Progress and challenges towards malaria control in Afghanistan

Najibullah Safi, MD, MSc. HPM, DMPPMNPO/PHC, WHO – Afghanistan

Presentation outline

• Introduction• Malaria risk in Afghanistan• Malaria control• Challenges• Prospects for malaria control and elimination

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Introduction

• Malaria transmission mostly occurred at the altitude of less 2000m above the sea level

• In Afghanistan, transmission of malaria is relatively low and unstable

• Almost half of the population live in malaria endemic areas

• Main species PV (95%) & PF (5%)• Malaria control remain a challenge despite

significant resource allocation

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Risk of malaria transmission in Afghanistan

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Malaria control

• Public Sector:– Basic Package of Health Services (BPHS)– Health post– Sub-center– Basic health center– Comprehensive health center– District hospital

– Essential Package of Hospital Services (EPHS)• Private sector

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Clinical Malaria

Confirmed Malaria

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Malaria control cont.

• Integrated approach for malaria control through general health services which includes:– Prompt and effective diagnosis and treatment– Integrated vector control– Surveillance (HMIS & DEWS) and control of epidemics– Information, Education and Communication– Health system strengthening and capacity building

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Trend of Vivax malaria 2002-2012

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Trend of Falciparum malaria 2002-2012

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Confirmed Vs. Clinical malaria 2002-2012

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Factors contributed to malaria control

• Financial support from Global Fund and other Donors• Close collaboration and support from partners• Political commitment

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Key challenges

• Service delivery (diagnosis and treatment)• Vector control • Issues related to health system

– Lack of motivation – Coordination among stakeholders– Absence of lab facility in BHC– Unregulated private sector & wide practice of self medication

• Poor absorption capacity and bureaucratic procedures • Poor cross border collaboration• Sustainability of the program• Scio-political stability

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Prospect for malaria control and elimination

• The prospect for continued effectiveness in malaria control and elimination is far from assured although effective tools exist to perform the task

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