Afghanistan is in early stages of a HIV epidemic and the main route of transmission remains needle-sharing among injecting drug users (IDUs); however, other vulnerable population groups and risky health behaviour individuals remain at risk of infection. Recent data show high concentration of positive cases among IDUs, with a 7.2% prevalence rate across three urban centers in the country. Reports indicate 636 people living with HIV (PLHIV), while UNAIDS and WHO estimate between 1,000 to 2,000 PLHIV in the country: this, overall, calls for developing and implementing prevention measures for the individuals at risk of direct or indirect risk of transmission.
In Afghanistan several factors concur to the increasing risk of HIV epidemic, including economic, social, demographic and behavioral determinants that, if not addressed effectively, may fuel the spread of HIV. In responding to the challenge, the national strategic frame work for 2011-15 for HIV/AIDS prevention and control addresses three main priority areas: 1) preventing further progression of the HIV Epidemic among IDUs and their partners; 2) prisons interventions; and 3) addressing intersection of risky behaviors in order to reduce mortality and morbidity associated with HIV/AIDS.
In coordination with multiple international partners, the Government of Afghanistan has taken important steps in halting the epidemic, which is largely concentrated among key affected population groups, such as IDUs, prisoners, female sex workers (FSWs), and men who have sex with men (MSM).
WHO’s role Statistics
WHO has been working closely with the National AIDS Control Program (NACP) of MoPH since its establishment, in 2003. WHO provides technical and operational support to NACP to curb the HIV epidemic in the country, hence contributing to develop the National HIV Policy, National HIV/AIDS Strategic Framework 2011-15, ART and blood safety guidelines. Further, WHO supports the process to strengthen and expand the service quality care and support for people living with HIV.
According to the UNODC survey report in 2009 there are one million adult drug users in the country, which represents 8% of adult population aged between 15-64 years. The harm reduction services for IDUs has been initiated in the country, and WHO has been involved in the capacity building of national staff and advocating for the implementation of full package of harm reduction interventions including Oral Substitution Therapy (OST). WHO has recently conducted a qualitative assessment of OST pilot program in the country, whose results show OST is an effective and feasible HIV prevention intervention: this should be a lesson learnt to build upon for further scale up and programming, in coordination with NACP and other relevant partners.
Opportunities Challenges Achievements
- Supportive leadership
- Leverage donors’ support through GF and other HIV/AIDS –earmarked funding programs Limited availability of skilled healthcare workers
- Cultural barriers and stigma towards the disease First ART site established by WHO in 2009 at national level
- Developed comprehensive package of strategic and operational documents, including national HIV strategy, and treatment guidelines
Partners
WHO has been working in coordination with other implementing partners thorough HIV and AIDS Coordination Committee for Afghanistan (HACCA) and other thematic working groups within NACP. WHO is chairing the Joint UN Team on AIDS (JUNTA) to coordinate HIV related activities among various UN agencies. The World Health Organization is also the technical focal agency for UN Cares activities: this means WHO has been providing support to other UN agencies for sensitization of UN staff on HIV and ensuring the implementation of 10 minimum standards of UN cares in the workplace.
