Archive for category: HIV/AIDS

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The Fight Against HIV/AIDS in Grenada Continue

HIV/AIDs in GrenadaGrenada has struggled to combat human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) due to social and political issues, including social stigma and political sanctions, according to a study published in the journal Medicine. This has led to fear among Grenadians about reporting their HIV status.

Since HIV/AIDS targets the immune system, this fear can result in loss of life and increase the chances of the disease spreading further.

The 2018 study, conducted by researchers at St. George’s University, indicates that HIV/AIDS prevalence in Grenada has been rising steadily since national surveillance began in 1984.

Geographic Location and Societal Structure

Grenada is a Caribbean country located south of the United States. English is the official language, and the majority ethnic group is Euro-Africans. According to Britannica, most Grenadians follow Christianity, primarily Roman Catholicism and Protestantism, with Roman Catholics in the majority.

Due to these dominant sects, Grenada’s society and government tend to be conservative, particularly in the capital, St. George’s.

Findings on HIV/AIDS in Grenada

Researchers at St. George’s University surveyed 49 Grenadians through online surveys and in-person interviews to examine HIV-related behavior and sexual health. The online surveys were self-administered, while a nongovernmental organization in Grenada, the Grenadian Chapter of the Caribbean HIV/AIDS Partnership (Gren CHAP), facilitated the in-person interviews.

Researchers considered participants’ age, residence, sexuality and gender. The study found that age and residence were significant factors, since conservatism varies by location and younger individuals reported less education about sex.

The study found that homosexual and bisexual participants were less likely to test positive for HIV and more likely to use condoms. Conversely, participants who engaged in genital sex and lived in St. George were more likely to test positive.

Participants who visited Gren CHAP in person did so mainly seeking condoms or sexual health information, the study found.

Gren CHAP’s Role in Grenada

The 2018 study noted that Gren CHAP has collaborated with the United Nations and the Grenadian government and has the opportunity to advocate to the Ministry of Health for expanded HIV prevention, testing and outreach. Antiretroviral therapy in Grenada is provided at no charge through community clinics under the country’s National Infectious Disease Control Unit, according to the study.

A separate study published in 2014 in the Journal of Family Medicine and Community Health found that Gren CHAP assisted researchers in recruiting participants to study how stigma affects men who have sex with men (MSM) and their treatment experiences.

The study surveyed 47 Grenadian MSM, with an average age of 28, and divided participants into two groups: Group A, who attended Gren CHAP’s Men’s Forum, and Group B, who did not. The Men’s Forum, a biweekly meeting Gren CHAP has run since 2007, provided a space for MSM to discuss stigma, relationships and HIV prevention.

The study found no significant differences in HIV knowledge or stigma experiences between the two groups. However, Group A was significantly more likely to get tested for HIV every 10 to 12 months.

The researchers noted limitations, including a narrow age range among participants. They suggested that more diverse studies could provide further insight into how stigma affects attitudes and treatment-seeking behavior among MSM.

Though conducted in 2014, the concern about stigma remains relevant, as highlighted by Grenada’s Ministry of Health in 2025.

Ministry of Health’s Stance on HIV/AIDS

Dr. Shawn Charles, Chief Medical Officer, said in an article covering his remarks that Grenada plans to integrate HIV testing, counseling, and treatment into routine primary care to reduce “stigma and discriminatory behaviour” toward people living with HIV. He said the country records between 20 and 30 new HIV diagnoses annually, and more than 400 people were living with HIV in Grenada as of 2023.

While Grenada has taken steps to improve access to HIV/AIDS care, public attitudes toward the disease and those affected remain largely unmeasured.

Gren CHAP continues to provide information about HIV risks facing the MSM community and to advocate against discrimination toward people affected by HIV/AIDS in Grenada.

– Hafsa Hussain

Hafsa is based in Aurora, IL, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Fighting the Spread of HIV/AIDS in Antigua and Barbuda

HIV/AIDS in Antigua and BarbudaAlthough HIV prevalence in Antigua and Barbuda is relatively low compared to several other countries in the Caribbean, HIV remains an important public health concern. They are currently holding at a prevalence rate of 1.1% of the adult population. Here is more information about HIV/AIDS in Antigua and Barbuda.

Addressing HIV/AIDS in Antigua and Barbuda

The government continues to invest in preventative and combative measures to ensure HIV prevalence remains low. One way that the government is doing this is through the AIDS Secretariat, which provides numerous services such as, “advocacy, counselling, development of materials, educational and training sessions, free male and female condoms, free and confidential HIV testing, information to the public, [and] research assistance,” as listed on its website.

These services are the foundation of Antigua and Barbuda’s efforts at controlling the spread of HIV, focusing on awareness and education on how to prevent catching the disease, as well as what actions to take. The AIDS Secretariat’s mission is to develop and then implement research on managing HIV, allowing the increase in cases to remain low over the past few decades. The efficiency of this system is reliant on the engagement of the community, as well as the resources that are now available, such as free testing and condoms.

Economic Concerns

Regardless of there only being a slight increase in the estimated prevalence, Antigua and Barbuda’s Social Systems Board is concerned with the consequences of reduced life expectancy, productivity and education. Continued importance is placed on prevention and treatment, especially on the young adult population, aged 15 to 24. This group is at a higher risk for obtaining HIV as they are in their prime years of productivity and labor, according to the Social System Board’s website.

Contracting an illness which affects the immune system generates a risk of becoming more susceptible for additional illnesses, weakening the body. Antigua and Barbuda’s Social Security Board has concerns with a negative economic impact as “persons affected may suffer repeated and prolonged illnesses, imposing great costs on households and national health systems.”

This threatens social systems financially as they are funded by the labor force or the investments that it brings. Workers may require prolonged absences from work based on their compromised health status, adding pressure to insurance and benefits provided by employers. 

Reductions in workplace participation and an increase in health care costs weakens the financial relationship between the economy and Social Systems.  

A report from the World Health Organization (WHO) from 2018 indicates lacking secondary and tertiary health services, with only a “186-bed facility in Antigua” and “one clinic and hospital in Barbuda.” This highlights challenges the country may have when meeting broader health care needs.

New and Incoming Strategies

The improvement to these clinics and hospitals is claimed to be ongoing in the same report, visible in the new steps that the Global AIDS Strategy 2026-2031 implemented. This is a community-and-people focused approach according to UNAIDS, shifting emphasis away from responding post-infection, and focusing on the social and structural changes needed to reduce contraction risk. The goal in this strategy is sustainability, rather than fighting an uphill battle, the aim is to find a long-term solution.

While the provision of services is incredibly helpful for countries struggling with the spread of HIV/AIDS, the new strategy outlines that the primary focus will be greater access to services by introducing resources for self-care and community-led models. The strategy consists of consultations with community members who are both at risk or have already contracted HIV.

The initiative aims to take their experiences and knowledge in order to create the plan that will be impacting these communities for the next five years. The information of the consultations will allow UNAIDS to separate their priorities into result areas or opportunities for progress.  In doing this, countries will have the ability to sustain treatment on their own instead of relying on the donor-and-partner system.

If this initiative meets the 2030 HIV targets, it could avert 3.3 million new HIV infections globally, according to research by UNAIDS.

Looking Ahead

Reducing HIV/AIDS infection rates in Antigua and Barbuda will lead to strengthened communities by improving public health, and protecting employment and Social Systems. Community-led care could be a promising strategy to maintain Antigua and Barbuda’s low risk status while improving the lives of those living with HIV/AIDS.

– Angelica Ciaravino

Angelica is based in Toronto, Canada and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Positives of USAID Programs in Lesotho

USAID Programs in LesothoAid is a quintessential piece of economic development and growth, specifically in places like Africa, a continent with some of the most significant challenges to furthering economic growth and development. Lesotho is a lower-middle-income country with a population of 2.3 million, which is projected to increase by 29% by 2050. This is consistent with lower-income countries, where mothers have more children when they do not expect one or more to survive.

The most vulnerable groups in Lesotho are farmers, young girls and children and women. USAID programs in Lesotho such as USAID Global Health Supply Chain Program-Procurement and Supply Management Program (USAID GHSCP-PSMP), which started in 2016, promote effective supply chain management for HIV/AIDS medication. Other programs include the DREAM Initiative, which started educating young women and girls about HIV protection in 2016, and Bophelo Bo Botle or Good Health Activity, which began in 2024 and works to educate people on good health practices.

The Ways That Lesotho Benefited From US Foreign Assistance 

USAID programs in Lesotho have helped address the HIV/AIDS epidemic. According to Lesotho’s 2025 National HIV Estimates Report, new HIV infections declined by 83% between 2010 and 2024, with approximately 3,200 new infections estimated in 2024. While this progress reflects the country’s broader HIV response, U.S.-supported programs have contributed through prevention, education and treatment. Programs such as the Bophelo Bo Botle Activity and DREAM Initiative have provided HIV prevention education, while USAID’s Global Health Supply Chain Program-Procurement and Supply Management (GHSCP-PSM) has helped provide access to life-saving HIV treatment. By helping people prevent and manage HIV, these programs can support healthier communities and enable more people to participate in education and economic opportunities.

Data from the World Health Organization and UNAIDS indicate that Lesotho has made significant progress in its response to HIV/AIDS. At the same time, life expectancy in Lesotho has increased from 44.3 years in 2008 to 57.8 years in 2024. Despite this improvement, Lesotho’s life expectancy remains well below the global average of 73.48 years. The gap reflects the country’s broader health and development challenges, including poverty, limited access to health care and the ongoing impact of HIV/AIDS.

USAID programs in Lesotho have helped significantly with the HIV/AIDS epidemic, with the United States funding more than $100 million towards economic growth and development in Lesotho. For example, through the GHSCP-PSMP model, it has helped promote the proper management of HIV/AIDS medications, leading to an increased supply of sterile needles and medications for HIV treatment. It has also provided $63.4 million towards irrigation planning and infrastructure, and allocated $29.5 million to primary health care services, such as the DREAM Initiative. This could explain the upward trends in life expectancy data.

Bophelo Bo Botle

The Bophelo Bo Botle Activity started in 2024 in Lesotho. This program focuses on educating people in Lesotho on general good health practices by utilizing people-centered prevention, care and treatment. This program was unfortunately terminated in 2025 due to United States budget cuts and cuts to the PEPFAR program. With the program only running for a year, the program did not have many accomplishments.

The DREAM Initiative

The DREAM Initiative began in Lesotho in 2016, focusing on the factors making adolescent girls and young women vulnerable to HIV/AIDS. Such factors include “gender-based violence, exclusion from economic advancement opportunities and a lack of access to secondary education.” After three and a half years of implementation, new infections among adolescent girls and young women decreased by 71.4% in the two districts where the program was operational.

USAID GHSCP-PSMP

The USAID Global Health Supply Chain Program-Procurement and Supply Management Program (USAID GHSCP-PSMP) began in 2016 and is scheduled to end in September 2026. This program has promoted supply chain management of HIV/AIDS medication and treatments. The USAID GHSCP-PSMP provided continued availability of HIV treatment and tuberculosis treatment. As of 2020, “97% of HIV positive adults were receiving antiretroviral treatments and 92% were virally suppressed.”

Setbacks

All of this progress comes with a substantial budget cut for USAID programs in Lesotho, and in U.S. foreign assistance all around. In 2025, the U.S. gave $24.7 million in total aid to Lesotho. This is a stark difference from just three years prior, when it gave $150 million.

However, the Chinese government has been strengthening relationships with Lesotho, along with 53 other African countries, and implementing many educational and health-based practices through foreign aid. For example, in 2024, China and UNAIDS pioneered a joint campaign called “Eliminating the Triple Threat in Girls and Young Women in Lesotho,” which reached 20,000 young women and promised $2 million. This is very promising after the budget cuts the United States made.

China also introduced scholarships for Lesotho in 2025. These scholarships are helping create skilled workers and “ease the financial burden of overseas education.” This is very promising after the budget cuts the United States made.

Looking Forward

Considering the U.S. foreign aid cuts, USAID programs in Lesotho like the DREAM Initiative, GHSC-PSM and the Bophelo Bo Botle Activity may not be able to continue. Thankfully, China has stepped in and introduced new programs and initiatives geared towards economic growth and development in Lesotho.

– Lily K Gibson

Lily is based in Bristol, CT, USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Pexels

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Addressing HIV/AIDS in Timor-Leste

HIV/AIDS in Timor-LesteAlthough HIV/AIDS in Timor-Leste remains relatively uncommon compared with many countries in the region, it remains an important public health concern. Timor-Leste has a low-level HIV epidemic, but new cases continue to be identified among the general population, including people attending antenatal, sexually transmitted infection and tuberculosis clinics. Limited access to HIV testing, stigma surrounding the disease and gaps in rural health care continue to challenge prevention and treatment efforts. While the country’s HIV epidemic remains relatively small, continued investment in prevention, education and treatment is essential to reducing new infections and improving long-term public health.

Timor-Leste Maintains a Low HIV Burden

Timor-Leste reported its first HIV case in 2003, shortly after gaining independence. Since then, the government has collaborated with international partners to strengthen HIV prevention, testing and treatment services. Although HIV/AIDS in Timor-Leste remains relatively uncommon, low HIV testing rates continue to limit early diagnosis, particularly in underserved communities. In remote areas, limited medical resources, shortages of trained health workers and long travel distances can delay testing and treatment, increasing the risk of undiagnosed infections.

Limited Access To Testing and Health Care Remains a Challenge

Several barriers continue to affect Timor-Leste’s HIV response. HIV-related stigma discourages some people from seeking testing or treatment because they fear discrimination from their families or communities. Limited health infrastructure outside the capital also makes it difficult for many people to access medical services. In addition, comprehensive sexual health education remains limited, leaving many young people without accurate information about HIV prevention. Together, these challenges highlight the importance of continued investment in public education, accessible health care and community awareness programs.

Despite these challenges, HIV testing services have reached thousands of people. In 2022, 10,913 people across five districts accessed HIV testing services and peer education on HIV prevention, testing and treatment. The country has also expanded efforts to improve access to HIV self-testing and pre-exposure prophylaxis (PrEP), with national guidelines developed to support these services. These efforts are important for increasing early diagnosis and connecting people who test positive with appropriate treatment and care.

In 2022, the Ministry of Health reported 250 new HIV cases, and 77 of those people had not yet started antiretroviral treatment, highlighting the continued gap between diagnosis and access to treatment.

HIV and Poverty Are Closely Connected

HIV/AIDS in Timor-Leste is not only a health issue but also a development challenge. Nearly 42% of people in Timor-Leste live below the national poverty line, making the cost of health-related services and prevention measures an important concern for vulnerable communities. In some areas, the cost of HIV prevention can create an additional barrier. For example, free condoms are distributed through a key-population organization in only five of Timor-Leste’s 13 municipalities, while people in other areas may have to pay around $2 for a pack of three condoms, a cost that some people cannot afford. For people living in poverty or in areas with limited health services, these financial and geographic barriers can make it more difficult to access HIV prevention, testing and treatment.

Government and International Partners Are Strengthening the Response

Timor-Leste’s Integrated National Strategic Plan for HIV, STIs and Viral Hepatitis (2022–2026) has strengthened the country’s response by bringing HIV, sexually transmitted infections and viral hepatitis into one coordinated framework. The Ministry of Health finalized and endorsed the plan, while it launched new national guidelines for eliminating mother-to-child transmission of HIV. The national response has also advanced HIV self-testing and pre-exposure prophylaxis (PrEP) through new guidelines and procedures, helping expand prevention and testing options for people at higher risk. Together, these measures support earlier diagnosis, stronger prevention and improved access to HIV services.

WHO has worked closely with Timor-Leste’s Ministry of Health to strengthen HIV services, including developing guidelines for antiretroviral treatment, HIV testing and the elimination of mother-to-child transmission. In January 2023, WHO and the Ministry of Health launched pilot projects for HIV self-testing and pre-exposure prophylaxis (PrEP) in Dili; nearly 1,000 HIV self-tests were made available and more than 200 people began PrEP. UNFPA has also supported the Ministry of Health’s HIV response, including a 2019 training that prepared 23 health workers on HIV testing, treatment, PrEP and PEP, prevention of mother-to-child transmission and HIV-related stigma. UNAIDS, through the UN Joint Team, has supported the national HIV response, including HIV testing, prevention education and the development of HIV self-testing and PrEP guidelines.

Continued Investment Is Key To Preventing New Infections

Timor-Leste has an opportunity to maintain its low HIV burden by continuing to invest in prevention, education and accessible health care. Expanding HIV testing, reducing stigma and strengthening health services in rural communities can help prevent new infections while improving the quality of life for people living with HIV. Continued collaboration between the government, local communities and international partners will not only strengthen Timor-Leste’s HIV response but also contribute to poverty reduction, healthier communities and sustainable development.

– Adebisi Aliyah Adeola

Adebisi is based in Cairo, Egypt and focuses on Global Health for The Borgen Project.

Photo: Wikimedia Commons

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3 Facts About the Response to HIV/AIDS in Brunei

HIV/AIDS in BruneiAcross the world, countries are working to slow down the spread of HIV/AIDS through several methods. In Brunei, a small country in Southeast Asia, the goal for the HIV/AIDS epidemic is to end it by 2030. According to the International AIDS Society (IAS), since the country reported its first confirmed HIV case in 1986, the number of cases has remained relatively low.

Yet, new cases of infection have continued to emerge slowly. As of 2020, a total of 289 Bruneians and permanent residents had been diagnosed with HIV/AIDS in Brunei. Of that total number, 75% are still living with HIV.

Barriers: Stigma and Discrimination

Brunei continues to face stigma and discrimination, which creates barriers for vulnerable communities seeking opportunities and support. These challenges exist among youth with disabilities (YWDs), who often face difficulties entering the workforce due to prejudice and misconceptions about their abilities. These barriers can prevent YWDs from becoming financially independent and fully participating in society.

A similar pattern of exclusion affects people living with HIV/AIDS in Brunei. Discrimination and homophobia can discourage individuals from seeking HIV testing, treatment and support services. For example, under the Infectious Diseases Act, which Brunei introduced in 2003, people diagnosed with HIV face legal restrictions related to transmission and disclosure. HIV advocates argue that these policies may increase stigma and create fear, making individuals less likely to access health care.

Brunei’s HIV/AIDS Response: Access and Awareness

However, HIV/AIDS in Brunei is supported by the healthcare system and local community organizations that work to address barriers faced by vulnerable populations, including marginalized youth affected by social and economic challenges. These efforts focus on increasing awareness, encouraging HIV testing, reducing stigma, and improving access to healthcare. Here are three facts about Brunei’s response to HIV.

1. Access to HIV Testing

In 2020, Brunei expanded access to rapid HIV testing by offering free screenings at seven private clinics. The partnering clinics are: Ammaan Medical Clinic, C.Y. Lim Clinic, Dr. Prema Clinic, Riverview Medical Clinic, Vitaliv Health and Wellness Clinic, Wholistica Clinic, Wellness and Panaga Health Center.

The rapid HIV testing provides results within 15 to 20 minutes. Then, the early diagnosis allows people living with HIV to seek support services at an early stage. The initiative was developed in collaboration with the Brunei Darussalam AIDS Council, which highlighted the importance of creating safe, nonjudgmental spaces for testing while combining medical services with HIV education and awareness programs. In addition, the country conducts approximately 200,000 medical screenings each year, including HIV tests for pregnant women and foreign workers.

2. Self-Testing

The Ministry of Health has approved access to HIV self-test kits. Along with it, institutions like Panaga Health (PH) provide access to these self-test kits at their facility, so anyone and their partners can simply go over the counter at PH and purchase them. The self-test allows individuals to conduct an HIV test in the privacy of their homes, with the results available in about 20 minutes. Also, the self-test does not include needles or blood, only saliva.

PH is a healthcare facility that provides a range of medical services, including primary healthcare, dental care, emergency services and health protection programs. In 2022, PH expanded its services to a wider community; it only supported workers in the oil and gas industry. By increasing access to confidential testing, PH helps reduce fear of discrimination, reduce barriers to care and connect individuals with treatment when needed.

3. Youth Education

In addition to expanding access to testing and treatment, Brunei has also focused on HIV education among younger generations. The HIV Awareness Programme for Peers and Youths (H.A.P.P.Y), which is run by Brunei Darussalam AIDS Council (BDAIDS Council), is a youth-focused initiative that teaches students about HIV transmission, prevention and sexual health. 

In 2026, the program reached around 70 students at Sultan Omar ‘Ali Saifuddien College, where participants learned about how HIV spreads, discussed common misconceptions and explored ways to make informed decisions about their health. In addition, the session emphasized the importance of setting healthy boundaries, understanding sexually transmitted infections and sharing accurate information with peers and families.

Through interactive activities and locally educational materials, H.A.P.P.Y aims to reduce misinformation and encourage young people to become advocates for HIV awareness in their communities.

Addressing HIV/AIDS Conclusion

HIV/AIDS in Brunei has remained relatively low due to the country’s effort in prevention, testing and treatment programs. Continued investment in inclusive health services and public awareness will be essential for Brunei to reach its goal of ending HIV/AIDS by 2030. Also, by addressing these barriers, Brunei’s HIV response helps prevent health challenges from creating further social and economic disadvantages for vulnerable communities. 

– Daniela Escobar

Daniela is based in Huntington Station, NY, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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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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Foreign Aid in Vietnam: Decades of Progress, a Year of Uncertainty

Foreign Aid in VietnamVietnam is one of the developing world’s clearest success stories. Vietnam launched sweeping economic reforms in 1986 and opened itself to deep international engagement, transforming the country from one of the poorest into a dynamic middle-income economy in a single generation. GDP per capita climbed from under $700 in 1986 to nearly $4,500 in 2023, and the extreme poverty rate fell from 14% to under 4% between 2010 and 2023, according to the World Bank. The economy grew roughly 8% in 2025. Much of that progress unfolded alongside foreign aid in Vietnam — and in 2025, a sudden freeze on U.S. assistance showed how fragile those gains can be when they hinge on a single donor.

A Partnership Built Out of War

Foreign aid in Vietnam has touched everything from public health to the unfinished business of the war itself. The United States has been Vietnam’s most prominent aid partner, and its most meaningful contributions addressed the legacy of the war. Since the 1990s, Washington has helped clear unexploded ordnance, clean up Agent Orange contamination and account for missing soldiers.

The American military sprayed vast areas of southern Vietnam with Agent Orange and other herbicides between 1962 and 1971. As many as 4.8 million Vietnamese may have been exposed to the dioxin those chemicals contained, and at least 1 million still live with related health and disability effects, according to the U.S. Institute of Peace. The Vietnam Red Cross estimates that about 150,000 children have been born with birth defects tied to that exposure — including limb deformities, spina bifida, developmental disabilities and other conditions that can leave people unable to walk or live independently, sometimes across two or three generations.

According to the U.S. State Department, the U.S. provided more than $250 million for unexploded ordnance clearance and more than $155 million for disability support in affected provinces between the early 1990s and 2025. The two countries completed a major dioxin cleanup at Da Nang Airbase in 2018 and began remediation at the larger contaminated site at Bien Hoa.

These programs did more than remove poison from the soil. They turned a painful history into a foundation for cooperation, helping the former adversaries normalize relations and, in 2023, establish a Comprehensive Strategic Partnership — Vietnam’s highest diplomatic designation.

Addressing HIV/AIDS

U.S. aid also propped up public health. About 250,000 Vietnamese live with HIV, and the epidemic has long been concentrated among marginalized groups — including people who inject drugs and men who have sex with men — who often face stigma that keeps them from seeking care. Through the President’s Emergency Plan for AIDS Relief (PEPFAR), American funding sustained HIV prevention and treatment for tens of thousands of Vietnamese. Vietnam became the first and only country in Asia to receive focused PEPFAR support after the program launched in 2003, and within a decade the U.S. was the largest single donor to the national HIV response. That investment helped Vietnam reach a 99% viral-suppression rate in PEPFAR’s focus provinces and shift most patients onto antiretroviral treatment paid for through domestic health insurance. Most of the country’s pre-exposure prophylaxis clients still rely on PEPFAR support, UNAIDS reported.

The 2025 Freeze

In January 2025, President Donald J. Trump issued an executive order pausing nearly all foreign aid, and his administration moved to dismantle the U.S. Agency for International Development (USAID). By March, the State Department had announced that most USAID programs would be terminated and the rest folded into the department; the agency effectively ceased operating by mid-2025.

The effects in Vietnam were immediate. Writing in the Georgetown Journal of International Affairs, two Vietnam specialists documented how the freeze idled more than a thousand deminers, cut off rehabilitation services for tens of thousands of people affected by Agent Orange, and reduced the world’s largest dioxin remediation project to a skeleton crew. In Quang Tri Province, Vietnam’s most contaminated region, over a thousand local demining workers lost their jobs. At Bien Hoa, U.S. diplomats warned of an environmental and public-health catastrophe as dioxin-laced soil sat exposed, ProPublica reported. UNAIDS found that the cuts suspended or terminated HIV and tuberculosis programs, leaving some patients to pay out of pocket.

A Partial Recovery — And a Lasting Lesson

After lobbying from Vietnamese officials and American advocates, funding for most war-legacy projects resumed by late March 2025, and in October the two governments signed a memorandum reaffirming cooperation. But the disruption left a mark. The Georgetown analysts argue that even a brief suspension in the “safest” area of cooperation signaled that any U.S. commitment could fall victim to domestic politics — prompting Vietnam to diversify its partners and giving China fresh evidence to portray Washington as unreliable. Just weeks after the freeze, Reuters reported, Xi Jinping visited Hanoi and signed roughly 45 cooperation agreements.

Foreign aid makes up about 1% of the U.S. federal budget, yet its impact in Vietnam has been enormous. Foreign aid in Vietnam shows both what outside assistance can build and how quickly it can stall: the events of 2025 underscored a simple truth — the gains aid produces are real, but they are not self-sustaining.

– Jen Phan

Jen Phan is based in Hanoi, Vietnam and focuses on Business and Politics for The Borgen Project.

Photo: Wikimedia Commons

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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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Ending HIV in the Asia-Pacific

HIV in the Asia-PacificWith an estimated 320,000 new HIV infections expected annually by 2030, accelerating HIV programs in the Asia-Pacific is crucial to ending the epidemic before it worsens.

Asia and the Pacific account for 23% of new HIV infections globally each year. In 2024, about 6.9 million people living with HIV resided in the Asia-Pacific alone. Progress remains uneven in many countries, with some even seeing an increase in HIV incidence. Without proper procedures and resources, HIV will continue to rise in the Asia-Pacific.

Barriers to HIV Response

Several barriers have slowed the response to HIV in the Asia-Pacific, impacting prevention efforts.

  • Political Attention Decline — A lack of awareness leads to constrained funding, misconceptions that HIV is under control and competition with other health efforts, eventually leading to inadequate funding.
  • Unsustainable Funding — Without proper funding, health programs and treatments are not readily available to health care workers. Many economies lack stability, leaving the budget for HIV prevention vulnerable to political shifts and over-reliant on international donors, leading to a fragile structure and an increased risk of funding decline.
  • Legal Barriers — Restrictive laws that clash with public health can deter communities from seeking treatment and testing, weakening their trust in health institutions. These laws can also limit accessibility.
  • Inaccessibility — A lack of access means many patients cannot reach health clinics for treatment due to lack of documentation, migrant status or residency.
  • Gaps and Delays in Treatment — Many patients slip through the cracks, and delays in treatment result in missed opportunities for early diagnosis and care, discouraging individuals and deterring them from returning to clinics for results.

Due to these barriers and challenges, the Asia-Pacific Economic Cooperation (APEC) launched the “Action Plan to End the HIV Epidemic” (2026-2031) in May 2026 to dissolve these barriers and push toward ending HIV in the Asia-Pacific. This initiative begins by helping countries strengthen political commitments, sustain funding and expand accessibility for HIV prevention to eliminate gaps and delays in treatments and testing.

The Action Plan

The plan brings together 21 economies, including China, Japan, Australia, Mexico, Chile and Southeast Asian economies, to promote financing, growth, collaboration and trading for HIV testing, treatment, awareness and protection policies for more vulnerable communities.

Under the action plan, all APEC economies will adopt a strategy to end the HIV epidemic by 2031. Focused on six pillars, the action plan aims to achieve the UNAIDS 95-95-95 target, expand HIV prevention in the Asia-Pacific and reduce new infections by 90% by the end of the plan.

  • Domestic Funding — Implementing an HIV/AIDS strategy with an economy that sustains its strategy by using domestic funding within its budgets and eliminating the heavy reliance on external partners.
  • Legal and Policy Barriers — Addressing legal policies that restrict access to HIV prevention, testing or services.
  • Expanding Accessibility — All economies will have less than 50% of people at risk of HIV infection by providing pre-exposure prophylaxis (PrEP) and other prevention tools as treatment.
  • Improving HIV Coverage — Implementing domestic policies that allow for HIV self-testing or community-based testing.
  • Providing Swift Treatment of HIV — APEC economies ensure that more than 95% of their population living with HIV receive antiretroviral therapy (ART), access to viral loads and a rapid response after receiving an HIV diagnosis.
  • Pathways for Long-Term HIV Prevention, Testing and Treatment — HIV medicines are covered under public insurance and have received market entry approval.

These six pillars aim to provide solutions to past barriers by offering a roadmap for countries to accelerate progress in treating HIV and AIDS. Described as “the beginning of a new phase” of regional cooperation on HIV by Leonardo Chanqueo, project overseer of the APEC HIV Project, the plan represents a significant step toward ending the HIV/AIDS epidemic.

Hopeful Future

With this plan, the barriers slowing the response to HIV in the Asia-Pacific are addressed and resolved. Though the plan is in its early stages, it represents human collaboration and a unified humanitarian effort, promising a hopeful future for the health of affected individuals and communities.

– Kianna Phosouvanh-Sythong

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

Photo: Flickr

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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