Afghanistan's health system may be challenged but its influenza surveillance system continues to function systematically, not only for monitoring influenza but also for testing and reporting COVID-19.
In August 2021, Afghanistan's health care system was on the verge of collapse following regime change and a freeze on international funding. Some health facilities have shut down and programmes have been suspended. Many health workers have either quit or left the country, leaving fewer workers trying to urgently respond to emergencies. At the same time, COVID-19 continues to spread across the country, with insufficient resources available to bring it under control.
And yet, despite all these challenges, the country's influenza surveillance system continues to function. The National Influenza Centre and WHO's influenza team in Afghanistan successfully advocated the Ministry of Public Health for influenza surveillance activities to resume and today they continue to build on successes achieved during the COVID-19 pandemic.
This success in advocacy was the result of years of investment from the Pandemic Influenza Preparedness (PIP) Framework Partnership Contribution (PC). It is thanks to this investment that an influenza surveillance system was already up and running when COVID-19 hit Afghanistan in February 2020 and could be leveraged to support the country's pandemic response. The system was rooted in nine major hospitals across nine provinces, chosen for their geographical and population representativeness. At each hospital, a fully trained and skilled team had been developed and was ready to take virus samples from infected patients. And laboratories were equipped with the reagents and supplies they needed to perform differential diagnostic techniques for influenza.
The first sample of COVID-19 was collected at a PIP-supported influenza sentinel site and shipped to the national influenza centre for confirmation by polymerase chain reaction (PCR) test. Afghanistan is among the very few countries in the region using the integrated approach to surveillance promoted by GISRS+. Throughout the pandemic it has been testing and reporting for both influenza and SARS-CoV2 within its sentinel network.
Having a well-established surveillance system and being able to transfer knowledge and skills to put that system to a different use during a crisis is life-saving in countries like Afghanistan. It is a role model for the region from which other countries can replicate best practice.
