OVERVIEW

Afghanistan is one of 22 countries with a high burden for tuberculosis (TB) globally, with an estimated 56,000 new TB cases each year.

Since 2008 USAID has trained health workers on TB case detection, diagnosis and treatment. Building on this foundation, the Challenge TB program improves TB control in Afghanistan by increasing case detection, improving treatment, and strengthening the Ministry of Public Health’s ability to coordinate and direct TB activities.

A main focus of the project is to expand the application of Directly Observed Therapy and short-course (DOTS) therapy. This internationally-recognized approach entails a medically trained individual directly observing the TB patient as they take their medicine and incorporates strong patient monitoring protocols. Close monitoring and therapy ensures patients take their medication, as well as feel more comfortable completing lengthy treatment regimens. This is critical to treating and curing TB and preventing strains of drug-resistant TB from emerging.

The project also seeks to improve management in Afghanistan’s National Tuberculosis Control Program (ANTP).

ACTIVITIES

• Scale up Urban DOTS: Implement an innovative urban model for TB therapy and observation in key cities across Afghanistan.
• Scale up community-based DOTS: Expand the community-based TB therapy and observation approach in focus areas across Afghanistan.
• Strengthen TB activities in the basic package of health services: Support the comprehensive implementation of TB detection and treatment within the basic package of health services, which provides health services in clinics and communities across the country.
• Strengthen the health system: Strengthen the capacity of the ANTP to monitor, coordinate, and oversee the implementation of TB activities throughout Afghanistan.

ACCOMPLISHMENTS

• Expanded existing TB services and Urban DOTS coverage in Kabul city and scaled up this model to include Mazar-i-Sharif, Herat, Kandahar, and Jalalabad private and public health facilities.
• Integrated TB tracking information into the Ministry of Public Health’s information system.
• Developed and disseminated TB national guidelines and standard operating procedures for treatment, infection control, and TB among children to health facilities and staff of 15 provinces (Badakhshan, Baghlan, Bamyan, Faryab, Ghazni, Herat, Jawzjan, Kabul, Kandahar, Khost, Paktika, Paktiya, Takhar, Nangarhar, and Balkh).