Afghanistan has a high burden of cutaneous leishmaniasis (CL), especially in Kabul. Around 23.6 million people are at risk of CL in 24 of 34 provinces that are reporting the disease. Over 27,000 new CL cases were reported in 2017. Kabul has a high burden of CL, with over 13,000 new cases reported in 2017 (48% of total). When leishmaniasis is not promptly treated, it can lead to disfiguration and disability and poses a high social burden, resulting in stigma and marginalization, especially for women.
In Afghanistan CL mainly affects the poorest people. Due to improved surveillance, the number of reported cases of visceral leishmaniasis (VL), a severe and sometimes fatal form of the disease, increased in recent years. Leishmaniasis case management was recently integrated into BPHS/EPHS, but still there are still some gaps in drug availability and the quality of drugs provided by BPHS/EPHS implementers in some endemic areas. The National Malaria and Leishmaniasis Control Programme (NMLCP), as a technical department of MoPH, is responsible for leishmaniasis control. WHO supports the capacity building of health staff and development of a leishmaniasis surveillance system to enhance its proper integration and implementation through BPHS health service delivery. Targeted interventions include disease control in at-risk communities by diagnosis and treatment, provision of drugs, support for the implementation of the National Strategic Plan, expansion of the regional and international network of expertise, community engagement and operational research.
Achievements:
Trained 937 health staff (doctors and nurses) from BPHS health facilities on management of leishmaniasis and surveillance.
Enhanced leishmaniasis surveillance under an integrated surveillance module, Malaria and Leishmaniasis Information System (MLIS).
New IEC materials (1,600 posters for health facilities and 1,000 leaflets for communities) developed, printed and distributed.
Strengthened leishmaniasis surveillance with training of health staff and provision of recording and reporting tools (1,100 registry books and 100,000 patient cards)
Programme Risks and Challenges:
Lack of adequate financial resources to support the leishmaniasis programme.
Lack of skilled staff at programme management and service delivery levels.
Poor health-seeking behaviour in communities.
Way Forward:
Support the National Control Programme in resource mobilization and capacity-building initiatives as well as with implementation of the national control strategy.
Raise public awareness on leishmaniasis prevention and control.
