Rapid responses are electronic comments to the editor. They enable our users
to debate issues raised in articles published on bmj.com. A rapid response
is first posted online. If you need the URL (web address) of an individual
response, simply click on the response headline and copy the URL from the
browser window. A proportion of responses will, after editing, be published
online and in the print journal as letters, which are indexed in PubMed.
Rapid responses are not indexed in PubMed and they are not journal articles.
The BMJ reserves the right to remove responses which are being
wilfully misrepresented as published articles or when it is brought to our
attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not
including references and author details. We will no longer post responses
that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
I commend Médecins Sans Frontières (MSF) for providing health care support to Afghanistan following the precipitous withdrawal of the US from Afghanistan in August 2021, and the transition to control by the Taliban regime (1). However, greater non-government organisation (NGO) activity is needed.
What will encourage NGO involvement? Since the takeover by the Taliban, the International Monetary Fund, the World Bank, and other international institutions have suspended hundreds of millions of dollars of financial aid to the country (2). The result is that NGOs do not have funds to continue and have shut their operations. What has happened to the $1 billion in funding that was pledged by the international community to Afghanistan at a UN conference in Geneva on 13th September 2021 (3)? International partners have to accept that they must work with the new government and reactivate these financial pledges, despite the risks of Taliban corruption. Additionally, NGOs should not be deterred by cynicism directed at the “humanitarian industry” by external agents, that they are simply seeking financial benefit. They should support Afghanistan anyway. For example, faith based humanitarian organisations (e.g. Caritas Australia, Buddhist Global Relief, Islamic Relief Australia, Anglican Overseas Aid), philanthropic foundations (e.g. Bill and Melinda Gates Foundation) and for-profit organisations providing philanthropy need to start contributing. Benefits to these NGO include linkages with governments and international organizations, making shareholders and staff value their corporations, and positive public images.
The benefits of greater NGO involvement to the people of Afghanistan will be immense. Historically, Afghanistan has demonstrated considerable health outcome success when provided with appropriate financial support. For example, the former Afghan government used previous financial support from international donors to contract NGOs (e.g. Mercy Ships, MSF, Islamic Relief Worldwide (4)) to deliver health care services within the country. These arrangements achieved remarkable success - life expectancy increased from 53 years to 63 years between 2007-2017, and under 5 mortality declined by 43% between 2010 to 2015 (5). Clearly Afghanistan is capable of managing their health care system through NGOs and local actors, when given the opportunity.
We hope the international community’s recent financial pledges to Afghanistan can be reopened enabling more NGOS - in addition to MSF - to provide health care services to preserve and extend the health gains of the last 20 years.
Re: The BMJ appeal 2021-22: MSF is working to ensure the people of Afghanistan have access to healthcare
Dear Editor
I commend Médecins Sans Frontières (MSF) for providing health care support to Afghanistan following the precipitous withdrawal of the US from Afghanistan in August 2021, and the transition to control by the Taliban regime (1). However, greater non-government organisation (NGO) activity is needed.
What will encourage NGO involvement? Since the takeover by the Taliban, the International Monetary Fund, the World Bank, and other international institutions have suspended hundreds of millions of dollars of financial aid to the country (2). The result is that NGOs do not have funds to continue and have shut their operations. What has happened to the $1 billion in funding that was pledged by the international community to Afghanistan at a UN conference in Geneva on 13th September 2021 (3)? International partners have to accept that they must work with the new government and reactivate these financial pledges, despite the risks of Taliban corruption. Additionally, NGOs should not be deterred by cynicism directed at the “humanitarian industry” by external agents, that they are simply seeking financial benefit. They should support Afghanistan anyway. For example, faith based humanitarian organisations (e.g. Caritas Australia, Buddhist Global Relief, Islamic Relief Australia, Anglican Overseas Aid), philanthropic foundations (e.g. Bill and Melinda Gates Foundation) and for-profit organisations providing philanthropy need to start contributing. Benefits to these NGO include linkages with governments and international organizations, making shareholders and staff value their corporations, and positive public images.
The benefits of greater NGO involvement to the people of Afghanistan will be immense. Historically, Afghanistan has demonstrated considerable health outcome success when provided with appropriate financial support. For example, the former Afghan government used previous financial support from international donors to contract NGOs (e.g. Mercy Ships, MSF, Islamic Relief Worldwide (4)) to deliver health care services within the country. These arrangements achieved remarkable success - life expectancy increased from 53 years to 63 years between 2007-2017, and under 5 mortality declined by 43% between 2010 to 2015 (5). Clearly Afghanistan is capable of managing their health care system through NGOs and local actors, when given the opportunity.
We hope the international community’s recent financial pledges to Afghanistan can be reopened enabling more NGOS - in addition to MSF - to provide health care services to preserve and extend the health gains of the last 20 years.
(1) Feinmann J The BMJ appeal 2021-22: MSF is working to ensure the people of Afghanistan have access to healthcare BMJ 2021;375:n29071 1st Dec 2021 https://www.bmj.com/content/375/bmj.n2907
(2) Editorial The Lancet Afghanistan: the international community must act Vol 398 November 20, 2021 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02535-6/fulltext?dgcid=raven_jbs_etoc_email
(3) United Nations $1 billion pledge a ‘quantum leap’ in commitment to Afghanistan: UN chief 2021 https://news.un.org/en/story/2021/09/1099782
(4) Devi S Aid agencies reassess need after Afghanistan takeover The Lancet 2021 398 10302 733-734 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01901-2/fulltext
(5) Samad D Naem AJ, Feroz F Afghanistan: health sector gains in peril The Lancet Sept 7 2021
Competing interests: No competing interests