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The Fight Against HIV/AIDS in Fiji 

HIVAIDS in FijiFiji, an archipelago made up of 300 islands and 540 islets in the Pacific Ocean, has declared an HIV outbreak after the alarming spike in cases over the last few years. According to experts, “since the first reported case in 1989, HIV-1 incidence in Fiji has increased by about tenfold, from 0.7 per 100,000 in 2000 to 7 per 100,000 in 2021. While this increase is largely due to improved diagnostic capacity, it is also suspected to reflect a growing epidemic.” Here is more information about HIV/AIDS in Fiji.

Causes

The Fijian Health Ministry credits the rise in HIV/AIDS cases in Fiji to illegal drug usage. There are two particular practices that are said to have caused the spike in cases, which are “bluetoothing” and “chem-sex.” However, others believe that the rise of cases is due to the lack of funding and research in HIV/AIDS as a whole. According to an EastAsiaForum article, “before 2012, they used a combination prevention approach to HIV. Funding had ramped up in 2008 through the HIV and STIs Regional Response Fund… [but] in 2013, the HIV Regional Response funding ended.” This may have played a significant role in the spike of HIV/AIDS cases in the Fijian Islands. 

Financial Implications

The HIV/AIDS outbreak has not only severely impacted the health of Fijians but also their finances and quality of life. Fiji’s increasing rates of urbanization, which have caused homelessness and unemployment, have also contributed to the HIV/AIDS epidemic in Fiji. Additionally, a large part of Fiji’s economy is reliant upon tourism, as they are still recovering from COVID-19. A reputation hit that could come from this outbreak would be detrimental to the Fijian economy, which would likely make the spread even worse, as it is disproportionately affecting those who are economically struggling.

Responses to the Spike

In January 2025, Fiji announced a 90-day containment plan that will guide the nation’s AIDS response until 2027. This is the start of the prioritization of HIV research in Fiji and helping the most vulnerable among the population get the treatment they need. However, there is still the underlying concern that some people who are HIV positive in Fiji are not aware of their status, and those who are too afraid to receive the care that they need due to prejudice and the stigmatization of the condition. Minister Lalabalavu, the minister of Health and Medical Services of Fiji, says that “discrimination and stigma will only serve to make our current situation worse.”

In order to combat this, there are many movements to increase education on HIV/AIDS in hopes of increasing knowledge and reducing stigma, such as the HIV Surge Strategy 2024-2027 that the Fijian government has endorsed. The focus of the strategy is based on intersecting issues that contribute to the rise in HIV cases, such as prevention, treatment, harm reduction, human rights and social justice. Additionally, it plans on coordinating public health responses due to the presence of hard drugs within the Fijian community.

Government Intervention

UNAIDS Deputy Executive Director Jan Beagle said, “The most effective results can only be achieved through partnership across sectors, through strong leadership, and with community at the center. By taking AIDS out of isolation, the impact can go far beyond the AIDS response.” Displaying that this issue has become a government issue, and due to this the government has given Fijian $FJ200,000 for its HIV/AIDS Prevention and Control Programme, a program that targets the prevention of drug use in underprivileged communities as well as destigmatizing testing centers and HIV itself, in the 2023-2024 budget and is only adding more every year to combat this crisis.

Looking Ahead

While the outbreak of HIV/AIDS in Fiji has extremely affected the country’s population, the increasing awareness towards this issue has allowed them to fight back and take control over their health. However, it is still important to continue raising awareness towards this topic. HIV/AIDS disproportionately affects Fijians that come from low-income communities, and the lack of knowledge has made the spread worse. Therefore, continued efforts are essential to ensuring that these people get the education and support they need to slow the spread. 

– Sydney Carr

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

Photo: Unsplash

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Navigating the Mental Health of Eswatini’s Youth

Mental Health of Eswatini’s YouthTeenagers in Eswatini have attempted suicide at a rate of 15%, as they reported feelings of anxiety, depression and self-dissatisfaction. The Eswatini Economic Policy Analysis and Research Centre (SEPARC) reports that poor mental health affects 8,229 people in Eswatini, with young people between the ages of 15 and 35 accounting for 40% of these cases. Despite the lack of national statistics, small-scale studies indicate that substance misuse and emotional distress are prevalent. Here is information about the mental health challenges of Eswatini’s youth.

The Mental Health Challenges of Eswatini’s Youth

A lack of economic prospects, recreational facilities, support systems and violence are all major contributors to worsening mental health among young people. UNICEF reported that 35% of Eswatini’s youth are neither employed nor enrolled in education or training, increasing the likelihood of engaging in risky behavior, resulting in adverse mental health outcomes. 

Violence detrimentally affects children’s development, cognitive ability and academic performance, leading to issues such as low self-esteem, emotional distress and depression. About 79% of children between the ages of 1 and 14 have experienced physical violence. Among adolescents, 32% of males between the ages of 13 to 24 reported experiencing physical violence in their lifetime. Meanwhile, 5.5% of females in the same age range reported experiencing violent incidents occurring before the age of 18.

How Violence Exacerbates HIV/AIDS in Eswatini

Furthermore, violence is a significant driver of HIV/AIDS, as it increases vulnerability to risky behaviors through trauma and its impact on emotion regulation. Among young people with a history of violence, the prevalence of HIV was 7.4% for females and 3.4% for males. In comparison, the HIV positivity rate for those without such experiences was 6.4% for females and 3.3% for males.

The country’s 27% HIV prevalence rate among individuals aged 15 to 49 further compounds the mental health challenges that Eswatini’s youth face, placing it among the highest globally. The dread of disclosure, which underscores the necessity of expanding disclosure programs for those who provide care with more comprehensive support for adherence and addressing mental health concerns, emotionally burdens Eswatini’s youth. The potential negative consequences of disclosing their HIV status to their spouse were a source of concern for 75.3% of HIV-positive men and 23.4% of HIV-positive women between the ages of 13 and 24.

Fortunately, some organizations like UNICEF and Education Plus are promoting change through institutional support and policy. Meanwhile, local organizations such as Young Heroes are focusing on vulnerable communities.

UNICEF’s Mental Health Support for Eswatini

UNICEF reached out to young people through social media and discussions to share information about mental health, sexual health, gender-based violence and violence against children in collaboration with non-governmental organizations (NGOs). These efforts allowed 1,782 young people to access mental health support.

Collaborating with Junior Achievement Eswatini (JAE), UNICEF implemented a Financial Literacy and Entrepreneurship Skills Program, helping 3,005 adolescents and providing opportunities through economic empowerment, allowing them to reduce engagement in risky behaviors, thereby lowering the likelihood of experiencing adverse mental health outcomes.

In partnership with the Ministry of Health, UNICEF supported teen clubs and mother-baby pairs clubs offering psychosocial support, counseling and health education. These initiatives have helped more than 13,350 young people access information on mental health, sexual and reproductive health and HIV prevention. 

Education Plus

A partnership of UN organizations leads the Education Plus Initiative. The initiative is a high-level global advocacy effort aimed to improve access to education, health care and economic opportunities, promoting stigma-free health care services. These efforts enable young individuals with HIV to seek help in a more supportive environment, reducing the likelihood of adverse mental health outcomes due to fear of discrimination.

The initiative safeguards adolescents by addressing fundamental needs and providing mental health care. Since a lack of recreational resources often lead to risky behaviors that undermine mental health, Education Plus aims to provide free secondary education for both girls and boys by 2025 to address this issue.

Furthermore, the initiative equips young people with the tools to achieve financial independence and stability. This is achieved through social protection, school-to-work transitions and economic empowerment. By fostering hope for a better future, it increases the likelihood of reducing the percentage of young people at risk of self-harm.

Young Heroes

Young Heroes is a charitable organization that aims to empower vulnerable youth and their caregivers in Eswatini through local initiatives. The organization collaborates with leading international partners, offering psychological support, social safety and prevention of gender-based violence. Programs for youth emphasize the importance of education, counseling, HIV-related support and treatment.

Young Heroes’ Sabelo Sensha project aims to increase mental health and resilience among Eswatini’s vulnerable young people. To support this, the project provides HIV treatment adherence assistance, counseling, support for caregivers, group referrals, positive parenting training, educational subsidies and socioeconomic empowerment programs.

Young Heroes supports disadvantaged children in Eswatini through Stepping Stones Sessions, which provide educational initiatives. Sessions teach essential life skills and offer opportunities for personal development. Babazile Bhila, a 20-year-old who endured psychosocial struggles and poverty, said Young Heroes’ Stepping Stones changed her life. Indeed, Babazile is now funded by CANGO’s Halt Project for her education. She thanked Young Heroes for enabling her to reach her full potential.

In August 2024, Young Heroes and the Ministry of Justice and Constitutional Affairs formed a partnership through Legal Aid Eswatini. This partnership is a critical step in addressing the vulnerabilities that children and adolescents face. Through this partnership, organizations will collaborate to mitigate the social and legal obstacles that Eswatini’s youth are encountering. Furthermore, this will foster greater emotional security and mental well-being.

Looking Ahead

Addressing the mental health challenges that Eswatini’s youths experience requires a multifaceted approach that includes mental health support, economic empowerment and community-based activities. However, the initiatives of world-renowned organizations demonstrate that there is hope for a better future for Eswatini’s youth.

– Imge Tekniker

Imge is based in London, UK and focuses on Global Health and Celebs for The Borgen Project.

Photo: Wikipedia Commons

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How big is the hole? Suspension of USAID in Ethiopia

ethiopia usaidEthiopia is the largest recipient of USAID in sub-Saharan Africa. After receiving the money for 2023, Ethiopia has seen a suspension in the $1 billion in aid it receives. The funding cut has left the country in a vulnerable position, disrupting critical aspects of its healthcare system, including data management, medicine procurement, delivery, and workforce training and retention

Where the Suspension Has Hit Hardest?

The suspension of USAID funding has severely disrupted Ethiopia’s fight against diseases like malaria, HIV and tuberculosis. Around 5,000 health care workers lost their jobs, affecting vital services such as vaccinations, patient care and disease surveillance. The funding cut also threatens Ethiopia’s global “95-95-95” HIV treatment goals, with 503,000 people receiving care across 1,400 health facilities. Additionally, 10,000 data clerks responsible for managing HIV treatment have lost their jobs, further hindering the delivery and monitoring of care.

This could cripple efforts to combat HIV in the short to medium term, leaving many patients vulnerable. This has worsened the strain on the health care system, leaving it unable to provide basic services and hindering disease eradication efforts, deepening health poverty. 

With USAID support, Ethiopia launched a five-year health sector plan (HSTP-II) from 2020-2025 to improve health care. The plan aims to ensure quality, accessible health care, strengthen governance and leverage technology for reliable health data. A key challenge is the severe shortage of health care workers, with less than 100,000 staff members, far below the 445,000 necessary for universal health coverage. The plan’s success is crucial to expanding services and addressing this workforce gap.

The suspension of USAID funding has severely impacted Ethiopia’s HSTP-II, halting training programs and delaying the expansion of the health care workforce. Many NGOs have been hit hard by the suspension, including the Tesfa Social and Development Association (TSDA), which aids HIV patients with food, clothing and school supplies, according to The Guardian. The funding cut has crippled the organization, leaving those who depend on TSDA in even worse health and poverty. Staff layoffs and operational challenges have worsened the already dire situation for those relying on the organization’s support.

Solutions

The government has tried to enhance its support for local NGOs by trying to empower them by simplifying regulatory frameworks, in the hope this will enhance the operational efficiency and sustainability of NGO’s despite the budget constraints they are now facing. Following the advice of the Ethiopian Civil Society Organisation Authority, NGOs that did not rely on USAID funding are forming alliances with other local NGOs, enabling them to share resources, have joint fundraising efforts, and increase advocacy for policy changes to support the nonprofit sector during this challenging period.

NGOs such as the Mekedonia Humanitarian Association focus on supporting the critically disabled, elderly and mentally ill by providing housing, clothes and other vital amenities. Another organization is the Ethiopian Human Rights Council, which focuses on providing legal aid and investigating human rights abuses. These have turned out to be important practices for non-USAID-funded NGOs as it has provided support for these NGOs to allow them to continue their work during the period of the suspension.

Conclusion

The suspension of USAID has left Ethiopia’s health care system in an unprecedented crisis, affecting disease eradication efforts, health care workforce expansion and the operations of vital NGOs. The abrupt withdrawal of $1 billion in aid has crippled essential programs, forced widespread layoffs and disrupted Ethiopia’s ability to meet global health commitments. The impact on HSTP-II and organizations like the Tesfa Social and Development Association underscores how deeply intertwined USAID funding was with Ethiopia’s healthcare infrastructure.

Efforts to diversify funding streams, improve private sector involvement and empower local NGOs mark a shift towards long-term self-sufficiency, though the short-term outlook remains dire. Ultimately, while Ethiopia is making strides to mitigate the crisis, the loss of USAID has left an undeniable mark on its healthcare system. Whether the government’s measures will be enough to compensate for the loss of funding remains uncertain, but one thing is clear: The suspension has deepened Ethiopia’s health crisis, and the road to recovery will be long and arduous.

– Oliver Hedges

Oliver is based in Lancaster, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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High-Risk Diseases in Botswana and Their Impact

High-Risk Diseases in Botswana and Their ImpactBotswana, a landlocked country in Southern Africa, is known for its economic stability and reliance on diamond exports. The government maintains strong trade partnerships with nations such as the United States (U.S.) and the United Kingdom (U.K.), but economic disparities persist. Unemployment remains high at 27.6% and Botswana’s Gini index—a measure of income inequality—stands at 53.3, indicating significant economic inequality. Public health challenges further compound economic hardships. Diseases in Botswana are a challenge. The country faces a high disease burden, particularly from HIV, tuberculosis (TB) and Kaposi sarcoma. While the government has made strides in addressing these conditions, limited resources, health care infrastructure challenges and economic instability continue to hinder progress.

HIV in Botswana: Progress and Challenges

Human immunodeficiency virus (HIV) remains a critical public health issue in Botswana. HIV attacks the immune system by targeting CD4 cells (T cells), weakening the body’s ability to fight infections and diseases. If untreated, it progresses to acquired immunodeficiency syndrome (AIDS), increasing vulnerability to opportunistic infections.

To combat HIV, Botswana’s Ministry of Health (MOH) partnered with the U.S. Centers for Disease Control and Prevention (CDC) to expand testing, prevention and treatment services. This collaboration has resulted in an extensive network of more than 200 HIV prevention sites nationwide. The Botswana AIDS Impact Survey collects critical data on sexual behaviors and risk factors, allowing policymakers to tailor interventions effectively. Additionally, the country has invested in widespread antiretroviral therapy (ART) programs to ensure HIV-positive individuals receive life-saving treatment.

Efforts have yielded significant progress. By 2021, Botswana achieved a 97% viral suppression rate among HIV patients on ART. Additionally, more than 334,000 people received antiretroviral treatment, contributing to a 9% decrease in HIV transmission over the past decade. Despite these advancements, challenges remain, including stigma, treatment adherence and reaching remote populations.

Tuberculosis: A Persistent Public Health Threat

Tuberculosis (TB) is an infectious disease that primarily affects the lungs but can also spread to other organs. TB is airborne and spreads when an infected person coughs or sneezes, releasing bacteria into the air. Symptoms include persistent cough, chest pain, fever, fatigue and weight loss.

Botswana has seen a rise in HIV-related TB cases, as individuals with weakened immune systems are more susceptible to the disease. The government has taken several measures to address TB, including expanding screening programs at hospitals and clinics, increasing access to diagnostic tools for early detection and ensuring the availability of effective TB medications, including aminoglycoside antibiotics.

Despite these interventions, co-infection rates of HIV and TB remain high, making TB prevention and treatment more complex. Ensuring consistent medication access, early detection and public awareness campaigns are essential to further reducing TB cases in Botswana.

Kaposi Sarcoma: Botswana’s Leading Cancer

Kaposi sarcoma (KS) is the most prevalent malignancy in Botswana. It affects the lining of blood and lymphatic vessels and is strongly associated with human herpesvirus 8 (HHV-8). KS is especially common among individuals with weakened immune systems, such as those living with HIV.

Kaposi sarcoma presents significant health risks, causing purple or dark-colored skin lesions, swelling, enlarged lymph nodes and respiratory complications if the disease spreads to the lungs. To address KS, Botswana’s government has established four public oncology centers that provide cancer treatment services, including chemotherapy and radiation therapy. However, the country continues to face significant challenges, such as limited access to advanced diagnostic tools, shortages of experienced oncologists and delays in treatment due to resource constraints.

Increasing investments in cancer research, early detection programs and expanded health care infrastructure is crucial for improving Botswana’s ability to manage and treat Kaposi sarcoma effectively.

Strengthening Health Care Response in Botswana

While Botswana has made notable progress in combating HIV, tuberculosis and Kaposi sarcoma, challenges remain. Limited health care resources, economic instability and high co-infection rates continue to strain the public health system. Ongoing government initiatives and international partnerships—such as those with the CDC—are vital in ensuring continued progress in fighting diseases in Botswana. Expanding health care infrastructure, medical training programs and public awareness campaigns could be key to improving disease prevention and treatment outcomes. By addressing these high-risk diseases, Botswana can potentially enhance public health, reduce economic strain and improve the quality of life for its citizens.

– Hayden Reyes

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

Photo: Flickr

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Mobile Clinics in Kenya Bring Health Care to the Masai Village

Mobile medical care in kenyaLocated on the east coast of Africa, Kenya is a country of mountains, lakes, savannahs and the Great Rift Valley. With more than 50 million people, Kenya is expected to see a 51% population increase in the next 25 years. Despite this steady growth, the country’s life expectancy remains 66 years—about five years below the global average. HIV/AIDS and tuberculosis are the leading causes of death in Kenya. To curb the spread of these diseases, local governments and organizations have introduced mobile medical care to improve access to health screenings, treatments and health care services.

Targeting HIV/AIDS

A global health issue, the human immunodeficiency virus (HIV) is a virus that attacks the body’s immune system, with acquired immunodeficiency syndrome (AIDS) occurring when the virus advances. More than 40 million people have died of HIV/AIDS globally.

In August 2024, the Military Health and Research Program (MHRP) reported collaborating with local government entities to bring HIV preventative measures and treatment to Masai village in Kenya’s South Rift Valley Region. To bring care to this rural area, the MHRP developed a mobile clinic that could get health care to those who could not access it otherwise.

Utilizing funding from the United States of America’s President’s Emergency Plan for AIDS Relief (PEPFAR), the mobile clinic in Kenya provides patients with HIV testing, preventative education and antiretroviral therapies for those who test positive.

Fighting Tuberculosis

In addition to providing HIV/AIDS treatment, mobile clinics in Kenya also focus on tuberculosis, the leading cause of death among men in the country. This infectious, airborne disease claimed more than one million lives in 2023 alone. Babies, children, malnourished individuals and people with diabetes face a higher risk of contracting tuberculosis. While the disease is both preventable and treatable, many lack access to education about prevention and treatment. Mobile clinics in Kenya are working to bridge this gap and improve health care access.

Before the arrival of the mobile clinic in Masai village, individuals infected with tuberculosis were treated in Tanzania, where there were no closer resources. The MHRP reports that treatment took six months and if an individual died in Tanzania, they were left there. Since the mobile clinic arrived, Masai village had seen no tuberculosis-related deaths for more than a year at the time of the report.

Maurice’s Account

In 2023, the Henry M. Jackson Foundation Medical Research International (HJFMRI) spoke to an individual from Masai village. Maurice, the individual living in the town, acknowledges the benefits of mobile clinics. He explains to HJFMRI that those sent to Tanzania for treatment before the mobile clinics had to walk there on an eight-day trek. Maurice says he and the others from his village are “so happy” and “grateful” for the PEPFAR initiative that allowed the mobile clinics.

Beyond Masai Village

Mobile clinics in Kenya extend well beyond Masai village. CURE, Kenya’s children’s hospital, operates multiple mobile clinics nationwide, bringing health care directly to people where they “work, live and play.” Mobile clinics give health care access to individuals who otherwise have little to none. With funding from PEPFAR and the efforts of MHRP, local governments and other private agencies, mobile clinics bring care to many people in Kenya and work to combat the global health issues of HIV/AIDS and tuberculosis.

– Hannah Pacheco

Hannah is based in Boston, MA, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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HIV/AIDS In Panama: Political Actions and Awareness

HIV/AIDS In Panama: Political Actions and AwarenessIn Panama, approximately 30,000 people are living with HIV/AIDS, with numbers increasing each year. The rise reflects improved testing and awareness, allowing more people to seek and receive the care they had long been without. However, poverty remains a major barrier, particularly among Indigenous communities, where extreme living conditions increase vulnerability to the disease.

Poverty in Panama

Poverty significantly influences both the spread of HIV and access to treatment. While Panama’s overall poverty rate stands at 22%, the impact is disproportionately severe in nonurban areas, where 76% of Indigenous people live in poverty. This stark contrast highlights the need for targeted support, as many Panamanians, particularly in remote regions, still lack essential resources.

The Intersection of Poverty and HIV/AIDS

Economic hardship often results in limited access to hygiene products, including affordable condoms, increasing the risk of HIV transmission. Those infected face further challenges in accessing life-saving medical treatment.  The adult HIV prevalence rate in Panama stands at 1.0% and the country reports nearly 1,000 AIDS-related deaths annually. In the Ngäbe-Buglé territory, AIDS is the leading cause of death, accounting for more than 7% of fatalities, according to Panama’s National Statistics Institute. This intersection of poverty and health disparities highlights the urgent need for comprehensive strategies, including targeted education, expanded health care access and culturally sensitive prevention efforts to curb the spread of HIV/AIDS in Panama.

Political Action Driving Change

Panama began addressing the HIV epidemic in 1985 by offering testing and treatment services. In the early 2000s, the government passed legislation requiring agencies to provide both material and financial support to combat HIV/AIDS. Initially, the national budget focused solely on treatment medication. However, in response to the evolving epidemic, Panama expanded its funding to include public education initiatives. The passing of General Law 3 on STIs in 2000 marked a significant step forward, aiming to prevent discrimination and ensure equitable access to HIV-related services. By 2005, Panama had allocated approximately $10 million from the federal budget toward HIV/AIDS prevention, treatment and awareness campaigns.

Raising Awareness and Reducing Stigma

While increased funding has improved access to treatment, stigma remains a significant obstacle, particularly within Indigenous communities. Misconceptions about HIV/AIDS continue to fuel discrimination, preventing many from seeking testing and care. Public education campaigns have played a crucial role in dispelling myths and fostering a more informed society. These initiatives not only teach people how HIV spreads but also promote understanding and compassion for those affected by the virus. Expanding educational resources to Indigenous regions remains a priority, as these communities face the highest rates of both poverty and HIV/AIDS.

Looking Ahead

The combination of political action, increased awareness and targeted support has allowed Panama to make meaningful progress in addressing HIV/AIDS. However, continued efforts are needed to ensure that vulnerable populations—particularly Indigenous communities—have equitable access to education, prevention tools and medical care. By prioritizing both policy-driven solutions and grassroots awareness initiatives, Panama can continue to bridge the gap between poverty and health, creating a safer, healthier future for all its citizens.

– Kaleb Monteith

Kaleb s based in Greeley, CO, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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HIV/AIDS in Paraguay: UNAIDS at the Forefront of the Response

HIV/AIDS in ParaguayHIV/AIDS left 7,000 children as orphans in Paraguay in 2023 alone. Natanael, an HIV-positive boy living in Paraguay, became an orphan after his mother died of HIV.

What Is HIV?

The human immunodeficiency virus (HIV) is an illness that affects a person’s white blood cells, specifically ones called CD4 cells, that are responsible for immune function. HIV is transmitted through the exchange of bodily fluids. 

Methods of preventing the virus includes using a condom, avoiding used or unclean needles, getting tested regularly, and in some cases, preexposure prophylaxis (PrEP). Treatment for HIV/AIDS involves antiretroviral therapy (ART). 

HIV/AIDS in Paraguay

Despite there being both preventative measures and treatments, HIV/AIDS is an epidemic that continues to burden many parts of the globe. In Paraguay, at least 22,000 people are currently living with HIV/AIDS. Of that number, about half are receiving ART for HIV/AIDS, meaning at least 10,000 are going without life-saving treatment.

HIV/AIDS is concentrated both geographically and among populations in Paraguay. Greater than 75% of those infected with HIV live in the country’s capital, Asunción, with the total number of nationwide cases rising each year. HIV/AIDS is also more prevalent among men who have sex with men (MSM) and sex workers.

Natanael, a young boy living with HIV in Paraguay, became an orphan when his mother died of the virus. Natanael’s mother contracted the illness at her work at a children’s home for kids with HIV, where she and her son also lived.

After her passing, Natanael became an orphan and had to continue living in the home without his mother, because his own family rejected him and his mother after discovering that they were diagnosed with HIV.

UNAIDS Response

To bring aid to people like Natanael, The United Nations has a Joint Programme called UNAIDS. UNAIDS is a global health effort that aims to address HIV/AIDS as a public health crisis. 

As a result, HIV/AIDS in Paraguay and other countries may begin to see a decline as the Joint Team successfully implements different health services throughout the country.

With a program expenditure of $425,483 USD in 2022-2023, UNAIDS was able to: 

  • Provide nearly 550,000 students in Paraguay with comprehensive sex education. 
  • Provide more than 15,000 people in uniform with information regarding HIV/AIDS.
  • Provide more than 5,000 people in Paraguay’s armed forces with rapid HIV and syphilis testing services.
  • Distribute nearly 11,000 condoms throughout the country to prevent the transmission of HIV/AIDS, and other STIs.

The Future

Looking to the future, UNAIDS hopes not only to continue to meet their 90-90-90 goal – 90% of those with HIV are diagnosed, 90% of those diagnosed are treated with ART and 90% of those on ART become virally suppressed — but have targets of 95-95-95.

UNAIDS in Paraguay has worked not only to achieve its 95-95-95 goal but to prevent HIV/AIDS altogether through comprehensive sex education for students and the distribution of condoms throughout the country.

Without education or awareness of HIV, the couple who fell in love with Natanael may have never felt prepared to adopt him. At 12 years old, Natanael finally met his new parents. He was able to go to a loving home and maintain his HIV treatment. 

Other initiatives, such as SOS Children’s Villages, work to provide stable and nurturing homes to children around the globe living in poverty and other extreme situations. Anyone can donate or sponsor a child living in Paraguay, and help them gain access to medical care, food, clothes and love. 

Looking Ahead

HIV/AIDS is a global epidemic. The efforts of UNAIDS in Paraguay since 2022 have expanded public awareness of HIV and its transmission, provided HIV self-testing programs in key areas, and provided health services and information to those in uniform. Efforts such as these are at the forefront of the HIV/AIDS response and should help to decrease the number of cases in the future. 

– Hannah Pacheco

Hannah is based in Boston, MA, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Methods of Treatment and Testing for HIV/AIDS in Italy 

HIV/AIDS in ItalyHIV/AIDS infection and treatment are consistent concerns that health organizations in Italy are levying. Since high infection numbers in the early 21st century, rates of diagnoses have decreased from 3,858 in 2013 to 1,888 in 2022 according to WHO. Still, the health risk of the disease remains prevalent. Poverty can be an obstacle for seeking diagnosis and treatment for HIV/AIDS in Italy. Universal health services provide a great resource for those experiencing poverty. Currently, hospitals and health organizations in Italy are developing programs to make this impact more wide-spread.

The Ministry of Health and other national organizations are working towards spreading awareness, providing testing and developing medication. They hope to eliminate the possibility of HIV infection altogether. Many institutions have created goals which aim to reduce the number of new diagnoses and provide equitable treatment and counseling to all residents of Italy, regardless of their financial situation.

Injective PrEP Could Prevent HIV/AIDS in Italy

In December 2024, The National Institute for Infectious Diseases (IRCCS) and the Regional Hospital of Lombardy (ASST) collaborated on a solution-oriented program. Authorities in health spoke about emerging technologies at the national health conference, “Long-Acting Retrovirals–looking to the future.” The goal is to investigate and approve PrEP (pre-exposure prophylaxis) as a preventative measure against HIV/AIDS in Italy. Currently, the only available form of PrEP is the once-daily pill.

PrEP is a medication that reduces the risk of contracting HIV when individuals who are at-risk for infection take it. In the United States, the FDA has approved both the oral and long-acting injective forms of PrEP. 

The Italian initiative will provide controlled access to the injective method for 800 individuals and monitor their response. These health servicers wish to provide an alternative to at-risk people who have difficulty accessing or using the oral method. Injective PrEP allows for longer periods between intake compared to the daily oral method. 

“Three Times Zero” 

To commemorate International Day Against AIDS in Italy (December 1, 2024), IRCCS held a health conference. Many Italian changemakers attended including the Minister of Health, Orazio Schillaci, and the Director General of Health of the Lazio Region, Andrea Urbani. 

IRCCS aims to promote the goal of “three times zero against HIV: zero risk of transmission, zero diagnoses and deaths, zero stigma and discrimination.” Powerful entities such as the Italian Red Cross signed the protocol. It sets the precedent for advances in prevention and treatment. It also addresses the marginalization that those with HIV in Italy experience. 

Likewise, this protocol acknowledges the groups of Italian residents facing a disproportionate risk of contracting HIV. This includes men who have sex with men, foreign-born migrants and injective drug users. 

The DiMePReJ (Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area) found that individuals living in marginalized conditions have higher rates of infection. Risk factors include “financial difficulties and lack of secure housing.”

UNAIDS argues that the fight against HIV/AIDS cannot succeed without upholding the human rights of those suffering from the disease.  

Free Testing for HIV/AIDS in Italy

Accessible testing and education are vital to the reduction of HIV infections, especially among marginalized communities. Many free and readily accessible testing methods are available in major cities of Italy. “Let’s do it quick” (facciamolo rapido) launched in 2017 to provide an alternative to the typical blood test for HIV and HCV. This innovative test offers results by testing the saliva, removing the risk of blood contamination among health workers. 

This program supplements “room 13” (stanza 13) at IRCCS in Rome. The institute offers blood tests for HIV and Syphilis at no cost with same-day results. It also provides free counseling for those seeking preventive measures or treatment information. Search engines are readily available online for residents to locate their closest testing and counseling facility.

Vaccine Development

New developments are on the horizon. The Higher Institute of Health (ISS) in Italy partnered with the European HIV Alliance in 2016 to support its development of an HIV vaccine. The EU’s Horizon 2020 Research and Innovation program provided funding for their work. The alliance hoped to develop two new prophylactic vaccine candidates for clinical development using a multidisciplinary vaccine platform (MVP) and further identify scientific basis for continued research. 

Although the alliance has concluded, clinical trials for their vaccine, “EHVA P01” continued. Trials concluded at the end of 2024 with pending results. Scientists aimed to test the efficacy of a vaccine for HIV-uninfected adults. A preventative vaccine for HIV in Italy could reduce infection rates by large margins.

Global Collaboration Against HIV/AIDS

Still, many trials for preventative and therapeutic HIV vaccines are ongoing. Italy is one actor in an international mission to reduce–and eventually eliminate–the risk of infection for HIV. Health authorities are employing both preventative and therapeutic measures to address at-risk and infected individuals. Programs like “Three Times Zero” are reducing the stigma surrounding the disease and those who carry it. National hospitals, like IRCCS, have the potential to close the infection gap between income and population groups by continuing to provide free and accessible health services. Scientific collaboration in Italy has led to emerging treatments that indicate an HIV-free future.

– Sarah Lang

Sarah is based in Pittsburgh, PA, USA and focuses on Technology and Politics for The Borgen Project.

Photo: Pexels

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Diseases Impacting Lesotho

Diseases Impacting Lesotho
Lesotho is a tiny country totally encircled by South Africa. It has a land mass more than 11,000 square miles. With the country sitting within the mountain range of Maloti, Lesotho is frequently called the “Kingdom in the Sky.” While nature-made peaks and valleys provide the country with a beautiful landscape, the population struggles under an ineffective health care system that is challenged with managing several diseases impacting Lesotho.

3 Diseases Impacting Lesotho

  • Tuberculosis (TB): Tuberculosis in the country ranks as the second-highest in the world. The World Health Organization (WHO) indicates that TB is the leading cause of death in Lesotho, and among men. It is the second-leading cause of death among women and almost three quarters of TB incidences occur in individuals who are also HIV positive.
  • HIV/AIDS: HIV infections in Lesotho are high. In fact, the country ranked as the second-highest country with HIV in 2023. HIV/AIDS is the number one cause of death among women and the second leading cause of death among men. In 2023, there were approximately 260,000 adults living with HIV and more than half of these individuals were women.
  • Cervical Cancer: Cervical cancer rates are also high in this country. While globally this type of cancer falls within the top five most common cancers affecting women, it is the number one type of cancer impacting Lesotho’s female population. On average, more than 500 women in Lesotho are diagnosed yearly with this type of cancer. Unfortunately, more than two-thirds of them die from the disease. The main virus contributing to developing cervical cancer is the Human Papillomavirus (HPV). A common virus easily spread during sexual activity. However, women infected with HIV have a six-time greater risk for developing cervical cancer compared to women who are not HIV infected.

Optimism in Lesotho

The good news is that the country is making progress in addressing the diseases impacting Lesotho. Lesotho’s Ministry of Health (MOH) is working jointly with the Center for Disease Control (CDC) on several projects focused on improving the country’s health care system. Some of these changes include:

  •         Updating processes for disease surveillance and detection in general.
  •         Improving policies addressing public health concerns.
  •         Providing additional training for medical personnel regarding testing and samplings.
  •         Modernizing laboratory facilities to work with the newest diagnostic tools.

With support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the CDC and Lesotho’s MOH also made improvements with testing, diagnosing and treating, specifically for HIV and TB.

Addressing TB in Lesotho

Regarding TB, the partnership between the World Health Organization (WHO) and MOH is focusing on identifying individuals with TB in a much quicker fashion. With many of the population living in difficult-to-reach areas, local health facilities are making an effort to screen and test individuals who seek care. This cost-effective practice is helping to identify TB positive individuals sooner and get them started on medication treatment quicker. In doing so, a higher survival rate is being achieved along with decreasing the risk for spreading the disease.  

Although the burden of TB is still high in Lesotho, the country is seeing success. As of spring of 2024, approximately 77% of positive TB individuals were on medication treatment. Many of the partnered organizations are confident that Lesotho will achieve WHO’s established goals for ending TB by 2030.

Lesotho and the 90-90-90 Goals

 As for HIV/AIDS, the country met the United Nations Programme on HIV/AIDs (UNAIDS) 90-90-90 goals. These goals roughly defined are:

  • 90% of people with HIV will know their diagnosis
  • 90% of people with HIV will receive antiretroviral medication
  • 90% of people with HIV on antiretroviral medication will have their viral load suppressed

Lesotho achieved these goals impart through partnerships between the MOH, CDC and PEPFAR. The joint efforts created a survey tool called the Lesotho Population-based HIV Impact Assessments (LePHIA). The purpose of this tool was to identify how the country was managing HIV disease. Data collection involved trained surveyors making home visits to evaluate people’s risks for contracting HIV. The surveyors also provided preventive education and performed HIV testing and counseling. These same surveyors also helped to ensure HIV positive individuals were receiving medication treatment.

Although rates continue to be high, additional data finds Lesotho improving with addressing HIV disease. Data collected from a second survey (LePHIA 2020) found the rate of new HIV infections dropped more than 50%. Furthermore, the data indicates that more HIV positive individuals are being appropriately treated for maintaining viral suppression. Similar to TB, improvements with the management of HIV are leading to higher survival rates and lower disease transmission rates. 

The HPV Vaccine

To address cervical cancer, Lesotho’s MOH and the CDC jointly implemented a nation-wide vaccination program. This program focused on immunizing young girls with the HPV vaccine. The program effectively immunized 93% of young girls with the HPV vaccine. With an efficacy rate more than 98%, the program is a strong effort towards decreasing the occurrence of cervical cancer.

Looking Ahead

In a country where more than 40% of the population lives in the remote areas of the mountain and foothills, controlling diseases country-wide is crucial. Especially when access to care is challenging. With meaningful changes to the health system, the health of the population will improve and with new processes in place for TB, HIV and cervical cancer, individuals will have much healthier lives. The life expectancy rates which averaged around 48 and 54 years of age for men and women respectively in 2021, will rise. With longer life expectancies, family life will improve. Besides providing loving and nurturing environments for children, having parents living longer will also help to ensure the education and personal growth of children. These are crucial elements for a population to retain its identity and to feel of value. These changes in the health system will go far for addressing the diseases impacting Lesotho and its population.

– Kelly Chalupnik

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

Photo: Flickr

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Changing the Stigma Around HIV/AIDS in Saudi Arabia

HIV/AIDS in Saudi ArabiaStudies conducted in Saudi Arabia have found that a big portion of HIV/AIDS cases are going unreported. The reason for this has been attributed to a stigma surrounding HIV, which causes fewer people to seek treatment. When cases go unreported it’s hard to understand how big the issue is. This has created a need for better education on what HIV is to change the stigma surrounding it.

History of HIV/AIDS in Saudi Arabia

The first case of HIV was described in the 1980s, however, reporting in Saudi Arabia did not start until 2004. Stigma has formed because people are unaware of how long this disease has been around and who it is affecting. Improvement in reporting has allowed the government and private companies to create programs to help people with HIV and in the process remove any stigma. Despite people being considerably more educated, there is still a large portion of people who feel negatively towards individuals with HIV.

Changing the Stigma

The Saudi government funded a blood screening program as early as 1984. This was a new technique at the time that helped track and diagnose the disease as it spread. In 1994, it founded the Saudi National Aids Program. Since then the government has also made treatment free for individuals diagnosed with HIV. Efforts have been made to improve public knowledge about the disease and how to get tested.

Founded as a countermeasure to the HIV epidemic, the purpose of the Saudi National Aids program is to provide education and treatment to the public. The Program has created amendments to the treatment guidelines for HIV that have allowed for more people to access care. The program claims to be responsible for improving treatment so much so that in 2018 about 93% of reported cases were currently receiving treatment.

Public awareness campaigns create awareness that the government cannot. Progress begins when citizens can support each other through difficult times. Evidence of this was found in a survey that showed that the majority of people felt that they would still be friends with someone if they had HIV/AIDS. Improvement in the resources available for communities is another way awareness is being built. The Saudi Government has released informational brochures that allow community members to educate themselves.

Making Improvements

Since the start of the 2000s, the Saudi people have worked hard to create awareness around HIV/AIDS. In that time, studies have shown improvements in public knowledge and an improvement in attitude towards the disease. The reason public awareness is so important is that it creates a safe environment for people to talk about their health issues. The improved stigma around HIV/AIDS in Saudi Arabia has led to an increase in diagnoses among men. The Saudi Arabian people have shown that they want to improve the quality of life for people with HIV/AIDS, and as public awareness rises so will the amount of people helped.

– Kaleb Monteith

Kaleb is based in Greeley, CO, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr