AFGHANISTAN: TB deaths halve but challenges remain – WHO

Kabul, January 7, 2008 (IRIN): The number of people dying from tuberculosis (TB) in Afghanistan has been going down by 50 percent over the past few months, thus saving the lives of at least 10,000 people on an annual basis, according to new statistics from the Ministry of Public Health (MoPH) and World Health Organization (WHO).

MoPH officials and Afghanistan's national human development report 2007 had previously reported that about 20,000 people every year (two TB patients every hour) were dying in the country.

"WHO estimates that now the number of TB cases resulting in death has declined to 10,000 annually," said Syed Karam Shah, a WHO official in charge of the TB control programme in Afghanistan.

Following decades of conflict, the health status of the Afghan people has seen "substantial improvements" over the past two years, according to assessments conducted by researchers from the Johns Hopkins Bloomberg School of Public Health and the Indian Institute of Health Management Research in July 2007.

Tuberculosis diagnosis and treatment is part of the Basic Package Health Services (BPHS), which Afghan officials say now reach over 80 percent of the country.

Over 103,000 TB cases were diagnosed and treated from 2001 to 2006, which not only saved the lives of over 67,900 patients but also reduced the chances of TB infection for over 500,000 other people, WHO said. The total number of health facilities providing TB diagnostic and treatment services has increased from 36 in 2001 to 991 to date.

WFP aid to TB patients

The UN World Food Programme (WFP) has also contributed to the fight against TB in Afghanistan through its mixed food aid for TB patients.

"WFP gives wheat and cooking oil to all TB patients which helps patients with food insecurity to recover quickly and effectively," said Yunus Ghanizada, a specialist at the national TB institute in Kabul.

Women particularly vulnerable

Despite marked progress, Afghanistan is still one of the 22 TB high-burden countries in the world where the disease is considered a major public health problem.

"WHO estimates that every year over 50,000 new cases of TB occur in Afghanistan," Karam Shah told IRIN on 7 January.

Afghan women make up about 67 percent of all TB patients in the country and are considered particularly vulnerable to TB infection due to their acute food insecurity, multiple pregnancies and a general lack of awareness about TB, public health specialists say.

Funding challenge

Funding is also a major challenge for the impoverished country to sustain its anti-TB efforts in the future.

From a requested US$12 million budget for TB control and treatment in 2007, the WHO received $2 million from international donors, according to WHO's Global Tuberculosis Control Report 2007.

"The whole TB control programme in Afghanistan is based on donors' support," said Karam Shah of WHO, adding that there were concerns about the "long-term" sustainability of donors' funding.

"Afghanistan will be able to eliminate TB by 2050 only if it is enabled to sustain its efforts in the long-term," he said.