Afghanistan has amongst the lowest life-expectancies in Asia, and its dysfunctional health system is exacerbated by years of conflict, its harsh climate and mountainous geography.
Up to a third of medicines used in Afghanistan are donated, with the vast bulk of the remainder distributed via the private sector. There are very few domestic manufacturers in the country, and much of the medicine supply is imported from neighbouring countries such as Pakistan, India and Iran. According to data held by UNCTAD, Afghanistan maintains a 2.5% tariff on all imported medicines, vaccines and active ingredients. Other sources state that the rate varies between 4 and 5%. VAT is levied at 2%.
Afghanistan's customs bureaucracy can lead to extremely lengthy delays for imported medicines. However, the lack of capacity for official enforcement means that the smuggling of pharmaceuticals is widespread.