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Afghanistan’s early measures to stem the spread of the coronavirus have yielded limited success. On February 24, the country reported its first confirmed case and three suspected cases—all patients in Herat province who had recently returned from Qom, the epicenter of the outbreak in neighboring Iran. Within days, the national government indefinitely closed all schools and banned public gatherings in the province. To enhance preparedness, the government also set up a high-level emergency coordination committee and various subcommittees tasked with raising public awareness and surveilling new cases.

Within a month of its first case, Afghanistan had not only confirmed cases in twelve of its thirty-four provinces, but also reported its first fatality, an individual with no history of foreign travel. Further, with just two laboratories—one in Kabul that could conduct over fifty tests per day and another that was recently established in Herat—limited testing capacity severely restricted the country’s ability to detect and contain cases. Faced with an impending crisis, on March 25, Afghan Minister of Public Health Ferozuddin Feroz stressed that if guidelines are ignored, “it is predicted that about 80 percent of Afghans will be infected with the coronavirus and about 70,000 will be hospitalized.”

Sharanya Rajiv
Sharanya Rajiv is a former senior program coordinator and research assistant at Carnegie India.

By early April, Afghanistan entered the community transmission phase. As of May 20, the coronavirus had spread to every province, with Afghanistan reporting 8,145 confirmed cases, and 187 deaths. Doubling down on its efforts to combat the disease, the Afghan government decentralized decisionmaking to empower governors to lead the coronavirus response. Kabul and Herat provinces were the first to enforce measured lockdowns in late March that restricted nonessential travel, limited the number of people who can travel together, imposed curfews, or closed parts of cities. While eighteen additional provinces instituted similar measures, many began to ease lockdowns around the start of Ramadan in April, although the national government had extended the nationwide lockdown through May 24.

With assistance from the World Health Organization (WHO), Afghanistan has quadrupled testing capacity. Currently, nine laboratories are operational, with plans for an additional eleven. Nevertheless, with only around 22,600 samples tested through May 14, coronavirus diagnostics remain limited. Limited lab capacity is exacerbated by a shortage of reagents and RNA extraction kits that persists despite international assistance.

Beyond testing, Afghanistan’s crisis is compounded by several other factors. First, protracted conflict has left a fragile healthcare system plagued by shortages of resources and health professionals, especially in rural areas. Second, cases of people escaping from quarantine facilities indicate low public awareness and lack of trust in the public health system. Finally, the government’s response is constrained by continuing conflict, a fragile political order, and largely open borders with Pakistan and Iran, through which returning migrants have poured in. While Afghanistan is making efforts to tackle the public health crisis, its limited resources, security situation, and political fragmentation present serious challenges.

Sharanya Rajiv is a former senior program coordinator and research assistant at Carnegie India.

 

Interview with David Loyn, Senior Visiting Research Fellow, War Studies Department, King’s College, London

How does Afghanistan perceive the role of international institutions in combating this pandemic?

The WHO has set up new testing laboratories and training programs in Afghanistan with particular support from the EU and USAID. U.S. military forces are the only entity with significant air transport capacity, which they are using to move emergency supplies around the country. A prolonged drought has led to significant food shortages, which are worsened by the lockdown and its associated increase in poverty, so there will be further calls for food aid by the World Food Program. Major humanitarian organizations in the International Committee of the Red Cross and the UN families have a substantial footprint in Afghanistan and are bound to scale up their programs accordingly—despite a fractious relationship with the government of President Ashraf Ghani in recent years. The UN Assistance Mission in Afghanistan has a new head—Deborah Lyons, the former Canadian ambassador to Afghanistan—who is likely to play a more activist role than her predecessor, the long-serving Tadamichi Yamamoto.

Given that South Asia is the most densely populated region in the world, what are the opportunities and challenges for the South Asian Association for Regional Cooperation (SAARC) amid this pandemic?

Afghanistan’s long border with Iran represents one of the key routes for infection into South Asia. Tens of thousands of Afghan refugees who had made their home in Iran have returned to Afghanistan since Iran became an early hotspot for the virus, putting more pressure on weak health systems. Iran has shown little global solidarity in managing the crisis, disguising its own losses and failing to disclose information, and the early lifting of its lockdown has sparked fears of a second spike.

Within SAARC, India’s delivery of hydroxychloroquine to Afghanistan and offer of medical support teams represent positive signs of regional cooperation. In contrast, there has been little cross-border cooperation with Pakistan, although a recent dispute over border crossings was quickly resolved between Ghani and Pakistan’s Chief of Army Staff, General Qamar Bajwa. The likelihood at this western edge of the SAARC region is that the pandemic will reduce the capacity of Afghanistan to seek cooperation from its regional neighbors. Since Afghanistan links South and Central Asia, this could be one of the worst strategic consequences of the crisis.

Given Afghanistan’s reliance on international aid, vast informal economy, and labor migration to neighboring countries, what are the implications of the coronavirus-induced global economic crisis?

As one of the most fragile economies in the world, Afghanistan faces a serious threat from the global slowdown. Aid fatigue from donor nations was already evident in 2014 following the steep reduction at a moment of political and security transition. A further hit this year will have profound implications for security. In the past, periods of poverty have made it easier for the Taliban to recruit. The threat of infection from the new virus is not being taken seriously in the Afghan countryside, where extended families living in close proximity would find social distancing hard. In the south, the poppy harvest is now in full swing and will not stop for a lockdown imposed by Kabul.

How will the coronavirus pandemic affect the peace process in Afghanistan?

The most obvious impact on prospects for peace is the loss of trust that could be built up in face-to-face contacts. When peace processes have worked in the past, they have always required leaps of faith, which only come through building personal trust—the lubricating oil necessary to build a workable negotiation with an enduring outcome.

It has taken the Ghani government some time to build a negotiating position after being sidelined by the United States, which negotiated its withdrawal with the Taliban. The recent appointment of the highly experienced former minister Masoom Stanekzai as the chief negotiator is a positive sign, although the appointment of Abdullah Abdullah, former chief executive of Afghanistan’s national unity government, to oversee the process as part of a power-sharing deal could slow things down. The process has inevitably become bogged down over prisoner exchanges, demanded by the United States as a confidence-building step in its deal with the Taliban. To avoid mass casualties in jails from COVID-19, the disease caused by the coronavirus, separate agreements have been reached in the meantime to release more than 60 percent of all prisoners.

Amid continued political fragmentation and in the absence of a nationwide ceasefire, how can Afghanistan bolster its response to the pandemic?

The Taliban tried to win public support by filming themselves in masks and gowns telling people to self-isolate. However, there has been no letup in the fighting on either side, which would be the best scenario for Afghan public health. The Taliban’s response to Ghani’s call for a ceasefire was to blame international and Afghan government forces for increasing levels of violence that supposedly forced them to respond.

It took two months and a cut of $1 billion in aid by the United States to force a political compromise after parallel presidential inaugurations at the beginning of March by both the leading candidates in the Afghan election. Abdullah won 50 percent of the posts available for appointment—again curtailing Ghani’s ability to run his own government. The end of the stalemate will mean that the government can now focus on the pandemic as well as other urgent business.

One advantage of the lockdown in cities is that it was impossible for the armed gangs who were gathering in support of Abdullah to make trouble, so the negotiations were not carried out against the specific threat of violence.