WHO | Regional Office for the Eastern Mediterranean

  • Increase font size
  • Default font size
  • Decrease font size
Arabic (عربي) French (Fr)
Home Afghanistan | Programme areas | Malaria and leishmaniasis

Afghanistan



Malaria and leishmaniasis

Print PDF

Leishmaniasis

Large leishmaniasis skin lesions on forearmLarge leishmaniasis skin lesions on forearm

Afghanistan has the highest prevalence of cutaneous leishmaniasis worldwide with approximately 13 million people at risk of the disease. As many as 17 000 new cases are reported in Kabul each year, representing 40% of the total annual incidence. Girls, women and children under the age of 15 represent 80% of the total number of confirmed cases annually in the country.

Leishmania, when not promptly treated, results in disfiguration and disability and a high social burden, resulting into stigma and marginalization, particularly among women. In Afghanistan cutaneous leishmaniasis extensively affects the poorest groups of the population. Although the diagnosis and treatment are free of charge, most of patients pay out of pocket up to US$ 200 for treatment leading to further impoverishment of leishmaniasis-affected patients.

Malaria

Afghanistan has the fourth largest malaria burden worldwide of any country outside of Africa and the second highest in the WHO Eastern Mediterranean Region with 63 districts in 12 provinces at high risk of malaria transmission. where 90% of both P. vivax and P. falciparum confirmed malaria cases reported. Rapid diagnostic testing is being piloted to diagnose malaria at community health posts, which will assist in reaching elimination targets for P. falciparum.

Cutaneous leishmaniasis is largely found among young girls, women and children who spend more time at home where the sandfly, transmitting Leishmania, hides and breeds.
The positive results achieved thanks to the partnership with Agence Française de Développement call for continuity and sustainable solutions; only when treatment is safe, affordable and available, can we expect patients to complete the necessary treatment and be cured.
Stigma and marginalization lead to misinformation about the nature of the disease and available measures to treat and cure patients.  More work needs to be conducted to raise awareness.
Leishmania can be cured if patients are treated promptly. Cost-effective treatment solutions need to be supported to make sure treatment is accessible to all.Lessons learned from the partnership with Agence Française de Développement help to guide the future directions of work at the national malaria and leishmaniasis control programme and WHO.
Leishmania, a disease of poverty,  poses a huge social burden in Afghanistan. When not treated in a timely way, the disease leaves  lesions and scars; sometimes preventing young girls from getting married. 
WHO is the only partner working in Afghanistan with the Ministry of Public Health to tackle leishmaniasis. WHO provides medicines to the Ministry of Public Health,  supports capacity-building and conducts health behaviour education.
Thanks to the partnership with Agence Française de Développement, WHO and the national malaria and leishmaniasis control programme have succeeded in expanding treatment for leishmaniasis among  difficult-to-access communities in Kandahar, Helmand, Nimroz and Kabul.
High-quality anti-Leishmania medicines are essential to stop the infection and transmission. Thanks to Agence Française de Développement, more than 20 000 treatment vials have been distributed in Kabul and the southern Region, curing more than 5000 patients a year.
Partnership with Agence Française de Développement made it possible to establish, for the first time, a new reporting system to provide information on treatment outcomes;  health workers can better follow-up treated, cured and relapsed patients.
Thanks to coordination with Agence Française de Développement, WHO and the national malaria and leishmaniasis control programme worked together to develop the first ever clinical guidelines for diagnosis and treatment of cutaneous and visceral leishmaniasis. This was a major step towards improving the quality of treatment service.
Visceral leishmaniasis, the deadly form of Leishmania, has been neglected for a long time. Improved surveillance and care service helped to increase by 50%  the number of visceral cases detected among children, in the southern Region and Kabul between 2010 and 2012.
Though the treatment for Leishmania is free of charge, many patients remain unaware of this right. Out-of-pocket expenses for full Leishmania treatment can reach up to US$ 200 in cities such as  Kabul and Kandahar.
Cutaneous leishmaniasis is largely found among young girls, women and children who spend more time at home where the sandfly, transmitting Leishmania, hides and breeds.Photo credit: Chris Black, WHO
01/12 
start stop bwd fwd

Logo of l'Agence Française de DéveloppementAfghanistan is the most endemic country in the world to be affected by Cutaneous Leishmaniasis: 20 provinces out of 34 are high risk of transmission. Kabul remains the world capital of CL, with over 10,000 new cases per year, hence 34% of the total annual incidence. Since 2009, the French Development Agency/Agence Francaise de Development (AFD) has been a key partner in supporting the efforts to prevent leishmaniasis, in Afghanistan, addressing the needs of curing Afghans from leishmania where most needed, namely in Kabul and Southern Region. This slide-show narrates how WHO, AFD and the National Malaria and Leishmania Control Program of Afghanistan (NMLCP) partnered together and made a change in the lives of the people bearing the health and social burden of leishmaniasis.