World Health Organization Briefing
29 November 2001
The World Health Organization is concerned about the declining situation for the detection and control of tuberculosis in Afghanistan. The WHO is also concerned about the possibility of further emergence of drug-resistant strains of the disease.
Conditions are now ripe not only for spread, but for renewed illness. Tuberculosis is easily spread from person to person amongst those living in crowded, poorly ventilated conditions. However those who were previously infected, but never ill, are now at further risk. Dormant TB bacilli can spring back to life and cause serious illness when people are especially stressed – for example when they’re concerned about adequate food, shelter and warm clothing. Therefore adequate provision of humanitarian relief supplies can help minimize this risk of TB reinfection.
There are an estimated 60-70,000 new cases of tuberculosis every year in Afghanistan. The toll is especially high for women – who make up 70% of those infected. About 15,000 people die of the disease each year.
In the current situation new TB control drugs are not reaching those who may need them. But what could be worse, those who were following a treatment course may not be able to finish it, laying the foundation for drug-resistance.
The World Health Organization has circulated guidelines for the treatment of tuberculosis in emergencies to all regional staff in the country. However it has been difficult to determine whether those guidelines are being followed.
As with other areas of the health crisis, lack of trained personnel is a constant concern. A priority is to train health workers for detection and control of tuberculosis before the year’s end.
The WHO would also like to conduct a full assessment, to determine the areas where the situation has taken the greatest toll. The WHO will provide training and supplies to staff in the existing TB Control Centres and will continue to work in close collaboration with NGOs and local health authorities. The WHO would also like to integrate TB diagnostic facilities into existing hospitals.
Ideally, tuberculosis patients should be treated using the DOTS (Directly Observed Treatment Short-course) strategy. This is recommended when adequately trained supervisors, health workers and medicines are in place.
The WHO update from Herat:
The WHO medical officer reports there is a shortage of medicine in hospitals in the city. The most prevalent health problem is acute respiratory illness in Herat and in IDP camps. Three cases of rabies have been recently diagnosed, and one person has died from the disease. The WHO has been asked to provide anti-rabies vaccine.
Update from Faizabad and Takhar
WHO is providing medical supplies and medicines to 16 clinics, to the Faizabad public hospital and to IDPs in the area. WHO is working with the Swedish Committee for Afghanistan and MSF to support needs in the health facilities.
The WHO will also be supplying medical kits to Takhar.
Overall, health coordination meetings involving UN agencies, NGOs, other partners and local health authorities are continuing. WHO has been pleased to help lead recent meetings in many cities including in Herat, Faizabad, Kabul and tomorrow in Takhar.