In the past two decades, despite ongoing war, international development assistance and funding, channelled through Afghanistan's Ministry of Public Health, expanded access to primary care, improved government hospitals, and trained thousands of health-care providers in Afghanistan, especially women. Accompanying technical assistance strengthened the capacity of Afghanistan's Ministry of Public Health to develop policy, design requirements for and oversee services provided by international and national non-governmental organisations (NGOs), and initiate surveillance, monitoring, and evaluation systems. ¹ 
Although progress was uneven, expanded access to higher quality care saved many lives. ¹ 
In some areas, primary health care became well enough established that in the years before the 2021 fall of Afghanistan's previous government the Taliban appointed liaisons to provincial health programmes in areas they controlled. Despite the clinics' affiliation with the former government, the Taliban engaged with managers on such issues as who was hired, which geographical areas were covered, and what health services were offered; although the Taliban used threats and coercion to influence decisions, their violent attacks on clinics and hospitals decreased. ² 
Afghanistan's health system remained fragile, however, and was largely reliant on donor funding and NGO implementation.