16 August 2022 – Decades of conflict, displacement, disease outbreaks and natural disasters have taken a huge toll in Afghanistan, leaving more than half of the country’s population in need of humanitarian assistance.
Since August 2021, the impact of the economic crisis on basic services has worsened the situation for vulnerable people and weakened the health system’s ability to cope with multiple threats, including widespread malnutrition, a surge in measles cases, COVID-19, acute watery diarrhoea, natural disasters and the increasing need for trauma care and mental health support.
Despite the challenges, the World Health Organization (WHO) continues to deliver for the people of Afghanistan. Here are 12 ways WHO is working to save lives and support health.
1. Delivering life-saving medical supplies
The delivery of medical supplies is critical to keeping health facilities operational. Despite the abrupt closure of traditional air and land routes into Afghanistan in August 2021, WHO managed to deliver the first shipment of medical supplies to Afghanistan on 30 August 2021. WHO has sent 2122 metric tonnes of supplies since then, and continues to deploy additional resources based on needs.
These supplies save lives – from helping children recover from malnutrition to treating wounded patients and stocking the shelves of emergency rooms. Within hours of the June 2022 earthquake, WHO sent trauma and surgical kits, and medical and other emergency equipment, to treat the injured and replenish health supplies for hospitals in the affected provinces of Paktika, Khost and Paktia.
2. Supporting the health system
The Sehatmandi project was established in 2018 to expand access to health services across Afghanistan, in particular in remote and underserved areas. WHO was one of the key partners in the project, which improved basic health and essential hospital services in 2331 facilities and grew to become the backbone of the country’s health system.
In August 2021, funding for Sehatmandi was paused. The United Nations Central Emergency Response Fund (CERF) and the World Bank-managed Afghanistan Reconstruction Trust Fund (ARTF) provided WHO and UNICEF with funding to sustain health facilities previously covered by Sehatmandi until June 2022.
The Sehatmandi Project enabled WHO to support 1202 hospitals and health facilities in 34 provinces, reaching 30 million Afghans with health services, including 8.7 million women and 3.5 million children under 5 years old. More than 14 000 health workers’ salaries were paid, 35.4% of them are women. In areas where access to health care is limited, WHO currently supports 23 mobile health teams, reaching about 90 000 people per month.
The health system in Afghanistan is grappling with a significant exodus of health workers. WHO trained hundreds of health workers in a variety of health issues, from COVID-19 vaccination to basic emergency care to mental health support and risk communication.
WHO is advocating for long-term solutions to continue to support the health facilities that provide critical services to millions of Afghans.
3. Detecting and responding to disease outbreaks
Dangerously low vaccination rates in previously inaccessible areas, widespread lack of safe water and sanitation, and skyrocketing malnutrition are making disease outbreaks in Afghanistan more frequent and more deadly.
Detecting outbreaks early and responding quickly is critical. The Health Resources and Services Availability Monitoring System (HeRAMS) provides decision-makers with up-to-date information on the availability of essential health resources and services. In total, 3314 health facilities have been registered by 72 partners in HeRAMS. During 2021–2022, this system helped to detect outbreaks of measles, acute watery diarrhoea (AWD) and dengue, and response efforts are ongoing.
WHO and partners help detect and respond to disease outbreaks through regular coordination among stakeholders, supervision visits to the health facilities managing cases, and training surveillance officers and rapid response teams. Supplies and equipment have been provided for laboratory testing and case management. WHO and partners have also provided hygiene kits and soap, and have conducted AWD awareness campaigns and community dialogue sessions.
WHO is supporting 170 rapid response teams across all 34 provinces for outbreak investigation and response.
To keep partners informed about WHO’s work in outbreaks and emergencies, weekly information products are issued, including the WHO Afghanistan Situation Reports, WHO Afghanistan COVID-19 Weekly Epidemiological Bulletins and WHO Afghanistan Infectious Disease Outbreak Situation Reports
4. Responding to disasters and health emergencies
On 22 June 2022, a 5.9 magnitude earthquake struck the south-eastern region of Afghanistan, devastating Paktika and Khost provinces. WHO launched a comprehensive response that involved deploying mobile health teams and ambulances, trauma kits and medical supplies, and equipment. Onsite, eight ambulances and 20 mobile health teams provided by WHO helped transport victims from affected areas to the nearest hospitals. To scale-up the response, a new shipment of WHO health supplies for Afghanistan’s earthquake response was delivered to Kabul from Dubai hub on 28 June 2022.
WHO supported the implementation of mass casualty management plans in health facilities and deployed mental health and psychosocial support experts to provide emergency counselling to families affected by the earthquake. To protect people from malaria and other vector-borne diseases, WHO distributed 144 713 long-lasting insecticidal nets in earthquake-affected communities of Bermal, Gayan, Ziruk and Naka Districts in Paktika and Spera District in Khost.
WHO also works to respond to the health impact of flash flooding, cold weather during winter and scorching heat in the summer.
5. Leading health coordination and improving efficiency
WHO leads the humanitarian Health Cluster in Afghanistan, coordinating more than 50 organizations working in more than 390 locations. This leadership role helps increase the coordination, efficiency and overall impact of the health sector in preparing for and responding to disease outbreaks and public health emergencies.
During the response to the earthquake in Paktika and Khost, WHO and 21 Health Cluster partners immediately deployed support and continue to provide primary health care services, reaching more than 114 000 people.
6. Working to end polio
Afghanistan is one of two countries in the world where polio remains endemic. With only one child paralysed by wild poliovirus to date in 2022, compared to four in 2021 and 56 in 2020, we have an unprecedented opportunity to stop wild poliovirus.
Seven nationwide polio vaccination campaigns and one subnational campaign have taken place since November 2021. Of the 3.6 million children who had been inaccessible to the programme since 2018, 2.6 million were reached during the first three campaigns. By reaching even more during subsequent campaigns, the number of missed children has been reduced to 0.7 million. Sustained access to all children is essential to end polio for good.
Eight polio workers were tragically killed while carrying out their life-saving work on 24 February 2022. WHO condemned the attacks, and continues to advocate for the protection of health workers in Afghanistan and around the world.
7. Protecting children from vaccine-preventable diseases
The already low routine measles immunization coverage of 66% and a longer interval since the measles follow-up campaign in 2018 have resulted in a high number of children aged under 5 years old with no measles immunization.
In 2021 and 2022, WHO supported health authorities to manage vaccination, including by providing technical advice, logistical support, training staff, deploying supplies and covering costs for operations. In December 2021, a measles vaccination campaign was conducted in six high-risk provinces (Kandahar, Helmand, Ghazni, Ghor, Paktika and Balkh). In March 2022, the first phase of a measles vaccine campaign was conducted in 49 high-risk districts in 24 provinces. During this campaign, more than 1.3 million children aged 6–59 (half of them girls) were vaccinated in the targeted districts. The second phase of this campaign will be conducted in 85 high-risk districts in 25 provinces in late August 2022, targeting 1.5 million children aged 6–59 months.
A measles vaccination campaign was also conducted in seven earthquake-affected districts in Paktika and Khost provinces.
8. Tackling COVID-19
In addition to helping coordinate Afghanistan’s COVID-19 response, WHO is providing critical response supplies, facilitating extensive support to boost COVID-19 testing capacity, equipping treatment centres, strengthening surveillance capacities and helping accelerate vaccination efforts.
There are 40 WHO-supported COVID-19 laboratories across Afghanistan that can test almost 10 000 people per day. WHO is also supporting nine health facilities to take care of COVID-19 patients.
To date, 8.9 million people have been fully vaccinated against COVID-19, comprising 24.5% of the population.
Regular updates on the COVID-19 situation and response efforts in Afghanistan are published in the WHO Afghanistan COVID-19 Weekly Epidemiological Bulletins.
9. Strengthening trauma care and rehabilitation services
Due to the long history of conflict in Afghanistan, health facilities have had to provide extensive trauma care and rehabilitation services. WHO supports 132 critical trauma units and 67 blood banks across the country. WHO has also supported 60 ambulances for emergency services and helped health facilities develop contingency and mass casualty management plans and conduct simulation training exercises.
WHO condemns the series of recent attacks in Afghanistan and we send our sympathies to the families of those who died and are injured. WHO has deployed people and sent medicines, anaesthetics, blood bags and other medical and surgical supplies to save lives following explosions in Mazar and Kabul. Trauma care training is provided to frontline health workers on a regular basis, including the course on WHO Basic Emergency Care.
WHO is also providing operational support to physical rehabilitation centres in Kunar, Laghman and Paktya, and a trauma care unit at Spin Boldak District Hospital in Kandahar.
10. Responding to malnutrition
Afghanistan has the highest number of people experiencing emergency food insecurity in the world: 1 in 2 people do not know where their next meal is coming from, and 1 in 4 pregnant women and 1 in 2 children are malnourished. Malnutrition makes children especially vulnerable to disease and can cause long-term damage to a child’s growth, development and well-being.
WHO helps to support 123 inpatient departments for severe acute malnutrition (IPD-SAM) centres in Afghanistan. The centres support severely malnourished children that have developed medical complications which need hospitalization and special treatment. There are 307 health workers trained on IPD-SAM management and nutrition surveillance.
11. Scaling up support for mental health
Afghanistan lacks essential services for specialized mental health care across the country. There are no specialized mental health services in the provincial hospitals, and only four partially-functioning psychiatric units exist in the regional hospitals.
To help improve mental health care in Afghanistan, WHO continues to train health workers on basic mental health and has introduced the Mental Health Gap Action Program (mhGAP) to hundreds of medical doctors. Health workers are trained regularly on psychological first aid and stress management. WHO has so far trained more than 320 community health workers and community health supervisors across Afghanistan and has also provided critical health supplies to the national mental referral hospital and the drug addiction hospital.
12. Advocating for women and girls
Women and girls in Afghanistan have made significant health gains in recent decades. As a result of the collective work of many partners and thousands of health care workers, the number of women in Afghanistan dying in childbirth has reduced by 60% and child mortality has reduced by over 50%. Almost 70% of all women now have a chance of surviving to the age of 65, compared to only 54% two decades ago.
It is critical that these gains are maintained. WHO has been supporting maternity hospitals and health facilities providing maternal care across the country for many years, and continues to do so.
The health of women and children depends on the availability of women doctors, nurses and midwives. WHO is committed to working with partners to invest in the health education of girls and women, and continues to advocate for Afghan women to have full access to health and education.
WHO acknowledges the dedication and bravery of Afghan women health workers as they continue to work tirelessly to deliver health services in the midst of the challenging situation in the country.
WHO thanks our donors and partners for their support for health in Afghanistan. For more information on our donors, see the Afghanistan crisis donor page.
Read the latest updates on WHO’s response to the health crisis in Afghanistan.
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