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A Clearer Future: Papua New Guinea Eradicated Trachoma

papua new guinea trachomaTrachoma is an infectious disease causing in-turning of the eyelids, visual impairment and often irreversible blindness. The disease is associated with crowded households and inadequate hygiene, access to water, and access to and use of sanitation, primarily affecting women and children within poor and rural regions. According to 2024 data, 103 million people worldwide live in trachoma endemic areas and are at risk of irreversible blindness. However, light is emerging from the dark. Following a 13-year-long struggle against the infectious disease, Papua New Guinea eradicated trachoma as a public health concern, as announced at the 78th World Health Assembly in Geneva.

About Trachoma

Trachoma is one of many neglected tropical diseases (NTDs) ― complex conditions prevalent among impoverished tropical areas and often transmitted through vectors, making them major public health concerns. Almost absent from the global health agenda, NTDs do not get enough resources and attention, perpetuating cycles of poverty, stigma and social exclusion within neglected populations

Trachoma is the leading infectious cause of blindness worldwide and is responsible for the visual impairment or blindness of more than 1.9 million people, according to the World Health Organization (WHO). The bacterium Chlamydia trachomatis spreads through personal contact, such as sharing beds, clothing, and surfaces, and by flies that have come into contact with discharge from the eyes or nose of an infected individual. The average immune system can overcome a single episode of infection but in endemic communities, infection re-occurs frequently, often leading to years of constant infection. If untreated, the infection can cause the eyelid to turn inward, resulting in pain, light intolerance, and eventually irreversible visual impairment or blindness.

Trachoma’s impact is especially harsh in remote and impoverished areas where access to care is limited. Prevalence rates are especially high among pre-school-aged children (as high as 60-90%), and due to greater contact with infected children, women experience trachoma blindness four times as often as men, WHO reports. Blindness and visual impairment cause significantly reduced productivity, the economic cost of which is estimated to be $8 billion per year

Global Elimination Strategies

As of October 21st 2024, 21 countries worldwide have successfully eradicated trachoma as a public health problem, including Cambodia, Ghana and Pakistan. These previously endemic countries implemented the WHO-recommended SAFE strategy, which encompasses:

  1. Surgery to treat trachomatous trichiasis (the blinding stage of the disease)
  2. Antibiotics to clear the infection (specifically mass administration of azithromycin)
  3. Facial cleanliness
  4. Environmental improvement (especially enhancing access to sanitation and clean water)

Papua New Guinea Elimination Strategy

Foundational efforts to eliminate trachoma in Papua New Guinea began in 2012, with organizations including Collaborative Vision, The Brian Holden Vision Institute and The Global Trachoma Mapping Project contributing towards the effort. However, surveys in Papua New Guinea revealed that despite signs of active trachoma in children, there were very low levels of Chlamydia trachomatis and negligible levels of trachomatous trichiasis, suggesting that children were not progressing to severe stages of the disease.

As a result, Papua New Guinea’s National Department of Health organized a series of further assessments, surveys and investigations, building a comprehensive understanding of trachoma’s status in the country. This confirmed that community-wide interventions such as mass antibiotic distribution and large-scale surgery were not necessary. Unlike other countries where trachoma elimination required vast surgery campaigns, mass antibiotic administration and targeted improvements in access to water, hygiene and sanitation, Papua New Guinea’s success was fueled by vigorous disease surveillance.

This is a powerful testament to the country’s ability to adjust its health strategies to the realities of local communities, ensuring the safety of its population whilst reducing unnecessary resource use. Dr Ana Campa, Trachoma Coordinator of the Fred Hollows Foundation New Zealand, stated that “Trachoma in Papua New Guinea is complex and presents atypically. Additional research and ancillary surveys … [were] crucial in understanding the picture of trachoma in the country and ultimately moving the country into drafting its dossier.”

A Clearer Future

To date, 56 countries globally have eliminated at least one NTD, including 22 that have eliminated trachoma as a public health issue. Papua New Guinea eradicated trachoma not only as a medical milestone, but as a demonstration of how context-specific strategies can achieve lasting health improvements. With the list of countries eliminating NTDs rapidly growing, we are gaining considerable momentum towards a world where NTDs are no longer a significant threat to vulnerable populations.

WHO and its partners remain dedicated to helping countries like Papua New Guinea protect their progress against trachoma and move closer to eradicating more NTDs, protecting the world’s poor.

While WHO’s SAFE strategy remains vital to tackling trachoma, Papua New Guinea’s success in eradicating the fatal disease provides a clear example of how innovative strategies rooted in distinct local realities can lead to sustainable health victories.

– Holly McArthur

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

Photo: Flickr

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WHO and Africa CDC Work To Curb the Spread of Mpox in Africa

Mpox in AfricaIn August 2024, the Africa Centers for Disease Control and Prevention (CDC) declared that Mpox infections had become a Public Health Emergency of Continental Security (PHECS). To combat the spread, the Africa CDC and World Health Organization (WHO) created a Joint Continental Preparedness and Response plan.

The original plan garnered positive results but not at the rate required to diminish the growth of the infection fully. Together, the Africa CDC and WHO are reworking the plan, hoping to accomplish the goals laid out.

Mpox in Africa

When the original plan was created in 2024, the spread of the disease occurred rapidly from sexual or close contact. It began in the Democratic Republic of the Congo (DRC) and quickly traveled to Burundi, Kenya, Uganda and Rwanda. Today, Mpox is present in 28 countries worldwide. However, outside of Africa, the cases are travel-related and rare.

Inside Africa, it is reported to have spread to the Republic of the Congo, South Africa, South Sudan, the Republic of Tanzania and Zambia. Prior to the PCEHS declaration, Mpox vaccines were not available in underdeveloped or developing countries despite originating in the DRC.

The Joint Continental Preparedness and Response Plan

The Joint Continental Preparedness and Response Plan, in its original efforts, focused on 10 key pillars in its efforts: coordination, risk communication and community engagement, disease surveillance, laboratory capacity, clinical management, infection prevention and control, vaccination, research, logistics and maintaining essential health services.

These pillars have managed to get more than 650,000 people vaccinated within the six countries at the highest risk. Of the vaccinations, 90% were administered in the DRC. Overall, more than one million vaccines were administered over the 10 listed countries and efforts to reduce the spread of Mpox in Africa through the implementation of the vaccination plan have not ceased.

The New Plan

The new plan, which still includes these pillars, intensifies the focus on controlling outbreaks and implementing Mpox prevention into routine health services. After the emergency period ends in August of 2025, the WHO and Africa CDC want the health services to continue. The aim is to prevent the further spread of Mpox in Africa.

To ensure this, the organizations agreed to continue to support countries in continuing the PHECS strategies. Beyond this, they aim to expand community engagement to strengthen the effectiveness of health strategies. Essentially, they will enhance and optimize each pillar, intending to finish the changes by the end of May 2025.

Final Remarks

With the reworking of the Joint Continental Preparedness and Response Plan, the WHO and African CDC hope to garner even more success in curbing and eradicating the spread of Mpox in Africa. Combating Mpox is not just a regional issue; it’s a test of our global commitment to health equity.

– Abby Buchan

Abby is based in York, PA, USA and focuses on Global Health for The Borgen Project.

Photo: Pixabay

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Natural Disasters and Disease in the Philippines

disease in the PhilippinesThe Philippines is highly susceptible to natural disasters such as droughts, earthquakes, flooding, cyclones and tsunamis. Natural disasters have a significant impact by displacing people from their homes and destroying agriculture, property and livelihoods. The political and socioeconomic climate of the Philippines exacerbates the damage as natural disasters significantly affect people in vulnerable situations due to lack of resources, income and access to social services and medical treatment. This further aggravates poverty and increases the spread of disease.

There is a correlation between natural disasters and disease in the Philippines. With disaster comes destruction and instability. People flee their homes as disasters decimate infrastructure, entire agricultural fields disappear and those from low incomes are unable to access medical care. Similarly, the disasters alone have direct links to negative health effects such as dengue, diarrheal syndrome, measles, cholera, meningococcal disease and acute respiratory syndrome.

Natural disasters cause disease in the Philippines, particularly impacting the lives of low-income people as they are less likely to obtain access to the resources necessary to rebuild their lives after a disaster or treat diseases caused by these events

Disaster, Disease and Poverty

Research has shown that infectious diseases occur following natural disasters as these circumstances hamper the foundations of many citizens’ lives and the health care system is not stable enough to cope with this. A deficit of clean water, stable housing and health care results in poor living conditions and higher rates of communicable disease.

A study on water-related diseases in the Philippines highlights that unless water availability is imperilled and people are displaced, the spread and risk of water-related diseases are low. Comparatively, following flooding, there is a significantly increased risk of such diseases because contaminated water is dominant – meaning that infections such as dermatitis and conjunctivitis are common. Similarly, following flooding, there is a higher risk of faecal-oral diseases such as paratyphoid fever, poliomyelitis and chlorea.

For those living in poverty in the Philippines, disasters such as flooding heighten the risk of communicable diseases, therefore pushing people into extreme poverty as they do not have the resources to treat such diseases. As a result, this worsens their quality of life.

The Work of Planet Water Foundation

Planet Water Foundation focuses on tackling a lack of clean water in the Philippines. Since 2010, the foundation has installed approximately 430 clean water schemes across the Philippines. This scheme involves the implementation of around 360 AquaTower water filter apparatuses in primary schools, ensuring students and staff can access clean drinking water

The foundation has also provided resources to aid communities during and following natural disasters by ensuring they have the resources to stay healthy and prevent disease. Through the placement of AquaBlock Emergency Water Systems following natural disasters such as flooding and cyclones, locals can secure clean water even amidst natural hazards. The Planet Water Foundation’s disaster responses include the Taal Volcanic eruption, Typhoon Odette and Typhoon Goni.

The implementation of systems that ensure there is sanitary water acts as a preventive measure for communicable diseases that arise from contaminated water that manifests from natural disasters. Correspondingly, this addresses the sanitation gap that low-income people and locals experience which helps them maintain basic hygiene even if they lose shelter because of natural disasters.

– Ella Dorman

Ella is based in Worcestershire, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Diseases Impacting Colombia

Diseases Impacting ColombiaColombia is a resource-rich country in the north of South America that is diverse and full of contrasts. Considering their challenging history, the nation has grown to become more resilient in terms of democracy and culture. Colombia is the world’s 55th largest exporter, with about $41 billion in exports to foreign markets. However, diseases impacting Colombia continue to be a serious threat as a whole, mainly due to its tropical climate and low awareness of some diseases which play a role in making the country more vulnerable to a variety of illnesses.

Understanding the difference between communicable and noncommunicable diseases (NCDs) is crucial to comprehending the illnesses that most commonly impact Colombia. Diabetes and cancer are examples of NCDs, which have a tendency to spread slowly. On the other hand, communicable illnesses such as TB or measles are more contagious and easier to transmit. 

NCDs

According to data from 2014, NCDs were responsible for 71% of Colombian deaths, with injuries and other incidents accounting for the remaining 17%. The three primary NCDs in Colombia as of 2014 were diabetes, cancer and cardiovascular illnesses.

In Colombia, 28% of all deaths were from cardiovascular diseases, with men dying at a higher rate than women. Furthermore, a report indicated that 35,000 Colombians lost their lives to cancer in 2014. By 2035, cancer-related mortality may rise by 31%, according to the International Agency for Research on Cancer. Additionally, diabetes claimed the lives of almost 19,000 Colombians in 2015, making up 10% of all fatalities in the nation that year. One million more people in Colombia may have diabetes without a diagnosis, making it one of the most underdiagnosed conditions that are impacting Colombia. 

NCDs were responsible for 22% of premature deaths among people under the age of 70. A report stated that Government health spending as a percentage of GDP rose from 5.4% in 2003 to 6.8% in 2013, indicating that NCDs have apparently had a significant economic impact on Colombia. Furthermore, individual health expenditure has also increased from $133.59 in 2002 to $569.19 in 2015 as a result of the rise of NCDs within the country. 

Communicable Diseases

Due to Colombia’s tropical environment and a lack of awareness about the seriousness of some diseases, communicable diseases impacting Colombia including malaria, HIV and tuberculosis (TB) are more common and transmit quickly among people.

According to Reports, in 2022 alone, TB affected 32 out of every 100,000 individuals, with a fatality rate of 2.4 per 100, 000. Within the same year, there were 25 HIV diagnoses for every 100, 000 people, resulting in a total 5.1 deaths per 100,000. However, one should note that in recent years, the HIV rate has dropped by 7.4%. This can be credited to Colombia’s strong and growing health sector. But due to its tropical climate, Colombia, like many other nations, the ever-increasing malaria sickness plagues it. Up until 2019, Colombia recorded between 60,000 to 80,000 cases of malaria annually for almost 10 years.

Despite being more contagious, communicable diseases typically have more treatments and medications available. The World Health Organization (WHO) ranks Colombia Healthcare sector as the 22nd best in the world, ahead of the United States and Australia. The government allocates 20% of its budget on health care, increasing access to care for individuals from a variety of circumstances.

Unemployment and Poverty in Colombia

Unemployment and the expenditures of health care for both individuals and families are two important elements to take into account when examining how poverty in Colombia contributes to a higher rate of illness infection. One major contributing cause to poverty is unemployment with Colombia’s unemployment rate currently at 9.1% at the moment, but it has remained constant since 2023. Since 9.1% of the population is unemployed, the majority cannot afford the present health care costs, which as of 2022 total $558 per individual.

A report showed that 19 million Colombians lived on just $97,94 a month in that same year. Alongside this is undernourishment, which has been a growing problem in Colombia, especially for women and in 2019, 88% of unemployed people, or 8% of the population, were undernourished. Furthermore, since inadequate nutrition is known to affect or weaken immune systems, more people are vulnerable to illnesses with the bulk of the unemployed population undernourished. Eventually, it leads to high health care costs, which furthers poverty.

The Colombian Government’s Efforts

The Colombian government introduced a national strategy to accomplish the “eradication and elimination” of the most contagious communicable illnesses in May 2024. It is strategy to improve the efficiency of medical care and expand public health services for Colombians. By 2035, the goal is to eradicate 30 additional communicable diseases; the eradication plan includes diseases that are impacting Colombia, such as HIV, malaria and tuberculosis. In order to accomplish its objectives, the Colombian government has established the “One Health” approach, which attempts to close the gap between communities and medicine. The Colombian government intends to pool medical resources in order to fully implement this policy, making it more efficient and providing services that benefit everybody. The Ministry of Health and Social Protection hopes that the one health strategy, which just originated in 2024, will yield benefits soon.

Looking Ahead

The health landscape in Colombia is shaped by both communicable and NCDs, each posing significant challenges to the nation’s well-being. NCDs such as diabetes, cancer and cardiovascular illnesses are leading causes of death and economic burden, contributing to premature mortality and escalating healthcare costs. At the same time, communicable diseases like malaria, tuberculosis and HIV remain persistent threats, exacerbated by Colombia’s tropical climate and limited awareness in some areas. These diseases disproportionately impact vulnerable populations, especially those living in poverty and facing unemployment, further straining the healthcare system.

However, the country’s resilient health sector and government initiatives, such as the “One Health” strategy, offer hope for tackling diseases impacting Colombia. By focusing on prevention, treatment, and greater accessibility to health care, Colombia aims to improve health outcomes and eradicate many infectious diseases in the coming decades. As the country continues to navigate these health complexities, effective policy interventions and improved public awareness will be key in reducing the impact of both communicable and NCDs on the Colombian population.

– Zacc Katusiime

Zacc is based in Kampala, Uganda and focuses on Global Health for The Borgen Project.

Photo: Flickr

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DRC Begins Mpox Vaccination Program

Mpox Vaccination ProgramIn October 2024, the Democratic Republic of the Congo (DRC) began its official vaccination scheme against Mpox, following a nationwide outbreak. First detected in the country more than 50 years ago, Mpox is a viral infection that can cause fatal illness. The emergence of a new strain in 2023 led the World Health Organization (WHO) to declare the recent outbreak a “global health emergency” in August 2024. Two months later, following 30,000 recorded cases and more than 900 deaths as of October 2024, the DRC’s Ministry of Public Health is beginning the rollout of hundreds of thousands of vaccines as the start of its official Mpox vaccination program.

Provisions from the EU

To curb the spread of the virus, the DRC relies on the European Union (EU), donation of 265,000 MBA-BN vaccines, with the help of the U.S. Government, Gavi and Africa CDC. These vaccines require two shots administered one month apart and are available only to adults, according to UNICEF.

With a population of more than 100 million, this means there is a limited amount of doses, so officials have had to target the campaign to those most vulnerable to Mpox. So far, the campaign has focused on the country’s North Kivu and Equateur provinces, the two regions that have recorded the highest number of cases. Within these areas, the Ministry of Health will provide the doses to the most at-risk groups, such as those with existing health problems. UNICEF has coordinated the transport and delivery of the vaccines, as well as the storage and shipment across the DRC.

Further Expected Doses

Although officials in the DRC are currently working with a limited supply of vaccines, the nation has also signed an agreement with the government of Japan, which promises the supply of LC-16 vaccines. LC-16 only requires one shot for immunisation and is currently the only one that has approval for children. One of the most disproportionately impacted, children under 15 are some of the most vulnerable to the virus, accounting for 60% of all recorded cases and 80% of deaths in the DRC, according to UNICEF.

Logistical Difficulties

Alongside limited availability, officials have also faced difficulties when planning the implementation of the Mpox vaccination program itself. Vaccines must be kept as low as -20 degrees Celsius, and, once defrosted, need to be used within 40 days to be effective. Officials are therefore working with a limited time frame in which they can transport and administer doses from the central storage facility in Kinshasa. This poses particular difficulty for the nation’s more rural areas which take longer to reach, an issue that has only been exacerbated by the ongoing conflict in the DRC between the government and rebel groups. This has made access to rebel-controlled regions much more limited and therefore made the transportation of medical resources such as vaccines to these areas much more difficult.

Government efforts, educational campaigns and attempts to raise awareness about the virus, and vaccines are just some of the ways the DRC is currently working to combat the spread of Mpox. Its collaboration with international organizations has proved key to the start of the Mpox vaccination program, and further provisions from nations such as Japan will hopefully allow for the continued suppression of the virus.

– Izzy Tompkins

Izzy is based in Leeds, UK and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr

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Mpox in India: Understanding the Outbreak and Response

Mpox in India: Understanding the Outbreak and Response India has confirmed its first case of a deadlier mpox strain, the clade Ib variant, in Kerala. Previously contained in the Democratic Republic of Congo, this strain is now spreading globally, leading the World Health Organization (WHO) to declare a global health emergency. Authorities detected the case in a 38-year-old man who had recently traveled from Dubai and have identified 29 contacts for self-quarantine.

The Spread of Mpox in India

Mpox, previously known as monkeypox, is an infectious disease caused by the monkeypox virus (MPXV), a double-stranded DNA virus from the Orthopoxvirus genus in the Poxviridae family. A global outbreak of the clade IIb strain occurred between 2022 and 2023. As of now, the mpox outbreak in India has primarily affected urban areas, especially New Delhi. Although the number of cases has not reached critical levels, there is concern about potential widespread transmission in densely populated regions. Public health officials are closely monitoring the situation, tracking cases and ensuring containment measures are in place.

India’s Public Health Response

India’s public health response to the mpox outbreak has been swift and coordinated. The central government has urged all states and Union territories to identify facilities and train personnel to manage both suspected and confirmed mpox cases. Union Health Secretary Apurva Chandra has emphasized the importance of timely sample testing, isolating cases and conducting genome sequencing through the Indian Council of Medical Research (ICMR) to determine the virus clade.

States have received instructions to boost public health preparedness at state and district levels, establish isolation facilities and enforce strict infection control measures. Public awareness campaigns are underway to educate communities about the disease, its transmission and the importance of early reporting. Additionally, diagnostic capabilities are robust, with 36 labs supported by the Indian Council of Medical Research (ICMR) and three commercial PCR kits approved by the Central Drugs Standard Control Organisation (CDSCO) to facilitate testing. These ongoing efforts aim to control the spread of mpox and protect public health.

Prime Minister Narendra Modi has intensified India’s response and preparedness for the mpox outbreak following the World Health Organization’s (WHO) declaration of the disease as a Public Health Emergency of International Concern. Guidance from WHO has significantly shaped India’s response to mpox, providing best practices from other countries and offering frameworks to manage the disease within a broader public health context.

Looking Ahead

India has responded swiftly and proactively to the mpox outbreak, demonstrating a strong commitment to controlling the virus’s spread. Coordinated efforts at both national and state levels have enhanced diagnostic capabilities, established isolation facilities and promoted public awareness.

– Aneela Agha

Aneela is based in Dubai, United Arab Emirates and focuses on Global Health for The Borgen Project.

Photo: Flickr

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A Look at Malaria in Ghana

Malaria in GhanaGhana is located in Western Africa and sits on the Gulf of Guinea. It boasts a fairly high gross domestic product (GDP) per capita, at $2,203. Nearby countries, such as its neighbor Togo, sit at $942. Despite the high income, the nation is suffering one of its largest economic crises, marked by rampant inflation.

As a result, poverty is widespread, affecting approximately 24% of its 33.48 million residents. This translates to around 8 million people living below the poverty line. Many of these individuals face significant hardships, including health challenges. Malaria, in particular, has been a persistent and severe issue for Ghana.

What Is Malaria?

Malaria is a parasitic disease transmitted through the bites of female Anopheles mosquitoes. It is caused by five types of parasites, with Plasmodium falciparum and Plasmodium vivax being the most severe. While malaria is found in various regions globally, it is most prevalent in sub-Saharan Africa, including Ghana.

In 2022, 94% of malaria cases occurred in sub-Saharan Africa. Although malaria is both preventable and curable, it is a serious and rapidly progressing disease that requires prompt treatment. Ensuring those at risk have continuous access to necessary care is crucial for combating this dangerous illness.

How Does Malaria Impact Ghana?

In 2022, Africa experienced a massive malaria outbreak, with approximately 249 million cases and more than 608,000 deaths reported. Ghana alone recorded 5.3 million cases and 11,557 deaths. Although the outbreak has subsided, Ghana’s vulnerable health care system, which receives only 4% of the country’s GDP in funding, remains at risk for future malaria outbreaks.

With little spending on health care, Ghana’s system is weak, making it challenging for many citizens to access efficient care. Coupled with widespread poverty, affording medications is a struggle for many. Although a national health care insurance program exists, about 48% of the population is not enrolled. The combination of a weak health care system and a significant amount of people in poverty means that the country stands at a higher risk of outbreaks and infections.

What Is Being Done?

The World Health Organization (WHO) has collaborated with Ghana to combat malaria, achieving significant progress. Notably, they facilitated the distribution of the world’s first malaria vaccine to 708,970 children nationwide. Furthermore, WHO introduced the National Malaria Strategic Elimination Plan to eradicate malaria in Ghana.

In addition to WHO, other organizations are actively combating malaria in Ghana. The United States Agency for International Development (USAID), in collaboration with the United States (U.S.) Centers for Disease Control and Prevention (CDC), has made significant contributions. They have distributed insecticides nationwide to protect against mosquito bites, provided malaria chemoprevention to more than one million children and delivered approximately 2.8 million doses of preventive medicine.

Final Note on Malaria in Ghana

Ghana continues to face significant challenges, including persistent poverty and various systemic issues. However, the efforts of WHO and USAID have yielded positive results. The country’s health system is gradually improving and receiving increased government funding. While eradicating poverty in Ghana will be a lengthy process, eliminating malaria will undoubtedly enhance the quality of life for many, especially those living in poverty.

– Tyra Brantly

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

Photo: Flickr

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Health and Vector-Borne diseases

Vector-Borne DiseasesVector-borne diseases comprise 17% of known infectious diseases, like malaria, Dengue fever and West Nile virus. Vector-borne diseases result from an infection transmitted to humans and other animals by vectors. Despite causing millions of cases each year worldwide, adverse climatic conditions can worsen the global burden of these infections and negatively impact human health.

Effect of Adverse Weather on Vector-Borne Diseases

Vectors are sensitive to their environments. An increase in the earth’s average temperature presents a difficult challenge for addressing vector populations, as altered weather patterns and temperature changes affect vectors directly and indirectly. Rising temperatures can increase the speed of vector life cycles and breeding, which can increase vector populations and the speed of pathogen replication in hosts.

Indirectly, the weather changes impact the habitats and environments where these vectors exist and can change their geographic range and distribution. Mosquitoes, for example, breed in stagnant water; increased precipitation in some areas can amplify the number of vector breeding sites. These long-term changing weather patterns can increase vector’s geographic range, as warmer winter temperatures allow vector species to live in a larger area, increasing the range of the infections they spread to humans.

The burden of vector-borne diseases is highest in tropical and subtropical areas, disproportionately affecting the most impoverished populations. Malaria is one of the most prevalent vector-borne diseases globally, with an estimated 219 million cases and more than 400,000 deaths annually, according to the World Health Organization (WHO). Most of these deaths occur in children under five, with mosquitoes being the primary transmission vector.

Helpful Organizations

Many international organizations focus on this issue, working with the public health perspective and tackling changing climatic conditions to safeguard human health. GAVI, the Vaccine Alliance, has played a crucial role in combating vector-borne diseases by funding and supporting the distribution of vaccines for diseases such as yellow fever and Japanese encephalitis. GAVI-supported yellow fever campaigns in more than 10 African countries protected more than 130 million people. Its efforts have significantly increased vaccination coverage in low-income countries, reducing the incidence of these diseases and enhancing human health security.

While Gavi seeks immunization coverage for many diseases, the Malaria Elimination Initiative (MEI) focuses on eliminating malaria through surveillance and response, vector control, program management and drugs and diagnostics. MEI has a global focus and projects in South America, sub-Saharan Africa and Southern Asia. MEI has made significant progress in working at national, regional and international levels. Furthermore, the Nature Conservancy is an international organization with multiple priorities, including improving resilience for vulnerable habitats and communities, working with governments on clean energy policies and maximizing natural carbon storage opportunities through habitat conservation and agriculture practices.

Conclusion

The impact of changing temperatures on vector-borne infectious diseases is profound, exacerbating their global burden and highlighting the need for targeted investments and improvements. Investing in outbreak responses and enhancing disease surveillance systems is crucial to counter the increased infection potential from changing climatic conditions. These strategies can reduce exposure to vectors and susceptibility to vector-borne diseases, particularly in vulnerable populations. Additionally, investing in ecosystem stabilization and forest and wetland preservation can reduce greenhouse gas emissions, limit climate variability and contain vector habitats.

– Hodges Day

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

Photo: Flickr

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Health Initiatives and Diseases in Somalia

Diseases in SomaliaFor a long period, Somalia has been a vulnerable target for many infectious diseases. Some of the leading factors can be attributed to the humanitarian crises of malnutrition, mass displacement and lack of access to clean water and food, as well as the several years of drought that started in 2015. With that said, here are three diseases in Somalia and the initiatives combating them.

Cholera

Cholera is a bacterial disease transmitted through contaminated water and food sources, posing a risk of mortality if left untreated. In 2024, there was another cholera outbreak after the flooding of El Niño rains. According to the International Rescue Committee (IRC), 980 cases were reported in the first two weeks of January, with 55% of them being children. The number of reported cases has been increasing for the past few years. The year 2023 experienced a 15% increase from the previous year, while there was a 48% increase in 2024 compared to the same period in 2023.

As of May 27, 2024, there were more than 10,000 cases and 120 deaths across the country since January. The outbreak also destroyed farmlands, which worsened the poverty and malnutrition among families across Somalia. As with other humanitarian crises, the cholera outbreak affected the vulnerable groups the most, adding to their instability with a lack of sanitation facilities, medical treatment and food.

As a response to address the public cholera crisis in Somalia, the National Cholera Task Force has been activated and the IRC has stepped up. The IRC has made an effort to mitigate the impact of the cholera outbreak by providing humanitarian aid such as clean drinking water and proper sanitation materials to affected populations. The Central Emergency Response Fund (CERF) also allocated $2 million to the cholera outbreak in Somalia.

Measles

Measles is a contagious disease with symptoms such as high fever and rash and it carries a risk of potential death. In Somalia, measles is prevalent, with cases reported annually. As of February 2024, there have been 3,365 reported cases and 37 deaths since the beginning of the year. This significant rise is due to limited access to health care services, medical supplies, proper sanitation, safe water and lowered immunity due to acute malnutrition. The risk is further aggravated among vulnerable communities due to low vaccination rates, widespread malnutrition and vitamin A deficiency among children younger than 5 years old.

Amid the measles crisis, the World Health Organization (WHO) responded by providing technical support on surveillance, vaccination, case management, training of health care workers and risk communication. In addition, in the last week of April 2024, Somalia’s Federal Ministry of Health, the WHO and the United Nations Children’s Fund (UNICEF) partnered to increase the immunization rate among children in Somalia.

Past initiatives include administering 933,000 vaccinations in January of 2018 through a campaign partnered with WHO, UNICEF and national and local health authorities. UNICEF also provided 4.7 million doses of vaccines and 1,700 social mobilizers to facilitate the vaccination programs with vitamin A supplementation.

Tuberculosis

Tuberculosis (TB) is another public health problem in Somalia. TB is a serious infectious disease caused by Mycobacterium tuberculosis that affects the lungs. In 2023, there were 246 TB cases per 100,000 population in Somalia. According to WHO, some of the factors related to TB transmission and progression are crowded and poorly ventilated living environments, undernutrition and limited general health knowledge. In other words, poverty correlates with TB cases, increasing the vulnerability of Somalia’s population.

In March of 2024, WHO Somalia, jointly with the Federal Ministry of Health and Human Services, marked World TB Day 2024 with continuous reinvigorated determination to end the TB epidemic. Since 1995, Somalia’s TB program has made significant progress in controlling the TB epidemic in Somalia. The program is based on WHO’s End TB Strategy, adopting WHO’s diagnostic and treatment regimens.

In 2023, TB cases decreased by 14% compared to 2010. Additionally, the number of TB treatment centers increased from seven in 1995 to 109 in 2023. The program saved 184,052 lives with TB cases from 2010 to 2023, with an average treatment success rate of 87%. With a renewed commitment to combat the TB epidemic, Somalia will continue to control TB and save the lives of its people.

Conclusion

Cholera, Measles and Tuberculosis are three of many diseases in Somalia, affecting thousands of people’s lives. With the increase in outbreak cases, there is also an active effort to mitigate the impact of diseases. According to Minister of Health Dr Ali Haji Adam Abubakar, the introduction of new vaccines, including Rotavirus and Pneumococcal Conjugate Vaccines, is also expected to help Somalia combat other diseases that are taking the lives of many children.

Despite ongoing instability and disease outbreaks, with collective and concerted effort, Somalia would be able to keep diseases affecting the population under control and save the lives of Somali citizens.

– Sein Kim

Sein is based in Bellevue, WA, USA and focuses on Good News for The Borgen Project.

Photo: Flickr

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Elderly Poverty in Botswana

Elderly Poverty in BotswanaWith Botswana’s extended family system, different generations keep closely in touch and often live under the same roof. It is refreshingly different from the isolating nuclear family set-ups common in other parts of the world. However, it also means that the responsibility of the young orphans of HIV and AIDS victims falls disproportionately on older generations, who bear the brunt of the financial obligations that come with caregiving. Thus, elderly poverty in Botswana is a considerable challenge.

Elderly Poverty in Botswana

Many elderly are impoverished but unable to take part in productive economic activity comfortably. Some force themselves to partake in hard labor like land tilling and alcohol brewing to keep afloat. Caregiving further strains those who suffer from non-communicable age-related health problems, like arthritis, according to the Journal of Nursing Scholarships. These issues, however, are not restricted to caregivers. They are symptomatic of the wider condition of the Botswanan elderly.

More and more people are reaching old age in Botswana, with the number of older people (60+) as a proportion of the population reaching 7% in 2020. Yet, socio-economic development has not kept pace with this increase. Elderly poverty in Botswana is a salient issue, with 91% of the older population living below the poverty datum line, or the level of income needed by a household to achieve minimal levels of well-being across different parameters.

Vulnerability to Poverty

One answer is that many Botswanans tend to leave the labor force relatively earlier, beginning at age 50. This is often because of ill health, participation in lower-productivity activities like subsistence farming, and obligations to undertake unpaid care work, as outlined above. This significantly reduces the period over which their retirement savings can build up. It also increases the number of years that such savings must provide for, according to the 2022 UNFPA report.

For those who do not exit the workforce so early, the legal retirement age is 60, according to the Journal of Nursing Scholarships. The five-year gap between this and the state pension age – 65 – leaves many in financial insecurity.

Households headed by older persons in Botswana tend to have relatively lower per capita income and more dependents than wage-earners, UNFPA reports. A more detailed individual-level analysis finds that the elderly show higher levels of multidimensional poverty than any other age group.

Although the old-age public pension scheme mentioned above is a step in the right direction, many have trouble accessing benefits. This is because of lengthy commutes to pay points and delays in processing life certificates.

Inadequacies in Public Health Care

Botswana has an effective public health care system, with minimal out-of-pocket expenses for citizens. Recent advances have reduced the incidence of communicable diseases. But it is yet to adapt to the increasing burden of non-communicable diseases: for example, 36% of 50 to 59-year-olds now self-report hypertension. Close to 34.5% of older men and 65.8% of older women are overweight or obese.

BMC Proceedings reports that there is a lack of expertise in treating such diseases across health care providers, especially in rural areas. National health care guidelines are not adhered to strictly. It follows that those who already suffer because of elderly poverty in Botswana are hit even harder by the uneven access to high-quality health care.

Additionally, studies estimate that only 3% of older adults have a good diet. Assessment scores show poor intake of dairy, fruits and vegetables. Many older people also report irregular access to drinking water, according to the 2022 UNFPA report.

Support and Empowerment

The government has responded to these difficulties by developing a National Healthy Ageing strategic programme, in collaboration with the World Health Organization (WHO). This includes a more thorough public health response to the needs of the elderly population. According to WHO, it also adopted the WHO’s Integrated Care for Older People guidelines to roll out a comprehensive health monitoring tool in 2022.

Masego Leepile’s Beno Society, founded in 2004, focuses on empowering the elderly to be self-reliant. Along with providing palliative care, it also encourages their social well-being by organizing “community wellness days, festivals and campaigns.”

The Sisters of the Charity of Nazareth administer the Pabalelong Hospice close to the capital city of Gaborone. Its experienced team provides home care to more than 90 patients nearby, and accessible palliative care services to people throughout the country.

Botswana has witnessed remarkable economic growth since its independence and has successfully lifted thousands of citizens out of poverty.

– Shiveka Bakshi

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

Photo: Flickr