Afghanistan and the development of alternative systems of animal health in the absence of effective government.

This case study describes the efforts by both non-governmental organisations and United Nations agencies to develop an alternative system for delivering animal health services in Afghanistan, during a period in which there was effectively no government. The authors examine the period from the mid-1980s to the year 2003. During this time, Afghanistan experienced war and severe civil unrest, resulting in the collapse of the veterinary infrastructure. As most trained animal health professionals had fled the country, an initial emphasis was placed on training intermediate and lower-level veterinary auxiliary personnel, as well as on the implementation of emergency treatment and vaccination campaigns. Gradually this programme has developed from an emergency-oriented approach to a more development-oriented process, resulting in a community-based system of animal health care in more than 250 districts (out of approximately 360). Some 500 paraveterinarians, trained for a period of five months, play a pivotal role in this programme, supported in outlying villages by trained vaccinators and basic veterinary workers. In this paper, the authors present an estimation of the impact of this programme. Essential elements of the programme are, as follows: ? the recruitment of trainees from areas where need has been identified ? an emphasis on practical and problem-oriented training ? the deployment of staff in so-called `veterinary field units?, supervised by more highly qualified staff and monitors ? a guaranteed supply of veterinary medicines, anthelmintics and vaccines ? a gradually increasing rate of cost recovery. The ultimate objective of the programme is to establish a self-sustaining system, based on the `user-pays? principle. The paper concludes by describing the present-day problems of the animal health infrastructure in Afghanistan. Not only must the new government try to regain its central position, it must also assimilate two decades of development in the veterinary sector, which has occurred largely outside governmental control.