1. Progress and challenges towards malaria
control in Afghanistan
Najibullah Safi, MD, MSc. HPM, DMPPM
NPO/PHC, WHO – Afghanistan

2. Presentation outline
• Introduction
• Malaria risk in Afghanistan
• Malaria control
• Challenges
• Prospects for malaria control and elimination
April 7/2013 Scientific Seminar on Malaria Control 2

3. Introduction
• Malaria transmission mostly occurred at the altitude
of less 2000m above the sea level
• In Afghanistan, transmission of malaria is relatively
low and unstable
• Almost half of the population live in malaria endemic
areas
• Main species PV (95%) & PF (5%)
• Malaria control remain a challenge despite
significant resource allocation
April 7/2013 Scientific Seminar on Malaria Control 3

4. Risk of malaria transmission in Afghanistan
April 7/2013 Scientific Seminar on Malaria Control 4

5. Malaria control
• Public Sector:
– Basic Package of Health Services (BPHS)
– Health post
– Sub-center Clinical Malaria
– Basic health center
– Comprehensive health center Confirmed Malaria
– District hospital
– Essential Package of Hospital Services (EPHS)
• Private sector
April 7/2013 Scientific Seminar on Malaria Control 5

6. Malaria control cont.
• Integrated approach for malaria control through
general health services which includes:
– Prompt and effective diagnosis and treatment
– Integrated vector control
– Surveillance (HMIS & DEWS) and control of epidemics
– Information, Education and Communication
– Health system strengthening and capacity building
April 7/2013 Scientific Seminar on Malaria Control 6

7. Trend of Vivax malaria 2002-2012
April 7/2013 Scientific Seminar on Malaria Control 7

8. Trend of Falciparum malaria 2002-2012
April 7/2013 Scientific Seminar on Malaria Control 8

9. Confirmed Vs. Clinical malaria 2002-2012
April 7/2013 Scientific Seminar on Malaria Control 9

10. Factors contributed to malaria control
• Financial support from Global Fund and other Donors
• Close collaboration and support from partners
• Political commitment
April 7/2013 Scientific Seminar on Malaria Control 10

11. Key challenges
• Service delivery (diagnosis and treatment)
• Vector control
• Issues related to health system
– Lack of motivation
– Coordination among stakeholders
– Absence of lab facility in BHC
– Unregulated private sector & wide practice of self medication
• Poor absorption capacity and bureaucratic procedures
• Poor cross border collaboration
• Sustainability of the program
• Scio-political stability
April 7/2013 Scientific Seminar on Malaria Control 11

12. Prospect for malaria control and elimination
• The prospect for continued effectiveness in malaria control
and elimination is far from assured although effective tools
exist to perform the task
April 7/2013 Scientific Seminar on Malaria Control 12

13. April 7/2013 Scientific Seminar on Malaria Control 13