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Afghanistan Flash Update | COVID-19 | Strategic Situation Report No. 90 | 04 February 2021

Situation Overview: UPDATED

Global Update: According to John Hopkins University, the number of people worldwide who have died with COVID-19 is more than 2 million, with many regions still reporting surging numbers of new infections as part of a second and sometimes a third wave of the pandemic. The pandemic is affecting 192 countries with almost 104 million confirmed cases globally, as of 4 February. WHO reports that while the emergence of new virus variants is common, those with higher speed of transmission or potentially increased pathogenicity (i.e. the capacity of a microbe to cause damage in a host) are very concerning. Crucial investigations are underway to comprehensively understand the behaviour of the new virus mutation (B117) and steer the response accordingly.

MOPH Figures: As of 4 February, MoPH data shows that 55,256 people across all 34 provinces in Afghanistan are confirmed to have had COVID-19. Some 47,995 people have recovered, and 2,407 people have died – at least 87 of whom are healthcare workers. Only 258,011 people out of a population of 40.4 million have been tested. Afghanistan now has a test-positivity-rate – positive tests as a percentage of total tests – of 21 per cent, suggesting overall under-testing of potential cases. Due to limited public health resources and testing capacity, lack of people coming forward for testing, as well as the absence of a national death register, confirmed cases of and deaths from COVID-19 are likely to be under-reported. Stigma is considered a major factor in people choosing not to get tests and risk communications work is critical to turning this around.

A second wave of the COVID-19 pandemic was confirmed in November 2020 by the Ministry of Public Health. While three had been some signs the number of new cases was slowing in early January, MoPH tracking data has recently seen an uptick in cases, with an average of 45 cases a day between 27 January and 2 February. WHO Afghanistan remains concerned about mutations of the virus. WHO has sent recent COVID-19 samples for genomic sequencing to track for variants and confirm if the mutation is currently present in Afghanistan. WHO suspects this to be the case and reiterates that vigilance should be maintained.

Health Services: Hospitals and clinics continue to report challenges maintaining or expanding their facilities’ capacity to treat patients with COVID-19, as well as maintaining essential health services, especially in areas of active conflict. WHO stresses the need to balance the demands of responding directly to COVID-19, with simultaneously engaging in strategic planning and coordinated action to maintain essential health service delivery, mitigating against the risk of system collapse. Almost eight per cent of the total confirmed COVID-19 cases are among healthcare staff and they will be the highest priority when vaccines are available. Health facilities across the country continue to report shortfalls in PPE, medical supplies and equipment, further challenging their capacity to treat COVID-19 patients. There is an urgent need to ensure a continued distribution of medical and protective equipment to all corners of the country. While 15 laboratories are now operating in Afghanistan, the capacity of these facilities remains limited and stocks of supplies have periodically run out. National capacity for COVID-19 testing has topped 5,800 a day however these laboratories are not being fully utilised. Humanitarian partners urge the Government to ensure laboratories are appropriately equipped, staff receive timely remuneration and that procured supplies go to under-resourced health centres in a transparent manner so that life-saving support can be delivered to those most in need.

Vaccination: The Government of Afghanistan and the UN have initiated a number of steps to prepare for the rollout of a COVID-19 vaccine across the country, including the development of a National Vaccine Deployment Plan (NVDP). A technical working group comprised of government and UN organisations and chaired by the Ministry of Public Health has developed plans for vaccine operations, cold chain management, communication, surveillance, training and monitoring and evaluation/data, and will complement the existing Vice Presidential COVID-19 Task Force. So far, India has pledged to donate 500,000 doses (one person requires two doses to have a complete course) of its domestically-produced COVID-19 vaccine to Afghanistan which may arrive to the country as soon as the first half of this month. This vaccine is in the process of approval by WHO. Health workers will be prioritised to receive some 128,000 doses. Some 100,000 further doses have been earmarked for humanitarian caseloads through the COVAX facility, using funding from the World Bank and the Asian Development Bank, although details on how the logistics costs of distribution will be managed are still under discussion. Further discussions are also underway with China on potential donation of additional vaccines.

Humanitarian Needs and Response Planning: The revised Afghanistan Humanitarian Response Plan (HRP) for 2018-2021 identifies 18.4 million people in humanitarian need in 2021, as a result of COVID-19, ongoing conflict and natural disasters. Approximately six times the number of people are in need of humanitarian assistance in 2021 compared to four years ago when the multi-year HRP was first developed. The health and socio-economic impacts of the COVID-19 pandemic have seen the number of people in need almost double in the past year alone. Afghanistan now has the second highest number of people in emergency food insecurity in the world (5.5 million), while nearly one in two children under-five will face acute malnutrition in 2021.

Concurrently, cold winter conditions continue to cause suffering for Afghans in inadequate shelter and millions are struggling to keep themselves warm amid soaring poverty driven by the economic shock of COVID-19. The ICCT’s winterisation plan (a subset of the HRP) aims to reach 2.5m people over the winter months with a range of life-saving support including cash and in-kind heating assistance for households, warm clothes, seasonal food support, nutrition treatment, and health services for winter sickness. As of 15 January, some 30,000 families have been reached with ES-NFI winterisation support. While some $71.7m requirements have been committed by donors and the Government, a gap of $65.8m remains to be urgently mobilised to mitigate against winter suffering.

Against this backdrop, a medium to strong La Niña event is causing below average precipitation, thin snowpack and above average temperatures in most parts of the country and it is expected that farmers and pastoralists will be negatively affected. While details on the degree of impact on agricultural and hydrological environments is still being evaluated, ICCT has started on common planning around the dry spell, flooding  and other contextual factors that will influence the scale of humanitarian needs during the spring season. 

Operation(s)/ Webspace(s): 
United Nations Office for the Coordination of Humanitarian Affairs
World Health Organization
Original Publication Date: 
04 Feb 2021
Document type: 
Situation Report
Coordination hub(s): 
National Level Coordination