Since 2018, HealthNet TPO has been working with the support of the UNDP to create a tuberculosis (TB)-free Afghanistan, reducing deaths by 75% by the end of 2025. Nowadays, this disease is slowly being stemmed thanks to increased screenings, early treatment and laboratory diagnostics.

TB has far-reaching consequences on the lives of the people it afflicts that go far beyond mere physical symptoms. An estimated 73,000 people lived with TB in 2019 in Afghanistan (the latest estimated figures by the WHO), and the additional psychological burdens and social stigma that come hand-in-hand with it. 

TB has a three-pronged effect to the people who catch this deadly air-born infection – physical, psychological and social. The infection is inhaled into the lungs causing coughing, chest pain and weight loss. From here it can spread to many parts of the body, including the kidney, spine and thyroid. The neurological influence of TB causes depression in many people who contract the disease. Consequently, the physical component biologically creates psychological implications. Lastly, the social stigma associated with TB severely affects the lives of people living with the disease. TB is still widely misunderstood and people face discrimination within their communities. 

For these unavoidable implications, integrating mental health support within our health interventions is a vital component of our work to support the psychological effects of the disease as well as community engagement to improve detection, dispel harmful myths and reduce stigma.

With the arrival of Covid-19, many diseases have taken a back seat. After improvements in TB treatment and prevention in Afghanistan, in 2020 alone, the first year of the COVID-19 pandemic, the Ministry of Public Health of Afghanistan reported 50,000 new tuberculosis cases with 10,000 deaths.

Worldwide, tuberculosis deaths increased for the first time since 2005, from 1.2 million in 2019 to 1.3 million in 2020, showing that this terrible trend is unfortunately not just a reality in Afghanistan. 

With the constant work of people on the ground, however, the campaigns for the prevention and treatment of TB continue. However, the situation remains difficult for both health workers and patients and a TB-free future in Afghanistan is still far off.

Abdul Nasir, Herat Province, Afghanistan

It's morning. Abdul Nasir wears local clothes and sits calmly and attentively in front of his house. It is a simple house, made of mud and with few facilities. Abdul shares it with his wife and four children, two boys and two girls.

A year ago, a new chapter began in Abdul Nasir's life. Suddenly, he started suffering from a productive cough and great fatigue. Even doctors could not improve his health and Abdul Nasir slowly began to get weaker and weaker, lose weight, and finally lose his job. The physical stress of the illness added to the mental stress of providing for his family. 

One day, Abdul Nasir came across an active screening for tuberculosis inside the IDP camp, where two screening focal points were educating people about TB symptoms. Recognising the symptoms from his own complaints, Abdul Nasir quickly collected his spit in one cup that evening and one the next morning before breakfast and sent it off for analysis with the screeners. One day was enough to confirm the results: it was tuberculosis.

Abdul Nasir immediately started treatment for two months with four different TB drugs. Given the slow diagnosis, the disease is entrenched, and it took another four months of treatment to eradicate it. Six months after the diagnosis, Abdul Nasir received the results of his sputum and could finally call himself cured. It was a difficult few months for Abdul Nasir: the disease took away his job and estranged him from his family for six months, who fortunately tested negative in TB tests and had to be protected from the disease.

Now, Abdul Nasir is happy to be cured but suffers thinking about the time it took him to realise he was suffering from TB. He does not know what might have happened if it had not been for HealthNet TPO's itinerant screeners. However, Abdul Nasir feels lucky: TB can be treated in Afghanistan, and thanks to HNTPO and other organisations working on the ground, it can be treated free of charge. Unfortunately, although he is living proof that this disease can be cured, TB is still highly stigmatised and people who suffer from it are excluded from society.

Life is slowly restarting for Abdul Nasir, he feels strong again and is ready to return to work. After feeling discriminated against, Abdul Nasir knows the symptoms of the disease and feels he must advocate for people to be tested and cured before it is too late. Abdul Nasir's dream for the future? That HNTPO will eradicate this disease and that the nation will soon be tuberculosis-free.