Djibouti has some of the lowest health indicators in the world with life expectancy at 46 years, maternal mortality at 546/100,000, and infant mortality at 67/1,000.   It also has the third highest tuberculosis (TB) prevalence rate worldwide and a staggering malnutrition rate.  Over the past four years, USAID made impressive gains in rural areas by increasing rural immunization coverage rates by 300%, and reducing the under five mortality rate by 27%.  In FY 2009, USAID supported tuberculosis (TB), polio and malnutrition programs detected, treated, and mitigated these diseases.

1. USAID provided consistent and strong technical assistance and training to build the tuberculosis (TB) laboratory capacity that complemented Global Fund (GF) assistance for anti TB drugs, logistics and other small equipment.  USAID’s work has ensured that the number of labs per population meet international standards.  USAID also established infection control measures, trained national reference center staff in those measures, and helped formulate recommendations that will be the basis for the development of a national policy on TB control.  
2. USAID has consistently supported an excellent surveillance system for Djibouti’s Polio Eradication Program. USAID’s support emphasizes training and communication activities to maintain the high quality work of the health staff delivering polio immunizations to each district.  During the national immunization days the country recently achieved the target of 95.9 % vaccinated nationally and at or above vaccination targets in four out of five districts.  Djibouti efforts have not gone unnoticed.  In December 2009, it was honored for its significant effort in boosting immunization coverage by the Global Alliance for Vaccines and Immunization (GAVI).  
3.  USAID’s Office of Disaster Assistance’s (OFDA) nutrition program helps ensure that severely malnourished children under 5 are treated and/or cured.