Disease Early Warning System (DEWS)


  • Implementation period: October 2008 - June 2014
  • Project budget: $19.7 million

Communicable diseases account for 60 to 80 percent of all outpatient visits and more than half of all deaths in Afghanistan, making control of communicable diseases one of the highest priorities for the Ministry of Public Health (MoPH). In 2006, the World Health Organization (WHO) developed the Disease Early Warning System (DEWS) for Afghanistan to reduce morbidity and mortality through early detection and response to disease outbreaks. By monitoring sites in all 34 provinces, DEWS provides accurate and timely outbreak and seasonal trend data. Investigations result in quick action to mitigate disease outbreaks and prevent epidemics. DEWS also coordinates health surveillance in the field, disseminates public health information, and collaborates with the Polio Eradication Initiative and Expanded Program on Immunizations (EPI). Since July 2014, support for USAID’s support for DEWS has continued through the WHO polio grant.


  • Infectious Disease Monitoring: DEWS monitors 15 priority infectious diseases through selected sentinel sites (health facilities) operating in 34 provinces of the country and report weekly to the national surveillance directorate. 
  • Outbreak Investigations and Response: Outbreak alerts received from health facilities or communities are investigated by DEWS in coordination with related stakeholders.
  • Disease Control Coordination: Disease control meetings are held in every province. DEWS collaborates with various disease control programs at national and provincial levels.
  • Capacity Building: Provides training in surveillance, outbreak response and related fields to its staff and stakeholders.
  • Logistical Support: Stores and transports specimens at recommended temperatures to ensure that they arrive at the Central Public Health Laboratory in good condition.
  • Quality Control: Introduces internal standard operating procedures and external quality assurance measures to outbreak detection efforts.  Delivers viral specimens to research facilities in Egypt and Pakistan for confirmation.


  • Gradual expansion of the DEWS sentinel sites starting with 123 sentinel sites initially in 2007 and expanded to 387 by the end of June 2014. The percentage of timely submitted weekly reports from sentinel sites to national level is 99.6 percent.
  • As of June 2014, a total of 1,820 outbreaks were investigated and responded to in a timely fashion by DEWS. More than 98 percent of the outbreaks were investigated within 48 hours of the first notification.
  • In the last seven years, 57 MoPH personnel received training abroad, including 19 graduates of master’s programs. DEWS also supported in-country training on technical and programmatic aspects of DEWS for health personnel.
  • Cases of Q-fever and Crimean-Congo Hemorrhagic Fever (CCHF) were detected for the first time in Afghanistan through DEWS.
  • DEWS has developed and distributed treatment and prevention guide for various infectious diseases such as Brucellosis, CCHF, and Q-Fever.

Last updated: March 04, 2015

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