Afghanistan Flash Update | COVID-19 | Strategic Situation Report No. 93 | 25 March 2021
Afghanistan Flash Update | COVID-19 | Strategic Situation Report No. 93 | 25 March 2021
Global Update: According to John Hopkins University, more than 2.7 million people have now died with COVID-19 across the world. The pandemic is affecting 192 countries with more than 124 million confirmed cases globally, as of 25 March. 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.
Afghanistan: As of 25 March, MoPH data shows that 56,226 people across all 34 provinces in Afghanistan are confirmed to have had COVID-19. Some 49,802 people have recovered, and 2,467 people have died – at least 91 of whom are healthcare workers. Only 335,965 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 close to 17 per cent, suggesting overall under-testing of potential cases. The majority of recorded deaths were men between the ages of 50 and 79. Men account for almost 67 per cent of the total COVID-19 confirmed cases in the MoPH data, although this may be the result of over-representation of men in testing. 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 overall in Afghanistan. Stigma is considered a major factor in people choosing not to get tests and risk communications work is critical to turning this around. WHO warns that widespread complacency and failure to follow public health advice in Afghanistan is creating grave risks in the community with people generally not observing physical distancing or mask wearing protocols. WHO Afghanistan remains concerned about mutations of the virus. There is significant increase in cases in Pakistan with the new variant which is potential more infectious and affect younger population. The Ministry of Public Health is preparing contingencies for a potential third wave which included scaling up surveillance at the border and improving testing.
Almost 8 per cent of the total confirmed COVID-19 cases are among healthcare staff and they are currently the highest priority for vaccination. There is urgent need to ensure continued distribution of medical and protective equipment to all corners of the country. While 22 laboratories are now operating in Afghanistan – with plans to scale-up to at least one laboratory per province by June 2021 – the capacity of these facilities remains limited and stocks of supplies have periodically run out. National capacity for COVID-19 testing has reached 8,500 samples 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 first batch of COVID-19 vaccinations through the COVAX facility – consisting of 468,000 doses – arrived on 8 March. Afghanistan is the first country in central Asia to receive the vaccine via COVAX – a facility that is set to deliver at least 2 billion doses of COVID-19 vaccines globally by the end of 2021. To date, Afghanistan has received 968,000 doses of the vaccine – 468,000 from the COVAX facility and 500,000 directly from the government of India--enabling the vaccination of some 484,000 people. There remains some concern, however, around the perceived low demand among healthcare workers and the equitable access of vaccine among all Afghans.
Socio-economic impacts: The socio-economic impacts of COVID-19 have translated into a dramatic deterioration in food insecurity with levels now similar to those seen during the 2018 drought. An estimated 16.9 million people are now in crisis or emergency levels of food insecurity. The current climate outlook is also worrying with reduced precipitation and higher temperatures potentially affecting farmers and pastoralists, as well as water availability over the next few months. Food prices are already at elevated levels due to COVID-19 and are likely to increase further if the current weather patterns persist. According to WFP’s market monitoring, the average wheat flour price (low price and high price) increased by 12 per cent between 14 March 2020 and the second week of March 2021, while the cost of pulses, sugar, cooking oil and rice (low quality) increased by 26 per cent, 20 per cent, 58 per cent, and 21 per cent, respectively, over the same period. These price increases are accompanied by declining purchasing power for casual labourers and pastoralists – which has deteriorated by almost 19 per cent and 20 per cent, respectively (compared to 14 March 2020). These factors, combined with COVID-19 related interruptions to informal employment and decreased remittances, are driving people into crippling debt. Data from the 2020 Whole of Afghanistan Assessment showed that the primary reason for taking on this debt last year was to pay for food (53 per cent).
Teachers in schools and universities set to receive the COVAX COVID-19 vaccine - WHO
Withschools re-opening on 21 March, the Ministry of Public Health has prioritized teachers to receive the COVID-19 vaccine so that schools stay open, teachers stay safe and children keep learning.
COVAX – a coalition of partners including the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance, UNICEF and WHO – was created to ensure that as COVID-19 vaccines are rolled out around the world, the process is done fairly so that all countries, especially the poorest, receive vaccines and are better able to protect their most vulnerable populations.
COVAX has shipped 468,000 doses of the COVISHIELD vaccine from the AstraZeneca Serum Institute of India in Mumbai to Afghanistan. The delivery is part of a first wave of arrivals that will continue in the coming weeks and months.
The COVID-19 pandemic has wreaked havoc on the world and children have paid the highest price as school doors shut and students were denied their right to education and, in many cases, protection. Last year in Afghanistan, nationwide school closures disrupted the learning of almost 10 million children. The longer children remain out of school, the less likely they are to return.
Vaccinating teachers is a critical step towards making sure schools reopen, stay open, children return to class and lessons commence. “When schools closed last year, children’s worlds shrunk. Learning was lessened. Play was paused. Friendships faltered. And futures were compromised – we saw children forced into dangerous labour and girls into early marriage,” said Sheema Sen Gupta, Representative a.i, UNICEF Afghanistan. “Together, we’ll get Afghanistan’s children back to their books, their friends and their studies - the foundation of every strong nation.”
Last month the Government of Afghanistan received 500 000 doses of COVID-19 vaccine from India. These were administrated to frontline health workers, under the leadership of the Ministry of Public Health. “Ensuring the safety and health of our compatriots is one of our highest priorities. The COVID-19 vaccine being rolled out in Afghanistan has gone through rigorous reviews and testing and is safe for use, said Dr Wahid Majrooh, acting Minister of the Ministry of Public Health. “The start of the new academic year is due and the only way to assure the safety of teachers is through administering the vaccine,” he added.
“WHO is delighted that teachers are among the key priority groups being vaccinated. This will ensure students can safely return to schools and those whom they interact with could also be protected by extension. WHO is working closely with the MoPH to ensure that the vaccination for other priority groups could begin soon. To scale-up the efforts, 2,000 newly recruited vaccinators are planned for WHO supported training this month,” said Dr David Lai, WHO Officer in Charge.
Humanitarian Needs and Response Planning: The Afghanistan Humanitarian Response Plan (HRP) for 2018-2021 2020 Year End Monitoring Report was published on 17 March with partners reaching 11.7 million people in 2020, exceeding planned reach. Overall partners reached 4.68m people with COVID-19 specific support in 2020. Humanitarian needs driven and exacerbated by conflict, natural disasters and the multi-dimensional impact of the COVID-19 pandemic continue to affect millions of people in Afghanistan in 2021. While the immediate response to COVID-19 focused largely on the health and hygiene impacts of the pandemic, humanitarian partners quickly adjusted approaches to respond to the pandemic's secondary impacts on protection, food security and livelihoods, nutrition, and education. In response, partners have scaled-up their capacity to respond via new approaches that are more suited to operations within this demanding environment.
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.
Against this backdrop, the 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, as well as water availability. Recognising the multiple, overlapping challenges facing the people of Afghanistan as spring approaches – including low rainfall , intensifying conflict, and ongoing COVID-19 challenges – the ICCT conducted a multi-sectoral analysis of likely needs across highly-impacted provinces and has published a Spring Disaster Contingency Plan identifying the most urgent needs.
Contributions: The World Bank announced on 18 March that it has approved $60 million from the International Development Association (IDA) to help the Afghanistan Government purchase and deploy safe and effective COVID-19 vaccines and strengthen its national program to ensure quick and fair access to health services and vaccinations. The total additional financing of $113 million to Afghanistan's COVID-19 Emergency Response and Health Systems Preparedness Project also includes a $50 million grant from the Afghanistan Reconstruction Trust Fund (ARTF) and a $3 million grant from the Energy Sector Management Program (ESMAP). The funding package will help vaccinations reach more than 17 per cent of Afghans, improve essential medical services, and support Afghanistan's recovery from the pandemic. Afghanistan's overall COVID-19 vaccination efforts include an agreement with COVAX to vaccinate 20 percent of Afghans. Further support from the Asian Development Bank is expected to fund the purchase vaccines for an additional 11 per cent of the Afghan people. With the World Bank's additional financing package, funding will have been provided to purchase enough vaccines to cover almost half of the population of Afghanistan.
Border Crossings: The Milak (Nimroz) and Islam Qala-Dogharoon (Hirat) crossings with Iran are officially open to commercial traffic and movement of documented Afghanistan nationals. Since the start of this year, a historically significant influx of 163,527 people have returned to Afghanistan, sparking new concerns related to the transmission of COVID-19 variants and overall absorption capacity of existing health resources. A sharp drop in remittances to Afghanistan has also been observed as well as the negative socio-economic impacts linked to the return.
Afghanistan’s border with Pakistan at Spin Boldak officially opened on 21 August 2020 and at Torkham on 28 September 2020. As of 12 February 2021, Torkham gate will be open 6 days a week (Monday-Saturday). Sunday is closed for pedestrians but will remain open for transit (24/7). Previously, Torkham border crossing was only open four days a week.
Reports from Returnees: According to UNHCR’s latest border monitoring report (covering the month of February 2021), 38 per cent of returnees interviewed at the Islam Qala and Milak border crossing points and 20 per cent of returnees interviewed at the Torkham and Spin Boldak border crossing points said they faced problems during the COVID-19 outbreak in neighbouring countries, such as lost work/wages, discrimination/stigmatisation by local communities, lack of access to markets, pressure from authorities to return to Afghanistan, movement restrictions related to the lockdown, and lack of access to medical services. Close to 100 per cent of respondents returning from Iran and 56 per cent of respondents returning from Pakistan stated that they had received information about COVID-19 in the respective countries, mainly through TV, radio, religious leaders and local communities. This figure has slightly declined compared to January 2021 (57 per cent) and December 2020 (60 per cent).
Commercial domestic flights are operating. The United Nations Humanitarian Air Service (UNHAS) is flying domestically and has announced an increase in the frequency of flights to five days per week as of 14 February. UNHAS will continue to support any required evacuation and relocation flights during all days of the week.
International commercial air travel continues with Air Arabia, Ariana Airlines, Kam Air, Emirates Airlines and Turkish Airlines providing round-trip international flight services to/from Kabul. Turkish Airlines has resumed flights between Istanbul and Kabul with seven flights per week. Similarly, Turkish Airlines will carried out three flights per week to Mazar-e-Sharif. Given the potential for airlines to change their flight schedules, passengers are encouraged to check with their airline for the latest advisories.