Prioritising communicable disease research in Afghanistan: an application of the Child Health and Nutrition Research Initiative (CHNRI) methodology

Introduction: Communicable disease control in Afghanistan has deteriorated amid growing fragility, health system disruption and declining international aid since the 2021 regime change. Outbreaks of measles, pertussis, pneumonia, cholera, malaria, dengue, Crimean-Congo haemorrhagic fever, tuberculosis and polio continue to plague the population in Afghanistan. This study addresses a critical evidence gap by systematically ranking research priorities for communicable diseases in Afghanistan. Methods: This study applied the Child Health and Nutrition Research Initiative (CHNRI) methodology, which is a widely used approach for systematic, transparent and collaborative research priority setting. It leverages expert consultation to generate, score and rank research questions. This study identified and invited 303 Afghanistan-health researchers, based globally, to complete the survey which consisted of 33 research questions related to communicable diseases that were submitted by 15 researchers. Results: This CHNRI exercise included 44 respondents, 63.6% of whom were of Afghan origin. The top 10 highest-ranked questions focused on identifying barriers to low measles and polio vaccination coverage, assessing disease burden by region and strategies to reduce the incidence of tuberculosis. Respondents of Afghan origin ranked antibiotic resistance and gender-related disparities in tuberculosis as the highest-priority questions. The majority of priority questions were description questions. Conclusions: Researchers, governments, donors, policy makers and programme implementers can use these findings as a starting point to strategically align research agendas, guide resource allocation, and prioritise evidence-based interventions for life-saving communicable disease prevention and control in Afghanistan.