HIV/ AIDS /STI Control Program  
Ministry of Health, Afghanistan  
By: Naqibullah Safi MD, MPH, NACP Manager, MoH

Introduction/ Background 

In late 1980s a blood screening lab. for HIV infection, has been sat up in the Central Blood Bank.

Except blood screening in very limited number of health facilities, there were no any other HIV/ AIDS control and prevention activities in Afghanistan until recent years.

In early 1990s some NGOs started awareness raising activities on HIV/ AIDS , with Afghan refugees in Pakistan.

Since 2002, some NGOs moved from Pakistan inside Afghanistan and started working with some of the vulnerable groups e.g Drug addicts, youth.

Intro …continue  

Only six cases have been diagnosed since late 1980s until end of 2002.

HIV/ AIDS has not been a priority for the MoH.

HIV/ AIDS is still not a top priority for the MoH.  

HIV/ AIDS Situation in Afghanistan  

Since January 2003, seven HIV positive cases have been diagnosed through blood screening in the blood bank facilities (exist only in 11 out of 33 provinces).

During 2003, in ICRC supported facilities, 6 VDRL positive cases have been diagnosed.

In ICRC supported health facilities (6 hospital) from January until April 2003, 335 cases of Hepatitis B and 30 cases of Hepatitis C have been diagnosed.

Response to HIV/ AIDS in Afghanistan  

MoH recognized the need for a national HIV/ AIDS control program.

HIV/ AIDS Technical Working Group has been established in May 2002.

NACP has been officially founded in June 2003.

A proposal for funding has been submitted to the Global Fund, ask funding for the following three areas of intervention:

Provision of safe blood for transfusion

Raising awareness of youth and general public

Targeting high risk behavior groups e.g. IDUs and CSWs

First assessment has been conducted, in order to collect the existing information and data, and identify major players in the field of HIV/ AIDS /STI control.

NGOs working with drug addicts, having drug demand reduction and health education programs.  

Response continue  

IEC material developed by different NGOs, but still are very limited and not widely available.

First draft of a five years strategic plan for HIV/ AIDS /STI control has been developed and widely shared with partners. The following are the objectives of the plan:

To expand the knowledge base in order to facilitate planning, implementation and evaluation of STI/HIV/ AIDS programmes.

To ensure an effective, well co-ordinated and sustainable multi-sectoral response to HIV/ AIDS in Afghanistan .

To reduce risk of HIV infection among vulnerable and high risk groups.

To reduce vulnerability of young people to HIV/ AIDS

Response continue  

To reduce the risk of infection amongst the general population through an increase in awareness levels.

To reduce prevalence and prevent transmission of sexually transmitted infections [STIs] both as an important public health issue in its own right and as part of the effort to reduce HIV transmission.

To reduce the risk of transmission of HIV and other blood borne infections through blood transfusion.

To improve quality of life for people living with HIV/ AIDS through the provision of quality care and support.  

Next steps  

After wide sharing of the NSP, incorporating the comments, arranging a national consultative meeting for finalization of the NSP.

In light of this NSP, developing a detailed annual action plan for HIV/ AIDS /STI program.

Starting the implementation of the plan with pilot projects.

Advocacy at different levels (policy makers, religious leaders, implementers, communities etc.).

Setting up a sentinel site surveillance system.  

Discussion and conclusion  

The available information does not represent a countrywide prevalence of HIV/ AIDS /STI.

The data suggest that there are much more undiagnosed HIV positive cases in the country.

Increasing IDU, unsafe injection practice and low level of awareness are key risk factors.

Proper steps for establishing a quality HIV/ AIDS /STI program have been put.