AIDS in the Solomon Islands. Rather than viewing this as a setback, health experts interpret increased numbers as a sign of enhanced diagnostic capabilities. 

The Ministry of Health and Medical Services (MHMS) has significantly expanded testing sites and medical supply procurement. By making testing more accessible, the government identifies cases earlier, enabling immediate treatment. This shift from low numbers through limited testing to active surveillance marks a positive evolution in the country’s medical strategy.

Overcoming Barriers to Treatment

With nearly 1,000 islands in total, treatment for HIV/AIDS in the Solomon Islands has not come without its unique set of obstacles:

  • Geographic Isolation: Realizing a central clinic for antiretroviral therapy (ART) can be physically and financially taxing for rural residents.
  • Stigma and Discrimination: Social and religious norms, combined with a lack of confidentiality in small island communities, create a fear of social rejection that discourages individuals from seeking HIV testing and life-saving treatment.
  • Regulatory Scrutiny: For non-nationals, entry and residency restrictions based on HIV status can create significant legal hurdles for accessing long-term care.

Strategic Measures To Improve Access

To address these difficulties, the Ministry of Health and Medical Services (MHMS) and its partners have introduced the following improvements:

  • Decentralized Testing and Treatment: The program equips area health centers with rapid diagnostic test kits and ensures that even in remote provinces, health workers can identify new cases within minutes and immediately connect patients to antiretroviral therapy (ART).
  • Commodity Security: Health Minister Dr. Paul Bosawai recently emphasized that the ministry is streamlining the supply chain to ensure that HIV commodities and diagnostic kits remain in stock and are readily available in all provinces.
  • Mother-to-Child Prevention: By integrating HIV testing into routine antenatal care, the MHMS has successfully maintained a near-zero rate of mother-to-child transmission in recent years. These proactive efforts mean that 100% of those diagnosed now have access to free, government-sponsored treatment, transforming a potential surge into a manageable and treated health condition.

Beyond clinical settings, the nation prioritizes education as a primary tool for preventing HIV/AIDS in the Solomon Islands. Community-led initiatives utilize radio broadcasts and local leaders to share information about sexual health and disease prevention. 

By involving traditional leaders and local health workers, the government ensures that health messaging respects cultural nuances while providing vital medical facts. These programs empower citizens to take charge of their own health and encourage voluntary testing, further contributing to the slight rise in known cases, which allows for a more accurate public health response.

Looking Toward a Healthy Future

The Solomon Islands is not merely reacting to HIV; it is building a prevention strategy. The government’s commitment to the Fast-Track targets set by UNAIDS shows a clear path forward. By prioritizing education and investing in rural health care infrastructure, the nation ensures that the recent surge in data translates into a long-term surge in survival and well-being. 

With continued international support and a dedicated local workforce, the Solomon Islands stands as a model for how a developing nation can manage infectious diseases through unity and proactive care.

– Rebecca Cameron

Rebecca is based in Edinburgh, Scotland and focuses on Technology and Global Health for The Borgen Project.

Photo: Flickr

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HIV/AIDS in Dominica

HIV/AIDS in DominicaDominica is a small island country in the Eastern Caribbean with a population of around 70,000. Historically, the Caribbean has been one of the regions that HIV/AIDS has affected the most in the world, with an overall incidence rate surpassed only by Africa.

Considered an epidemic in the Latin American-Caribbean region since the beginning of the 1980s, HIV has had a widespread and lasting impact across many countries. Many Caribbean countries witness a prevalence rate of more than 1%, markedly above the international average of 0.7%.

Despite the fact that the greater region is still witnessing a ‘generalized epidemic’ of HIV, Dominica has made remarkable progress in tackling the disease and today accounts for some of the lowest rates of transmission and new infections in its locality, thanks to targeted testing efforts, expanded training and local education programs. Here is more information about HIV/AIDS in Dominica.

Improvement of Prevalence Rates

Dominica has succeeded in improving all of its incidence rate metrics in the fight against HIV and AIDS. In terms of new infections in the past year, Dominica saw a decisive downturn from a rate of 0.47 per 1,000 people in 1990 to 0.23 by 2024, demonstrating a fall by over half of new cases. This places it significantly below the regional average for the Caribbean, which is at approximately 0.58 per 1,000 people in 2024. Similarly, deaths stemming from HIV infections decreased by almost half from 14.46 per 100,000 people in 2000 to 7.64 by 2021.

In 2021, Dominica announced that it had eliminated mother-to-child transmission of HIV and the World Health Organization (WHO) duly awarded the country the official certification. The organization described this landmark achievement as indicative of the strength of government and civil society efforts and Dominica became the eighth country in the region to be awarded this certification.

Work on the Ground To Address HIV/AIDS in Dominica

Dominica’s success in tackling HIV has been accredited to tireless work on the ground and successful partnership between government bodies and civil society partners. 

The National HIV and AIDS Response Programme (NHARP), headquartered in the nation’s capital Roseau, is a government initiative that the Health Ministry overseeds. The program has made significant inroads in minimizing stigma and has helped to dramatically reduce cases through its provision of education, training and support. Its efforts led to regional recognition in 2017, when Dominica received the Most Improved Award at the Caribbean HIV Testing Day ceremony.

Pan Caribbean Partnership Against HIV/AIDS (PANCAP) is another regional organization which supports Dominica in tackling HIV/AIDS. The umbrella organization of governments, local members of civil society, agencies and donors not only funds Regional Testing Day but also advocates for policy coordination in relation to HIV, has established a regional HIV directory search function and manages an accessible log of HIV data for its constituent countries. Such efforts have proven instrumental in the fight against HIV.

Looking Ahead

In conclusion, despite an ongoing struggle against HIV in the Caribbean, Dominica has successfully reduced rates of HIV/AIDS through successful testing and education programs and a directed campaign to support pregnant mothers, which has led to the eradication of mother-to-child transmission. Consequently, Dominica has become one of the most visible examples of successful communicable disease reduction in the region and trajectories suggest the country is moving in a promising direction towards continually reducing HIV rates.

– Phoebe Lang-Clapp

Phoebe is based in Montréal, Québec, Canada and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr