In Afghanistan, tackling leishmaniasis—and narcotics

UN Chronicle, March-May, 2003

Decades of civil war in Afghanistan have destroyed much of its infrastructure. At the same time, neglected but treatable diseases have taken hold throughout this long history of conflict and defeated the efforts of doctors and clinics to bring them under control.

One of the most serious examples is leishmaniasis. Women and children are particularly affected. The disease is so widespread in some areas that it is known as "little sister" as it is almost a part of the family. However, in Kabul there is an opportunity to bring leishmaniasis under control and end the suffering of some 200,000 people there who are believed to be infected with this parasite. Due to their lower levels of resistance, returning refugees and other displaced persons are at a higher risk of infection. International staff working in Afghanistan also face a substantially higher risk.

The World Health Organization (WHO), together with the Government of Afghanistan and a number of international non-governmental organizations had launched an urgent appeal for funds to bring this serious outbreak under control. This is one case whereby a remarkably small amount of money could make an enormous difference.

"A little over $1 million is all we need to fund a two-year programme that would have a huge, long-term impact on this disfiguring disease once and for all", said Dr. Gro Harlem Brundtland, WHO Director-General. "But we need to act now: if this opportunity is missed, there will be a severe increase in the number of cases next year."

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The United Nations Office on Drugs and Crime is helping Afghanistan to break a decade-long dependence on opium-poppy cultivation. In close coordination with the transitional Government and the overall United Nations Assistance Mission in Afghanistan, the Office has been implementing a broad range of projects aimed at strengthening the country's drug control and crime prevention capacity. A progress report on ten of the projects was presented at a July 2002 meeting in Geneva.

"The United Nations and the international community in general have been very generous. However, ultimately, Afghan society needs to build its own institutions in order to beat the evil of drugs, crime and terror", the UN Office Executive Director Antonio Maria Costa said. in 1999, the country was the source of 70 per cent of global production of opiates--equivalent to over 450 tonnes of heroin. The 2002 production was estimated at 200 to 250 tonnes.

In Afghanistan, the UN Drug Control Programme is engaged in a wide spectrum of anti-drug activities, which include monitoring of illegal crops, with the UN Office on Drugs and Crime's Opium Poppy Survey being the world's most reliable estimate of the extent of narcotic cultivation in the country. The report also highlights projects to help the Government establish a judicial framework consistent with international law and to set up effective drug control and law enforcement agencies. The growing drug abuse in Afghanistan is emerging as a new problem and, for this reason, projects for demand reduction and narcotics prevention have been developed.

"Most importantly, farmers need to be helped to break the dependency on illegal crops. Therefore, the United Nations has adopted a long-term approach aimed at offering Afghan farmers sustainable agricultural alternatives to drug cultivation", Mr. Costa said. The Office also works with other international partners, assisting them to include the drug control element in their reconstruction and development projects. Similar initiatives have been undertaken in Iran, Pakistan and Central Asian countries. "Afghanistan's drug problem affects the entire region. We are working with all of Afghanistan's neighbouring countries to develop joint measures", Mr. Costa said.

The UN Office reopened in Kabul in February 2002. Its staff include programme officers and specialists running a broad range of projects, and about 100 people engaged in monitoring opium-poppy cultivation.