Capacity, Key Accomplishments and Situational Analysis for NCDs in South Asian Countries(cont...)

Afghanistan

Capacity, Key Accomplishments, and Situational Analysis

The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) was signed in 2004 but little implementation has occurred. All cigarettes are imported. A cigarette tax has been brought in, although it is the lowest in the region (8 percent). Cigarette smuggling is an issue but it is unclear how substantial. In addition, the country faces a tremendous challenge with narcotics and illicit drug use.

In 2003, the National Security Alliance developed a National Drug Control Strategy to counter drug trafficking. In terms of tracking the burden, NCD surveillance has been very limited. Behavior risk factor data are not available with the exceptions of tobacco use among youth and mental health. There is currently no national NCD policy or strategy.

The agenda for new health projects is guided by the Millennium Development Goals (MDGs), which also orient donor funding, on which the Ministry of Public Health relies to a large extent. Maternal and child health (MCH),family planning, and communicable diseases have been the higher priority areas. Except for European Commission, none of the donor partners have prioritized NCD-related preventive or curative services in their programs.

The World Bank has completed a review of Mental Health and exploring options to implement mental health interventions. The World Bank has completed a review of Mental Health and exploring options to implement mental health interventions. Although supplies of essential drugs are included in the BHPS, the essential drug list lacks medications for prevention and treatment of several NCD conditions.

For example, the list has no hypoglycemic agent for diabetes or statins for high cholesterol. Also, the range of cardiovascular drugs is limited. Such drugs are not necessarily stocked at basic health units and can only be dispensed by a physician. As a result, access to NCD-related drugs remains a major issue even for people using public health care infrastructure.