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Outbreak of Ebola in the DRC Poses Major Health Risk

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

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

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

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

How Did the Outbreak Start?

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

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

What Does Treatment on the Ground Look Like?

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

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

What Has Been the International Response?

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

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

– Ella Goulet

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

Photo: Unsplash

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HIV/AIDS in Uzbekistan

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

Overview of HIV/AIDS in Uzbekistan

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

Key Challenges

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

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

HIV/AIDS and Poverty in Uzbekistan

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

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

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

Efforts and Solutions

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

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

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

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

Conclusion

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

– Dias Assan

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

Photo: Unsplash

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Health Care for Non-Communicable Diseases Impacting Ghana

Diseases In GhanaNon-communicable diseases (NCDs), such as cardiovascular diseases, diabetes, chronic lung diseases and cancers, have become one of the largest burdens to worldwide health care systems. Roughly 41 million people die of chronic non-communicable diseases (CNCDs) each year, with the majority of these deaths occurring in developing countries, despite the misconception that they are most common in developed countries. While CNCDs impact people from all walks of life, those living in poverty are disproportionately affected due to the high costs of care and limited health care knowledge, making this not just a health care issue, but a socio-economic one. Lack of adequate care also leads to a higher rate of complications and premature deaths as a result of CNCDs within poorer communities.

CNCDs in Ghana

Chronic non-communicable diseases impacting Ghana have hit epidemic proportions, accounting for nearly half of all deaths, and calls to reduce their growing health and economic burden have become increasingly urgent. The drivers of CNCDs are systemic within society and typically linked to behaviors in adolescence, with unhealthy food environments and limited access to physical health infrastructure being two pillars of the increase.

While there has been an attempt to control the rapid swell of these diseases, the August 2012 policy aimed at reducing cases of CNCDs was largely ineffective. With this policy, Ghana strove to prevent and control non-communicable diseases, and focused on strategies such as primary prevention, clinical care and strengthening the health system. However, there were many interconnected challenges which limited its efficacy. On a national level, poor awareness, inadequate coordination and a lack of funding inhibited the policy’s functioning. There was also limited attention afforded to the management of patients who already have CNCDs. In addition, on a sub-national level, inadequate clarity on translating the policy into action rendered ground-level operationalizing ineffective. What the 2012 CNCD policy made evident was the need for comprehensive structural and strategy development which focused on both preventive and curative care.

Recent Progress in CNCD Policy

Despite this, there have been fruitful strides towards constructing an overarching and effective policy to combat chronic non-communicable diseases impacting Ghana. Earlier this year, the Ministry of Health in Ghana, with support from the World Health Organization (WHO), convened a stakeholder agreement with more than 50 people from government ministries, regulatory agencies, academia, civil society and United Nations partners to galvanize support for legal reform which promoted healthier diets and physical activity – the two pillars of prevention. This was part of Phase II of the Global Regulatory and Fiscal Capacity Building Programme (Global RECAP), a program seeking to implement measures to reduce the occurrence of NCDs by creating healthier environments.

In addition, Ghana is preparing to roll out the 2025 Global School Health Survey, a nationally representative survey aimed at gathering critical data on the personal health behaviors of school-aged adolescents. To ensure the successful implementation of the survey, a national training program has been held in Kusami for collectors and administrators, equipping them with technical knowledge, ethical guidance and practical tools for survey administration. The questionnaire includes modules on nutrition, physical activity, mental health, alcohol and drug use and the role of familial support, as well as measuring height and weight. Illustrating the importance of this initiative, Dr Pascal Mwin, Technical Officer for Non-Communicable Diseases at the WHO Country Office, emphasized the “critical investment in building a stronger foundation for adolescent health in Ghana,” which will ultimately aid the effectiveness of the policies it will inform.

Looking Ahead

With continued aid from the WHO, there is cause for hope for encompassing and productive legislation to tackle the rising tide of chronic non-communicable diseases impacting Ghana, foster healthier school environments and increase access to adequate health care for those living in poverty.

– Libby Foxwell

Libby is based in Sherborne, Dorset, UK and focuses on Global Health for The Borgen Project.

Photo: Unsplash

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Addressing Mental Health in Guinea-Bissau

Mental Health in Guinea-BissauIn the small West African country of Guinea-Bissau, rich culture and strong tradition mask a growing crisis, mental health neglect. Among the most prevalent conditions are depression and anxiety, often left unaddressed due to systemic gaps and social stigma.

A System Without Specialists

As of 2017, Guinea-Bissau had zero practicing psychiatrists. The country’s ratio of just 0.13 doctors per 1,000 inhabitants falls far below global standards for basic health care. This shows that mental health support is almost absent from the primary care setting. Additionally, a screening of adults attending general health facilities in Guinea-Bissau revealed that at least 12% had a diagnosable mental disorder. This shows the urgent need for integrated mental health services in the nation’s fragile health system.

A baseline study found that general practitioners correctly diagnose only one in three patients, meaning that the people in Guinea-Bissau’s rural communities are unknowingly struggling with mental disorders. They carry a silent weight that forces them to push through each day with far greater effort than others, struggling in isolation just to survive.

Poverty and Psychological Strain

Things such as rising climate anxieties and pandemic poverty are worsening mental health in Guinea-Bissau. In 2021, the poverty rate was reported to have increased by 2.8 percentage points, adding an additional 80,000 poor. Research shows that mental illness reduces employment and therefore income.

Cultural Beliefs and Stigma

Mental health in Guinea-Bissau is often interpreted through a spiritual lens. Communities blame mental issues on things like curses and ancestral wrath. As a result, individuals often look down upon seeking help from medical professionals. Sixty-three percent of rural mothers go to the witchdoctor, and 65% believe that curses have the power to kill. While traditional healers play a vital role in this community, their methods can delay access to cures. Stigma remains a barrier to those suffering silently.

Lending a Helping Hand

This West African nation faces a mounting crisis that demands international attention. Every person deserves access to necessities like mental health care. Guinea-Bissau’s struggle is a global problem; poverty, trauma and neglect reflect broader challenges that low-income countries face worldwide.

Progression Efforts

Mental health in Guinea-Bissau is beginning to see a glimpse of hope in this landscape. International organizations such as the World Health Organization (WHO) have stepped in to support the country. Guinea-Bissau’s fragile health system has improved as groups are working to train general health workers in basic psychiatric care.

The NOVAFRICA Knowledge Center is working to strengthen health care in Guinea-Bissau through an inclusive and culturally sensitive approach. Its model brings together modern medical practitioners and traditional healers, including witchdoctors, to bridge trust gaps and improve access to care. By acknowledging and respecting spiritual traditions deeply embedded in the community, NOVAFRICA promotes the acceptance of modern medical practices and helps lay the groundwork for more effective health interventions, including in mental health.

The Path Forward

In collaboration with NGO VIDA, NOVAFRICA supported the launch of a community health insurance program that allows residents to pay affordable premiums in exchange for access to medical care, transportation and essential medicines. Though the country still lacks a national suicide prevention strategy, collaborative efforts between NGOs and local health authorities are laying groundworks for a future policy reform.

Guinea-Bissau’s challenges are steep, but the people are resilient. With continued international support and growing local engagement, the nation is taking its first steps toward a future where the silenced have a voice. Acknowledging, treating and respecting mental health is not just the goal, it is the path to a future defined by dignity and resilience.

– Marissa Schoth

Marissa is based in Benton, LA, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Unsplash

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Everything To Know About HIV/AIDS in Mongolia

HIVAIDS in MongoliaMongolia is a vast country in East Asia, bordered by China and Russia, with a population of about 3.5 million people, nearly half of whom live in the capital city, Ulaanbaatar. Once part of the Mongol Empire and later a Soviet satellite, Mongolia has undergone a rapid political and economic transformation since the 1990s. Today, it is a democratic state with a growing, resource-based economy. However, the country still faces infrastructure gaps, urban-rural inequality and a fragile health system stretched across immense distances.

In the context of public health, Mongolia has been largely spared from large-scale epidemics. HIV prevalence remains low, but that does not mean the risk is absent. For a nation often overlooked in global health discussions, Mongolia’s quiet battle against HIV is a story of early success—and urgent, unfinished business. Here is information about HIV/AIDS in Mongolia and efforts to combat it.

The Prevalence of HIV/AIDS in Mongolia

Mongolia has maintained a low overall HIV prevalence, estimated at around 600 people living with HIV in 2023. Men account for a significantly larger proportion of cases than women. While the numbers remain low compared to other countries, the number of cases has been slowly increasing over time. This highlights the need for sustained prevention efforts and real awareness campaigns.

The country reports fewer than 100 AIDS-related deaths annually, a reflection of progress in raising awareness, early detection and improved access to antiretroviral therapy (ART). However, treatment coverage remains below international targets; approximately 39% of people living with HIV receive ART, falling short of the UNAIDS 95-95-95 goals aimed for 2030. Without adequate treatment, the virus risks spreading further, especially among vulnerable populations.

Key Populations Most Affected by HIV/AIDS

Sexual contact is the primary mode of transmission. Certain groups carry a disproportionate burden of HIV infection:

  • Men who have sex with men face stigma and discrimination, which discourages them from seeking timely treatment.
  • Sex workers are at higher risk due to multiple partners and inconsistent condom use, compounded by social barriers to health care.
  • Transgender people experience similar stigma, limiting their access to prevention and treatment services.
  • People who inject drugs face heightened risk due to needle sharing, with limited awareness of safe injection practices in Mongolia.

Poverty and HIV/AIDS in Mongolia

Poverty exacerbates vulnerability to HIV infection and limits access to health care services in Mongolia. Many people living in poverty, particularly in rural and ger (traditional tent) districts around Ulaanbaatar, face barriers such as transportation costs, limited health care infrastructure and social stigma. These challenges reduce access to testing and treatment, increasing the risk of undiagnosed and untreated infections.

Mongolia’s Efforts To Address HIV/AIDS

To address these challenges, Mongolia has implemented several programs focused on vulnerable populations and poverty reduction:

  • Since August 2023, the Payment-for-Results model has incentivized NGOs to increase HIV testing and outreach among key populations, linking funding to performance outcomes.
  • The Undarga microfinance program, piloted since 2010, targets women engaged in sex work, offering financial education and savings services to reduce reliance on risky income sources.
  • Mobile health clinics that have support from the World Health Organization (WHO) and international partners bring HIV testing and health care services to rural and nomadic communities, overcoming geographic and economic barriers.

Looking Ahead

Mongolia has kept HIV prevalence and AIDS-related deaths relatively low, but a slow rise in new cases, especially among impoverished and stigmatized groups, presents ongoing challenges. Addressing poverty’s role in HIV vulnerability and improving health care access through innovative programs and sustained investment will be essential for Mongolia to sustain its progress and meet international targets. With continued commitment, Mongolia can look forward to a healthier future.

–  Julia Skowrońska

Julia is based in Wrocław, Poland and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Raising Awareness of Mental Health in Antigua and Barbuda

Mental Health in Antigua and BarbudaEveryone knows that mental health is just as important as physical health. That does not change the fact that mental health encounters neglect concerning overall health and well-being. Antigua and Barbuda, similar to other small Caribbean island nations, faces unique challenges in conversations focusing on mental health due to limited resources, stigma and lack of awareness. However, the government and various organizations, such as the World Health Organization (WHO) and the Antigua and Barbuda Association of Mental Health Counsellors Inc. (ABAMHC), have created public awareness campaigns and taken the steps necessary toward improving mental health in Antigua and Barbuda.

The majority of people with mental health challenges in Antigua and Barbuda are diagnosed with schizophrenia, schizoaffective disorder and depression. In 2007, only three male patients and one female patient made any visits to one mental hospital for psychiatric treatment, meaning a large number of Antigua and Barbuda citizens lived untreated. Data collected presents assessments and treatments for 174 outpatients through primary health care centers. Out of 174 patients, 114 (66%) carry schizophrenia and other related disorders, 23 (13%) mood (affective) disorders, and 8 (5%) other mental illnesses. In addition, people with mental disabilities are more likely to experience poverty. Social support groups, health care, jobs and education are not easily accessible to impoverished families to provide for the members, specifically children and adolescents, who require extra care.

Health Institutions

Care for mental health in Antigua and Barbuda is severely underdeveloped and primarily focused on confinement rather than treatment. The placement of individuals diagnosed as neurodivergent, someone whose brain processes information differently, in improperly trained health institutions, unfortunately, led to a crisis across the region, where mental health conditions proceed without formal examination, resulting in several people living without necessary care.

In addition to undertrained health institutions, there is one mental health hospital named Clarevue Psychiatric Hospital. Surprisingly, the Clarevue Psychiatric Hospital is the “sole mental health care facility in Antigua and Barbuda,” with enough space for 130 patients who are 18 years old or older. Similar to other health facilities, Clarevue Psychiatric Hospital was “ill-equipped to satisfy the mental health needs of the country.” 

Authorities and mental health specialists, like Health Minister Sir Molwyn Joseph, are stepping up to create a supportive environment for Antigua and Barbuda residents. Plans and programs are underway to construct new mental hospitals and provide appropriate training for mental health professionals. Thankfully, local leaders are passionate and persistent about positively changing other people’s lives by providing support and resources.

“When I reflected, back in 1998, I made [an] appeal…, so you can see the level of urgency,” Joseph said.

Effects of Poverty on Mental Health

Studies indicate that poverty significantly impacts mental well-being economically. Poverty and mental health in Antigua and Barbuda are intertwined as poverty leads to social stresses and trauma, and mental health can lead to impoverishment resulting in a cycle of hardships to access basic needs such as food, housing and healthcare. According to the United Nations Children’s Fund (UNICEF), 18% of Antigua and Barbuda citizens lived in poverty, and 5% were indigent in 2016. Compared to the remainder of the Eastern Caribbean, Antigua and Barbuda has a lower poverty rate than the average of 23%.

Economic hardships disproportionately affect children and adolescents. The poverty rate for children between the ages of zero and 17 is 24%, and for adolescents, it is 25%, which is higher than the rate of 16% for adults ages 18 years or older and the overall rate of 18.4%. The higher percentage among the younger population signifies an urgent call for social and economic policies to improve living conditions for vulnerable groups.

Mental Health Crisis Among the Youth

Experienced psychiatrists have expressed concerns about the mental health among the youth. “In a 2021 report showing that nearly 20 percent of teenagers in Antigua and Barbuda between the ages 13 and 15 had seriously considered taking their lives.”

Dr. Chenelle Joseph, a psychiatrist who has worked with the mental health challenges of the younger generation, has witnessed a growing mental health crisis in Antigua and Barbuda, with increasing reports of suicide idealization and mental health disruptions like depression, bullying and anxiety.

To lower the percentage of teens idealizing taking their lives, a new initiative to amplify community stability and address ascending suicide rates will launch in Antigua and Barbuda. Antiguan-born psychotherapist and former United Nations official Jamion Knight will introduce the Mango Bucket Project, the country’s first suicide prevention hotline to relieve the pressures of modern life of individuals in the Caribbean islands.

“If persons and communities across the country could make a small contribution to improving the mental fitness and resilience of the nation, we can collectively transform the lives of thousands of people who are facing significant and crushing pressures daily,” Knight said.

Mental Treatment Act of 1957

On February 7, 2025, the National Youth Parliament Association of Antigua and Barbuda (NYPAAB) hosted a debate to tackle the Mental Treatment Act of 1957, a 70-year-old piece of legislation that was enacted in various countries, including Antigua and Barbuda, to regulate the treatment and care of people with mental health conditions.

Several government officials have voiced their opinions on the Mental Treatment Act of 1957 and criticized it as insufficient for managing modern questions in mental health care services. Prime Minister Marver Woodley, Attorney General Christal Percival, and Speaker of the House Jessica Zouetr reconsidered the context of current comprehension of mental health and utilized their voices to lead some countries to call for reforms that better align with mental health care practices and rights. 

Mental Health Awareness

While the challenges to improving mental health in Antigua and Barbuda still exist, the collective efforts of the community, government and organizations signal a positive shift toward a more supportive mental health landscape. The nation’s ability to shine through as it navigates these difficulties together reminds everyone that they are not alone in their struggles.

As Antigua and Barbuda pushes forward, the need remains to maintain an environment where mental health is prioritized and celebrated. The road toward healing is bumpy, but the community strides toward a healthier, happier future with every development. The story of the mental health crisis in Antigua and Barbuda is one of hope, compassion and unwavering strength of the human spirit from which all beings should learn.

– Makayla Johnson

Makayla is based in Clayton, NC, USA and focuses on Good News and Technology for The Borgen Project.

Photo: Freepik

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Ebola in Uganda: Strengthening Response and Prevention

Ebola in Uganda: Strengthening Response and Prevention
Since the initial discovery of orthoebolavirus during the 1976 disease outbreaks in Zaire and Sudan, nearly 40 additional incidences have occurred. While these Ebola disease (EBOD) episodes have been reported globally, Sub-Saharan Africa accounts for most of them. Countries such as Sierra Leone, Guinea and Uganda have all experienced EBOD outbreaks. In fact, Uganda itself has had several different episodes over the last 20 years. While these disease outbreaks cause harm and disruptiveness to many communities, they also provide valuable learning opportunities. Additionally, information that medical professionals glean from previous events can be useful for addressing future epidemics. To successfully control emerging outbreaks of Ebola disease in Uganda, medical professionals should heed lessons they learned from past orthoebolavirus outbreaks.

Knowledge Gains

Lessons learned from past orthoebolavirus outbreaks are plentiful and many partnerships between the country’s Ministry of Health (MOH) and global agencies have led to positive improvements for addressing Ebola disease in Uganda. These include:

Additionally, lessons learned from past orthoebolavirus outbreaks in Uganda involves supporting culturally appropriate burial processes. For this, the MOH is working closely with Uganda’s Red Cross teams. These teams include individuals from the community who understand the culture and who can work directly with those who have lost loved ones due to EBOD. Team members receive training in using personal protective equipment (PPE) and following rigid universal precaution requirements. This is especially important when addressing orthoebolavirus outbreaks.

Ongoing Challenges

While progress has occurred in addressing Ebola disease in Uganda, communication remains a challenge. Even though the government shares disease information about orthoebolavirus outbreaks, people do not always trust it and are hesitant about vaccines.

Because of the current Ebola disease in Uganda, many countries have implemented travel bans and advisories. Those in the tourist industry believe that the lack of clear communication from the government is causing a decrease in their revenue. This is significant for an industry that gained more than $1 billion in revenue during 2023. This is of great concern for the more than 42% of the people living in poverty.

Lessons learned from past othoebolavirus outbreaks also revealed the depth of distrust and culturally embedded conspiracy theories developed from previous Ebola disease in Uganda events. Some believe the outbreaks are a way for the government to remove certain populations or cover up the selling of people. They also believe that those infected with EBOD have had a hex cast upon them.

To remove communication barriers, more engagement with local communities needs to occur. Besides clear information, people also need increased education regarding Ebola disease in Uganda, especially as the country tries to initiate a new vaccine trial to fight the EBOD outbreak of 2025.

Summary

Uganda is located in East-Central Africa. It is home to six major lakes including Lake Victoria, which is the second-largest inland freshwater lake in the world. The country has a population of more than 48 million people of which almost 75% live in rural communities along Lake Victoria, roughly 72% of the rural population does not have access to improved sanitation facilities and nearly 20% of the rural population does not have access to clean drinking water.

These are significant aspects to consider when managing any orthoebolavirus outbreak. As Peter Piot, (the Belgium-British microbiologist involved with identifying Ebola) states, “We shouldn’t forget that this is a disease of poverty, of health systems and of distrust.” But with the lessons learned from past orthoebolavirus outbreaks and ongoing global support, efforts to contain future outbreaks of Ebola disease in Uganda will prevail.

– Kelly Chalupnik

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

Photo: Flickr

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Guinea Worm Disease: Nearing the End of a Neglected Disease

Guinea Worm DiseaseDracunculiasis, also called guinea worm disease (GWD), is a crippling parasitic infection that has afflicted humankind for thousands of years. The parasite Dracunculus medinensis causes this infection, which spreads when infected copepods (water fleas) contaminate drinking water. Historically endemic across large swathes of Africa, Asia and the Middle East, GWD has long been linked to excruciating pain, disabling disease and economic deprivation in affected populations. However, a global eradication campaign led by the Carter Center, supported by the World Health Organization (WHO) and UNICEF, has nearly eradicated this parasitic disease. The near-elimination of GWD highlights the power of coordinated global health efforts to combat neglected tropical diseases (NTDs). Here is more information about guinea worm disease eradication across the world.

The Lifecycle of the Guinea Worm Parasite

People contract GWD when they drink water containing copepods infected with Guinea worm larvae. Once ingested, the copepods die, releasing larvae into the host’s body. The larvae penetrate the stomach and intestinal walls, eventually maturing into adult worms. Female worms, which can grow up to one meter long, migrate to the skin’s surface about one year after infection. The worm forms a painful blister, typically on the lower limbs, which eventually ruptures, allowing the worm to emerge over several weeks. This agonizing process causes intense pain, inflammation and secondary infections. Many victims submerge the affected area in water to seek relief, inadvertently releasing new larvae into the water source and completing the transmission cycle.

Health and Socioeconomic Impact

Although rarely fatal, guinea worm disease wreaks havoc on affected communities. The intense physical pain and immobility render individuals unable to work, farm or attend school. In rural agricultural settings, this loss of productivity can jeopardize food security and local economies. Beyond health consequences, GWD perpetuates cycles of poverty, increasing economic strain on already overburdened healthcare systems.

Global Guinea Worm Disease Eradication Campaign

In 1986, GWD affected 3.5 million people annually across 20 countries. The Carter Center spearheaded a global guinea worm disease eradication campaign to combat this debilitating disease. The strategy included four main interventions: improving access to safe drinking water using water filters, conducting health education to promote behavior changes, containing cases to prevent water contamination and applying larvicides to kill copepods in stagnant water. By 2023, these efforts reduced cases to a handful in South Sudan, Chad, Mali and Ethiopia, with most countries, such as Ghana and Nigeria, declared free of GWD.

Challenges Eradicating GWD

Despite significant progress, several challenges impede the final push toward eradication. Guinea worm infections in animals, primarily dogs in Chad, complicate efforts to interrupt transmission. Political instability and conflict in countries like South Sudan and Mali hinder surveillance and containment efforts. Environmental factors, such as changing weather and shifting water patterns, may also alter transmission dynamics, creating new challenges for eradication teams.

The Role of Community Engagement

Community involvement has been the cornerstone of the eradication campaign. Empowering local populations to take ownership of the process has accelerated progress. Several community-driven initiatives have played crucial roles in combating guinea worm disease (GWD) with measurable successes.

In 2010, Chad implemented a cash reward program, offering financial incentives to individuals who reported suspected cases of GWD in humans. In 2015, this program was expanded to include reports of infections in animals, significantly improving case detection and containment efforts. Public awareness campaigns through radio, television and community outreach have been key to the program’s success.

Another critical initiative launched in South Sudan, where extensive surveillance networks originated, engaging thousands of volunteers to track and report cases. By 2018, these efforts led to the country announcing the interruption of GWD transmission after 15 consecutive months of zero reported cases.

Health workers and volunteers have also played an essential role in educating communities on water filtration and promoting early case reporting. In addition, local leaders have enforced containment measures and promoted safe water practices, fostering a sense of shared responsibility and resilience in affected areas. Through these sustained efforts, community engagement continues to be a driving force in the final push toward eradicating guinea worm disease.

Looking Ahead

The near-eradication of guinea worm disease represents a historic milestone in global health. It demonstrates how long-term collaboration among diverse partners, community engagement and innovative solutions can overcome even the most persistent health challenges. While obstacles remain, the lessons learned from this campaign will inform future efforts against other NTDs. Achieving eradication will improve millions of lives and affirm that with the right tools and strategies, even the most neglected diseases can be defeated.

– Maheer Zaman

Maheer is based in Fairfax, VA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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The Impact of Poverty on Mental Health

Impact of Poverty on Mental HealthPeople from lower-income countries are often overlooked as a target audience for mental health care. In impoverished countries, in particular, mental health care is crucial for breaking the cycle of potentially exacerbated mental illnesses that disproportionately affect underprivileged populations. According to the World Health Organization (WHO), 13% of people across the globe suffer from mental health disorders, varying in type and impact, with depression and anxiety being the most prevalent of them all. Poverty puts people at a higher risk for developing mental health disorders, and makes it difficult for those people to receive proper care. Only 33.33% of people suffering from depression around the world may have access to mental health care. The mental health care that is available is limited and poverty negatively affects it.     

The Impact of Poverty on Mental Health

According to research that Yihan Sun of the Department of Science at the University of British Columbia in Canada conducted, “mental illness … increasingly causes severe disability in both wealthy and underdeveloped countries,” and “poverty is one of the factors that affect mental health.” In short, the relationship between mental health and poverty is that of a snowball effect. 

Mental health as a result of poverty can make preexisting mental illness worse. More specifically, poverty can worsen symptoms of depression, anxiety and post-traumatic stress disorder (PTSD). Yihan Sun goes on to mention that depression can result from concerns about “erratic income and spending” related to poverty. For example, anxiety can increase due to people not being able to make bill payments on time. People may also experience PTSD when they live in locations that are “disaster-prone” to such things as “fire incidents, traffic fatalities, environmental hazards and gun-related violence.”

Non-Communicable Diseases and Mental Health

Mental health can be considered a non-communicable disease (NCD), which is a disease that is not transmissible from one person to another and often includes chronic diseases and conditions like diabetes, heart and kidney disease. Mental health disorders have links to various non-communicable diseases. People suffering from diabetes and cardiovascular disease can be more at risk of developing anxiety or depression.

Unfortunately, non-communicable diseases are a significant cause of death for low to middle income countries. According to the World Health Organization (WHO), for the countries of Angola and the Central African Republic, non-communicable diseases are the broader cause of at least 20% of the deaths of their population in 2021. For the countries of Bangladesh and Cambodia, NCDs are the cause of more than 60% of the deaths of their populations in 2021. These countries are all classified as being low-to-middle income countries according to WHO.  

Current Global Poverty Status

Despite the devastating impact of poverty on mental health, particularly in developing countries, there is hope on the horizon. In the past 30 years, poverty has steadily and significantly declined in regions such as Latin America and the Caribbean, Eastern and Southern Africa, sub-Saharan Africa and Western and Central Africa, with poverty rates decreasing by at least 13% in each region—some by as much as 28%. 

East Asia and the Pacific have experienced the most dramatic improvement, with poverty rates plummeting from 65.2% in 1990 to just 0.6% in 2024. Although Latin American and Caribbean countries haven’t seen as much of a decline in poverty as the rest of the world, their poverty rate has still diminished significantly compared to the ’90s. 

The MINDS Act

Where there is hope, solutions to persistent problems are often within reach and this holds for those living in poverty in low- and middle-income countries. One such solution is the Mental Health in International Development and Humanitarian Settings (MINDS) Act, which offers a pathway to addressing these challenges.

The MINDS Act aims to enhance investment in mental health care from high-income countries, such as the U.S. and the U.K., to establish or support programs focused on breaking the cycle of poverty worldwide. By doing so, it seeks to address the reciprocal impact of poverty and mental health, helping to disrupt the harmful connection between the two.

Children would benefit significantly, as the rate of their anxiety and depression (due to living in poverty) would lessen. They would also be less susceptible to developing psychiatric disorders in their adulthood.

Solutions in Rwanda

Another solution could be in the form of programs like the ones implemented in Rwanda, after the sovereign state’s genocide of 1994. Findings determined that around 94% of the survivors witnessed traumatic events that would affect them decades later in the form of PTSD, depression and panic disorder. In response to the aftermath of the genocide, the state created a community-based psychotherapy that allows for “healing and peacebuilding for survivors.” Rwanda then proceeded to create the Gacaca Courts through the Government of National Unity, which would provide justice for survivors while emphasizing accountability for the perpetrators. The sovereign state eventually acquired enough stability to be able to provide it’s citizens with universal health coverage for mental health to each citizen for $2 a year.

Through the implementation of these programs, Rwanda has successfully and significantly lessened the state’s suicide rate from 8.84 in 2005 to 5.57 in 2018 as a result of community-based psychotherapy.  More than 1.2 million cases were tried in more than 12,000 courts after the creation of the new judicial system of the Gacaca Courts. Life expectancy within the country has since risen from 56 to 70 after the implementation of universal health care and the inclusion of mental health.

Conclusion 

Rwanda is proof that mental health care is incredibly important to the health of a community, especially during the aftermath of traumatic and tragic events. With the implementation of programs that changed and incorporated mental health care into Rwanda’s judicial system, universal health care system, and community, the country has, since the genocide of 1994, been able to look forward to its future with much better days ahead. It is possible to provide mental health care and restore hope, and solutions can emerge with humanity at the wheel.

– Sadie Treadwell

Sadie is based in Grovetown, GA, USA and focuses on Business and Good News for The Borgen Project.

Photo: Pexels

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Public Health Action for the Western Pacific Region by WHO

Western Pacific RegionThe Western Pacific Region is struggling to provide people in that Region with access to public healthcare. Rural areas in Cambodia, the Philippines and Vietnam are more adversely affected than urban areas. About two out of every five people do not have access to services such as immunization, pregnancy, childcare and disease treatment. By 2048, an expected 21 million people in the Western Pacific are expected to die each year from noncommunicable diseases.

However, the World Health Organization (WHO) is working to bring adequate health services, human resources and financial protection to these impoverished communities. WHO is currently endorsing a publication for Universal Health Coverage (UHC). It includes a framework for action and aims to transform public systems as a whole and support people in maintaining health for life.

Public Health Care Struggles

Within many countries in the Western Pacific, some can access health care yet face high out-of-pocket expenses that cause financial hardship. This can become a catalyst for dipping below the poverty line. As much as 10% of the population’s income is used for health care purposes, which can then force choices between health care or adequate food and shelter.

In 1940, only 40% of the Region lived until age 60; this number is expected to reach 94% by 2048 after the implementation of the WHO initiative. About 90 million people within the Region do not utilize a primary drinking water facility. Furthermore, about 400 million have no access to sanitation services that safely manage human waste. Diarrhea is often then contracted and contributes to malnutrition and antimicrobial resistance, which creates an overall unhealthy population over time.

Viral hepatitis is a significant threat in the Western Pacific, claiming around 1500 lives every day in the Region. Other environmental stresses pose challenges to the health, safety and physical well-being of rural populations. The increasingly polluted air and water supplies are contributing to a rise in cancer, diabetes and heart disease.

Vulnerable Populations in the Western Pacific Region

The most vulnerable populations in the Region include those living in rural and peri-urban areas. These areas struggle with accessing and paying for health care. Additionally, there are high disease burdens, poor health outcomes and limited access to affordable and nutritious food. More than 300 million people in the Western Pacific Region cannot afford a healthy diet, contributing heavily to malnutrition.

Cambodians struggle with unsafe drinking water and a lack of sanitation facilities. The overall population health is negatively affected by poverty, lack of essential commodities and adverse social conditions. Similar to other countries, populations face high out-of-pocket payments that threaten impoverishment. In recent years in the Philippines, the top causes of death have been heart diseases, neoplasms and cerebrovascular diseases.

The country is also struggling with a lack of hospital beds and adequate medical equipment in rural areas more than in urban areas. Rural areas often contain non-licensed doctors and ill-equipped facilities, while larger cities such as Manila have better medical resources. This creates a more significant disparity between minority groups.

Similarly, the public health care system in Vietnam is underfunded, with insufficient resources allocated to health care infrastructure, equipment and staff training. This occurs in the majority public sector of the public health care system. High out-of-pocket payments account for large percentages of health expenditures in the country. This significantly burdens low-income families, resulting in delayed or inadequate care.

WHO’s Initiative

WHO understands that the right to health does not just include services. Other factors include safe, clean water, air, nutritious food, adequate housing, quality education, decent working conditions and freedom from discrimination. Therefore, its UHC initiative will contain action frameworks and health financing for social well-being and sustainable development for public health systems.

This initiative could create a strengthened public health system in Cambodia. It could reduce infant, child and mother mortality, as well as provide more adequate sanitation facilities. In the Philippines, having a collaborative public health system between the government and the public could provide a safe, effective, quality health system to those who need it, with a minimal waste of resources.

In Vietnam, removing disparities in the quality of care between urban and rural settings and public and private sectors would create a healthier population overall.

– Chloe Landry

Chloe is based in Providence, RI, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr