Afghanistan + 2 more

Afghanistan: COVID-19 Situation Report, 05 May 2020

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Key Advocacy Messages

  • Lockdown measures to control the spread of COVID-19 are exacerbating economic vulnerability of already impoverished households; exposing women and children to a heightened risk of exploitation and abuse; and increasing the likelihood of adoption of negative coping mechanisms, particularly in families where daily labour is the only source of income;

  • Religious leaders, respected elders and influential community members must be included in awareness raising campaigns to reduce violence against women and children, including abuse and gender-based violence resulting from the lockdown;

  • Dedicated efforts must be made to protect returnees from Iran and Pakistan (perceived COVID-19 hotspots) from stigmatization and discrimination, and to disseminate accurate information to dispel rumors on the cause, transmission and treatment of COVID-19.

Country Context

Afghanistan has been ravaged by four-decades of violent conflict and war, fracturing the social fabric of the country, destabilising development efforts and leaving the majority of citizens impoverished. Grievances between individuals, communities, tribes and political leaders are deep seated, multi-faceted and impact on all segments of society.

More than 4.1 million people are displaced and reside in urban and rural informal settlements, characterised by overcrowding, poor ventilation, and lack of access to safe water and sanitation facilities. Even for non-displaced people, dwellings tend to house large families with multiple members sharing sleeping space, and access to services in the community are limited or non-existent. Displacement, economic instability, lack of livelihood opportunities, and cultural norms force some individuals and families to adopt negative coping mechanisms to meet urgent needs.

Many Afghans experience physical and mental health issues; it is estimated that over half of the population suffer from depression, anxiety, or post-traumatic stress. Individual, cultural and structural barriers influence health seeking behaviour, ranging from poor knowledge about health and available services, to poverty, social exclusion, gender discrimination and the ongoing conflict. Violence against women, including murder, beating, mutilation, child marriage and the giving away of girls for dispute resolution remain widespread. Women’s access to health care and other protective services is limited in large parts of the country.

Through 2019-2020, all parties to the war violated international humanitarian law protections for medical care, including attacking hospitals and health workers, raiding medical facilities, and sporadically suspending security guarantees or access to organisations providing vital health services and vaccination programmes. Afghanistan is one of only three countries in the world where polio remains endemic.

On 29 February 2020, the U.S. and Taliban signed an agreement on a phased U.S. military withdrawal, including Taliban guarantees to sever ties with terrorist groups, and swift initiation of peace negotiations among Afghan parties to the war. Intra-Afghan negotiations are now required but are stalled by a government in paralysis – seven months after the 2019 elections, both incumbent President Ashraf Ghani and former Chief Executive Abdullah Abdullah both claim electoral victory. The seriousness of the situation is underlined by the US decision on 23 March to immediately reduce assistance by 1 billion USD for 2020. Given Afghanistan’s heavy reliance on donor funding, this may have severe consequences for the state’s fiscal viability and socio-economic outcomes across the country.

The Taliban have capitalised on this political instability and the more restrained US military position to recommence attacks on strategic rural areas. It is estimated that the government control only 33% of the country’s 398 districts. In addition to the effects of conflict, environmental shocks and climate change – droughts, floods and earthquakes – compound the fragility of the country and the capacity of humanitarians to respond. See the Humanitarian Needs Overview 2020 for further details.

COVID-19 Situation Overview

At the end of April 2020, there are close to 2,000 cases of COVID-19 in Afghanistan, including in areas with internally displaced persons (IDPs). One staff member of a partner organisation has contracted COVID-19, resulting in all staff ceasing field activities and quarantining for 14 days, and dependents of UNHCR staff also tested positive in one Sub-Office. Media reports suggest at least 40 staff members in the presidential palace have tested positive for the virus.

COVID-19 was first identified in Herat and Nimroz provinces (bordering Iran), brought into the country by Afghan returnees. The virus has spread to at least 33 of the 34 provinces of Afghanistan. According to IOM, between Jan 1-April 11, nearly 243,000 people crossed back into Afghanistan from Iran, tens of thousands also returned from Pakistan. Returnees are at high risk of stigmatization. The Iran border remains open, but fewer people are travelling due to lockdown restrictions. The border on the Pakistan side has opened for four days in April to allow for the return of Afghans stranded in Pakistan. Now two border points open twice a week for documented returnees to return to Afghanistan, although ad-hoc openings and closures are also in place. The establishment of quarantine camps at the border has been suggested by the authorities, but the humanitarian community has expressed its concerns should camps be set up, and the Afghanistan Protection Cluster (APC) contributed to the preparation of a Guidance Note on self-isolation in overcrowded setting. Meanwhile lockdowns have been imposed throughout the country in all provinces except one (Ghor) until 24 May 2020, but with difficulties in implementation.

COVID-19 poses grave dangers to the health of Afghans. Community transmission is expected to escalate due to the infeasibility of social distancing measures, particularly in overcrowded homes, IDP settlements, detention centres and prisons. Social distancing will be particularly challenging during Ramadan (April-May) when individuals visit mosques and homes en masse. Though many villages across the country are remote and isolated – which might initially serve a protective function – if the virus reaches them, very few healthcare options are available. This is problematic for both Afghanistan and the international community – risking turning Afghanistan into an incubator of the virus long after a vaccine is distributed, as is the case for almost-eradicated diseases like polio.

To help mitigate the health risks, and subsequent socio-economic consequences of the lockdowns, the UN has developed a response plan to support the efforts of the Afghan Government in responding to the pandemic. This will require funding of USD 108.1 million until 30 June. The government has emphasised the need to coordinate at the provincial level with governors, so UN and government plans align. The 3rd RA, in which the APC is included, is about to be launched to respond for the next three months.

Partial lockdowns of varying severity across the country are limiting movements of humanitarians. The Protection Cluster are undertaking advocacy at the highest level to maintain freedom of movement for humanitarian organizations, with some exemption letters being issued to partners requiring them. Overall, there is reduced partner presence on the ground, with essential staff teams working on a rotational basis. The humanitarian community does not support the establishment of camps to isolate people returning to Afghanistan. This is not in line with current Government of Afghanistan recommendations or global best practice and has proven an ineffective tool in other contexts.