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World Health Organization action in Afghanistan aims to control debilitating leishmaniasis

Girl with leishmaniasis. Jean-Marc Giboux/WHO
Jean-Marc Giboux/WHO

A rapid intervention by the World Health Organization and its partners, the Massoud Foundation and HealthNet International, in Kabul, Afghanistan, made possible by a donation from the Belgian government, should dramatically reduce the incidence of leishmaniasis in less than two years. Without immediate action, the current epidemic threatens to escalate into an uncontrollable situation. This emergency initiative aims not only to treat those currently affected in the acute phase of the epidemic, but to prevent further transmission of the disease.

Kabul is the largest centre of cutaneous leishmaniasis in the world, with an estimated 67,500 cases. The figure accounts for a third of the 200,000 cases in all of Afghanistan. Cutaneous leishmaniasis is a disabling disease transmitted by the bite of the sand fly. The disease leads to disfigurement usually on the face and hands, and social stigma, particularly for women and children. As an immediate measure, WHO and partners expect to begin distributing insecticide treated bednets soon to protect more than 30,000 people from sand flies.

"This is a unique opportunity to stop a debilitating disease in its tracks, and make gains in a country where people so deserve to see improvements to their health," says Dr Philippe Desjeux, head of WHO's leishmaniasis control programme. The initiative also reflects WHO's commitment to ensuring that diseases of neglected populations are addressed with a sense of urgency.

While effective control programmes for leishmaniasis once existed in Afghanistan, the past two decades of ongoing conflict has gravely weakened much of the health infrastructure. Environmental damage and poor sanitary conditions have resulted in the proliferation of sand flies' breeding sites. At the same time, the influx of large numbers of displaced people threatens to increase the disease's already epidemic levels. With little immunity to leishmaniasis, displaced people, or in this case, people returning from neighbouring Pakistan, are typically more susceptible to the disease.

"We must act now if we are going to have any chance of controlling the situation," says Desjeux.

To avert a sharp increase in cases, WHO and its partners are today launching an emergency initiative in Kabul that will include not only drug treatment, but the distribution of insecticide-treated nets. As in the past, the provision of first-line drugs has been secured by WHO in collaboration with Afghanistan's Ministry of Health. At the same time, 16 000 insecticide-treated bednets will be distributed throughout Kabul. These will help to protect nearly 30 000 people. As a result of a grant of €200 000 from the Belgian government, this immediate initiative is a timely intervention that aims to curtail the peak transmission season from September to October.

This rapid intervention is essentially the first phase in a one-year plan to implement a national leishmaniasis control programme. If the initial initiative is successful in Kabul, it will then be replicated in other parts of Afghanistan.

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For more information contact:

Maria Cheng
Telephone: +41 22 791 3982
E-mail: chengm@who.int