The Devastating Toll Of Covid-19 In Afghanistan

Afghanistan has faced a number of challenges in its fight against COVID-19. The country's healthcare system was already weak before the pandemic, and it has been further strained by the influx of Afghan refugees returning from neighbouring countries. As of March 25, 2020, there were 75 confirmed cases of COVID-19 across 12 provinces of Afghanistan, with a total of 37,000 cases and nearly 1,300 deaths as of August 7, 2020. However, the true number of cases is believed to be much higher due to limited testing and weak health systems. The pandemic has also exacerbated existing issues such as poverty and food insecurity, with many Afghans unable to afford basic necessities. Despite the challenges, the Afghan government has implemented various measures to control the spread of the virus, including restrictions on travel and gatherings, as well as the establishment of diagnostic centres and medical centres within them.

COVID-19 cases in Afghanistan are likely under-reported due to limited testing

Afghanistan's COVID-19 cases are likely under-reported due to limited testing. The country's first case was reported on 24 February 2020, in Herat province. As of March 2024, there have been 229,289 confirmed cases and 7,965 deaths, according to the World Health Organization (WHO). However, the actual number of cases and deaths is likely much higher due to limited testing and inadequate healthcare infrastructure.

Afghanistan has a shortage of healthcare workers and equipment, with only 9.4 skilled health professionals and 1.9 physicians per 10,000 people. The country also has a low testing rate, with less than 0.2% of the population tested as of June 2020. The lack of testing kits and medical supplies has forced many suspected cases into weeks of isolation, impacting the country's security forces and their ability to conduct operations.

The Afghan government has struggled to control the spread of the virus, with partial lockdown measures and ongoing internal conflict with the Taliban. Common people have largely ignored physical distancing recommendations, and cultural norms such as shaking hands and hugging continue to aggravate the crisis.

The true extent of the COVID-19 outbreak in Afghanistan is difficult to ascertain due to limited testing and under-reporting. However, it is clear that the country's healthcare system is overwhelmed and the situation is likely much worse than official figures suggest.

Afghanistan's health system was weak even before the pandemic

Afghanistan's healthcare system was already facing significant challenges prior to the COVID-19 pandemic, with limited infrastructure, inadequate facilities, insecurity, and ongoing conflicts. The country's healthcare system relies heavily on external aid, with 80% of its budget coming from international donors. However, even before the pandemic, there was a shortage of healthcare professionals, with only 9.4 health workers per 10,000 patients, compared to the WHO-recommended 22.8 workers.

The COVID-19 pandemic has exacerbated these existing issues and further strained the country's fragile healthcare system. Afghanistan has struggled to control the spread of the virus, particularly among internally displaced people, who often live in crowded camps with limited access to hygiene and healthcare services. The pandemic has also disrupted the economy, driving up food prices and putting people out of work, which has further worsened the situation.

The lack of financial resources and infrastructure has impacted the country's ability to test, diagnose, and treat COVID-19 patients effectively. There is a shortage of testing kits, personal protective equipment (PPE), and other medical supplies, and the limited number of healthcare facilities have been overwhelmed by the influx of patients. The low rate of testing and inadequate contact tracing have made it difficult to accurately assess the spread of the virus, and the true number of cases and deaths is likely much higher than official figures suggest.

The pandemic has also highlighted the disparities in access to healthcare between urban and rural areas, with a disproportionate distribution of physicians. Additionally, the pandemic has had a significant impact on women's access to healthcare, as restrictions on movement without a male companion have further limited their ability to seek medical care.

The combination of the pandemic, political instability, natural disasters, and the withdrawal of international support have pushed Afghanistan's healthcare system to the brink of collapse, and there are concerns that the situation could lead to a humanitarian catastrophe.

The pandemic has worsened the food and livelihood crisis in Afghanistan

Afghanistan has been facing a food crisis for years, with 90% of its population living below the poverty line. The COVID-19 pandemic has only worsened the situation, causing an economic downturn and driving up food prices.

The pandemic has had a devastating impact on Afghanistan's economy, with the country experiencing a 1.9% contraction in 2020. This has resulted in rising poverty levels, with the number of people living below the poverty line increasing from 41.6% to 45.5%. The loss of employment and reduced income due to the pandemic have left many Afghans unable to purchase sufficient food. The closure of borders and supply routes, as well as the disruption to trade and labour opportunities, have further exacerbated the food crisis.

The pandemic has also disrupted food production and supply chains. Afghanistan's agriculture sector, which accounts for a significant portion of the country's economy, has been severely impacted. Many farmers have lost access to their lands due to conflict and displacement, and those who remain have struggled with drought and irregular rainfall patterns, reducing crop yields. The pandemic has also limited the availability of labour, particularly affecting small and medium-sized farmers.

The impact of COVID-19 on the health system has further worsened the food crisis. The already fragile health infrastructure has been overwhelmed by the pandemic, and the lack of access to healthcare, especially in rural areas, has left many vulnerable. The limited testing and treatment capacities, as well as the shortage of healthcare workers, have resulted in a high number of untreated cases and deaths.

The combination of these factors has resulted in a significant increase in food insecurity, with around 10.9 million people estimated to be facing crisis or emergency levels of food insecurity during the early months of the pandemic. This has had severe consequences, with malnutrition and hunger affecting a large portion of the population.

The Afghan government and international organizations have implemented various measures to mitigate the impact of the pandemic on the food crisis. However, the complex context of Afghanistan, including conflict, displacement, and economic instability, has hindered their efforts.

As the pandemic continues to evolve, with new variants emerging and vaccination rates remaining low, the impact on the food and livelihood crisis in Afghanistan is likely to persist. The situation is further complicated by the ongoing conflict and the recent Taliban takeover, which has resulted in reduced monetary aid and increased economic instability.

Addressing the food and livelihood crisis in Afghanistan requires a multi-faceted approach that takes into account the complex interplay between health, economic, social, and political factors. It is crucial that the international community provides sustained support and that efforts to improve food security, strengthen the health system, and promote economic development are prioritized to alleviate the suffering of the Afghan people.

The Taliban has used the outbreak to strengthen its bargaining position

The Taliban has historically been known to disrupt public health and education efforts. However, the group has taken the threat of the Covid-19 pandemic seriously. They have emphasized the provision of public health services as part of a wider effort to reduce the spread of the virus and the number of fatalities.

In April 2020, the Taliban took concerted efforts to reduce the spread of Covid-19 in areas under its control. They declared a ceasefire, gave permission to health workers to enter their areas, executed awareness workshops on public health, gave out medical equipment to the public, and set up quarantine centers. The Taliban also implemented a new rule that Afghans returning from Iran, where the pandemic was proliferating, would need to serve a two-week mandatory quarantine in their homes.

The Taliban's response to the Covid-19 pandemic has been a stark contrast to other terrorist groups, including ISIS and al Qaeda, who have called Covid-19 a "divine retribution" and have used the opportunity to mount attacks and recruit new followers. The pandemic could be the moment where the Taliban transforms itself into a credible political force.

The Taliban's acceptance of the Covid-19 vaccine is a departure from its usual position against immunization programs. In the past, the Taliban issued fatwas against polio vaccination, targeted vaccine officials, and called it an American conspiracy aimed at sterilizing Muslims or a cover to target people. The Taliban's unexpected approach to tackling Covid-19 gave a ray of hope that it might pause its hostilities and cooperate to contain the pandemic.

The pandemic may end up giving the Taliban a moment of glory, both within Afghanistan and internationally. The group has been running a shadow government, parallel to the existing constitutional apparatuses, for almost two decades since its 2001 ouster by the US-led coalition following the 9/11 terror attacks. This "parallel underworld" of public health policy and strategic messaging is, for the first time, being used in conjunction with national and international efforts.

The scale of the crisis and the singular attention it is receiving across the world have given the Taliban an opportunity to project itself as a responsible and credible actor. With international legitimacy seemingly within the group's reach, the pandemic could be the moment where the Taliban transforms itself into a credible political force.

Afghanistan's health department is concerned about women's access to healthcare

Afghanistan's health department has expressed concern about women's access to healthcare, especially during the COVID-19 pandemic. The pandemic has exacerbated existing challenges faced by women in the country, including poverty, cultural norms, and a fragile healthcare system.

Even before the pandemic, women in Afghanistan faced significant barriers to accessing healthcare. Cultural and religious norms restrict women's mobility and interaction with male doctors. The requirement to have a male chaperone, known as a "mahram," when seeking healthcare creates additional obstacles, particularly for women without male relatives. This has led to a lack of access to reproductive and sexual health services, including prenatal and postnatal care, cancer treatment, and family planning. The World Health Organization (WHO) has also noted a shortage of female healthcare workers, with only 4.6 doctors, nurses, and midwives per 10,000 people as of May 2021.

The COVID-19 pandemic has further strained the country's healthcare system. Afghanistan relies heavily on foreign aid, but the withdrawal of US and NATO troops and the subsequent Taliban takeover led to a freeze in international funding. This has resulted in a shortage of medical equipment, supplies, and personnel. The pandemic has also disrupted food security and exacerbated poverty, with around 90% of Afghans living below the poverty line. This has made it even more difficult for women to access healthcare, as they often have to bear the cost of medical equipment and transportation.

The Taliban's restrictions on women's education and employment have further impacted their access to healthcare. With universities and schools closed for girls above the sixth grade in most provinces, there will be a shortage of female healthcare workers in the future. The Taliban's rules on gender segregation and travel restrictions have also made it difficult for female healthcare workers to practice and for women to seek treatment.

The health department's response to these concerns includes hiring more female staff and separating wards for women in hospitals. However, the effectiveness of these measures is yet to be seen, and the situation for women's access to healthcare in Afghanistan remains precarious.

Frequently asked questions