28 January 2002

Planning Begins for Reconstruction of Afghan Health Sector

The Afghan Health Ministry and the World Health Organization (WHO) begin a three-day meeting February 3 to plot a course for rebuilding the nation's devastated health care system.

A WHO press release says the Afghan health system "will be building up its health sector practically from scratch." After more than 20 years of conflict, the nation's medical infrastructure is so diminished that at least six million Afghans have no access to medical care or very little.

WHO has completed an assessment of pharmaceutical needs, finding that "the overall pharmaceutical situation in Afghanistan has deteriorated dramatically." Drugs have been either unavailable or unaffordable for Afghans, though recent contributions from international donors have relieved shortages somewhat.

WHO is currently supporting 23 clinics in under-served districts in several provinces. Fifty of the country's 330 districts have no health facilities at all.

Following is the text of the WHO press release:

The World Health Organization (WHO) is assisting the Afghan Ministry of Health to prepare its first planning meeting for reconstruction of the health sector. The meeting will be held for three days beginning Sunday February 3 in Kabul and will include regional health officials, health-related UN agencies, and key NGOs.

Afghanistan will be building up its health sector practically from scratch. It is important that this is an Afghan-led process, supported by international agencies and NGOs. Currently, at least 70% of the Afghan population is dependent on health services provided by the international community.

Ensuring Afghans living in rural areas have access to quality health care is a key concern. The Ministry of Public Health is currently conducting an assessment of health facilities in the countryside around Kabul. The World Health Organization will then move quickly to ensure these facilities are rehabilitated to provide needed services to the population.

A WHO team has completed a 10-day mission to Afghanistan to conduct a preliminary assessment of the pharmaceutical situation. It was the first WHO technical mission to Afghanistan since September 11.

Following visits to key sites of the pharmaceutical sector in Kabul, such as the drug manufacturing plant, warehouses and the Quality Control Laboratory, the team found that the overall pharmaceutical situation in Afghanistan has deteriorated dramatically.

Lack of essential drugs is very common in public health facilities. Expensive brand-named medicines available in private pharmacies remain unaffordable for most Afghans. In addition there is wide spread consumption of low quality and ineffective medicines procured both in public and private facilities. Recent events, however, have provoked a huge influx of drug donations in the country, temporally alleviating the recurrent shortages.

WHO has concluded that major technical and financial assistance will be required to develop pharmaceutical systems capable of offering an appropriate level of services critically needed by the population. WHO has proposed to donors a US$ 25 million budget for the first year to allow for the establishment of medical stores at the central and provincial levels.

In Herat, the World Health Organization is now supporting 23 clinics in under-served districts in Ghor, Baghdis and Feryab. These clinics are receiving no support from NGOs or any other international agency. The World Health Organization is ensuring the districts where these clinics are located have adequate medical supplies in place to last through the next three harsh winter months. In addition, the World Health Organization is planning to set up six mobile clinics for the same region. At least six million Afghans have none or very little access to medical care. In addition, 50 of the country's 330 districts have no health facilities whatsoever.

In Islamabad, the World Health Organization is set to work with the Capital Police and Pakistani Ministry of Health to promote the improvement of primary health care for refugees in the city.

The Capital Police is trying to make a shift from "traditional policing" to "community policing". This means providing social services to the community in a bid to build confidence between authorities and the refugee population. As part of this campaign, the Capital police and local community on Saturday organized a one-day medical camp for Afghan refugees residing in clay houses in the I-11 sector. Throughout the day, various specialized doctors provided medical advice and treatment, free of charge to residents in the area.

In addition, the World Health Organization is planning to provide technical support to the Capital Police and Ministry of Health to train Lady Health Workers for the Afghan refugee community. There are 35,000 to 40,000 Afghan refugees living in the area. The plan calls for one woman for every 3000 people to be trained to work on Mother and Child Health issues, and communicable disease control. The World Health Organization will also procure essential drugs for the refugees are repatriated or placed in proper camps.