At a time when global media attention is focused on the instability of Iraq, Afghanistan is quietly developing health-care policies that could have considerable positive impact on its 25 million inhabitants.

The editorial comments how remarkable progress has been made by a fledgling health administration with virtually no previous Governmental or health-policy experience. Recent progress is commented on: 'Advances have been made in both immediate service delivery and long-term policy planning. Outreach programmes have achieved successes not previously documented in complex emergencies.

For example, under the Taliban, measles claimed an estimated 30 000 lives a year in Afghanistan. A Ministry of Health campaign with donor technical support and funding visited mosques in 2002 and vaccinated 11 million children between the ages of 6 months and 12 years. 94% coverage was achieved nationally and epidemic transmission has stopped.'

Afghanistan's example is viewed by The Lancet as a potential model for other countries dealing with post-conflict circumstances, and concludes: 'Afghanistan's response to the steep health-care challenge has the potential to serve as a blueprint for the post-conflict reconstruction for other nations.

One of the most serious threats to progress would be an insistence by powerful nations that their aid is channelled outside the core strategy. Too often in such situations, powerful donors have been allowed to fund projects such as building of tertiary hospitals that generate high domestic political visibility but that drain resources away from more immediately needed services in the recipient nation.

We call on donors to focus financial health support on the package of services that Afghanistan has seen fi
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Contact: Joe Santangelo
j.santangelo@elsevier.com
212-633-3810
Lancet
11-Sep-2003