Leishmaniasis in Afghanistan
Afghanistan has had a turbulent history of conflict with almost constant war and instability over the past 39 years. In the most recent estimates by UNOCHA, 6.3 million people had been affected by the conflict in 2015 alone and the ongoing insecurity has since shown little sign of subsiding. Amongst the 2.7 million people whose health has been compromised as a result of the conflict, the neglected tropical disease, leishmaniasis, has emerged as a significant and growing social and economic challenge.
Leishmaniasis is a parasitic disease, spread by the sandfly, with a history of epidemics recorded across Afghanistan since the 1960s. These epidemics have been correlated to peak periods of violence, at their worst during the mid to late 1990s. Conflict creates the perfect conditions for sandfly breeding grounds, in the inevitable increase of rubble, domestic waste and poor sanitation, whilst vulnerable communities become more susceptible to contracting the disease. Furthermore, some 70% of Afghans live in chronic poverty and this poverty-related disease is now largely unopposed by the current lack of targeted interventions. The disease’s most resent resurgence in Kabul is demonstrative of this and shown in particularly sharp relief by living conditions in District 13.
MENTOR is currently the leading specialist in leishmaniasis control in conflict zones in the Middle East. It’s programmes cover an area populated by 5 million people in Northern Syria, providing protection services for almost 4 million and ensuring access to diagnosis, treatment and surveillance systems for all. Since initiating the programme in Syria with OFDA support, 2 and a 1/2 years ago, MENTOR’s interventions have dramatically cut disease transmission from 200,000 reported cases in 2013 to just 78,000 in 2015.
MENTOR’s primary aims for support on the ground
Kabul exhibits a concentration of risk factors which are further complicated by the ongoing conflict. MENTOR is looking to provide targeted disease control interventions in Kabul province, in particular Kabul city and surrounding villages, where many of the population live in informal settlements, swollen by growing numbers of internally displaced people. Leishmaniasis, in its character and epidemiology, in the urban and rural surrounds of Kabul province is very similar to Northern Syria. Immediate reduction in leishmaniasis transmission will be achieved through vector management strategies, capacity building of health workers and facilities, supported by social behaviour change communication.