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Afghanistan: Strategic Situation Report: COVID-19, No. 91 (25 February 2021)

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Situation Overview: UPDATED

Global Update: According to John Hopkins University, close to 2.5 million people have now died with COVID-19. The pandemic is affecting 192 countries with more than 112 million confirmed cases globally, as of 25 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 25 February, MoPH data shows that 55,693 people across all 34 provinces in Afghanistan are confirmed to have had COVID-19. Some 49,281 people have recovered, and 2,441 people have died – at least 91 of whom are healthcare workers. Only 293,649 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 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. 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 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 and suspects that it is currently present in Afghanistan, making preventative measures even more important.

Almost 8 per cent of the total confirmed COVID-19 cases are among healthcare staff and they will be 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 Government of Afghanistan and the UN have initiated a number of steps to prepare for the rollout of COVID-19 vaccines 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 MoPH 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. On 7 February, Afghanistan received 500,000 doses (one person requires two doses to have a complete course) of AstraZeneca’s COVID-19 vaccine from India - the first vaccine supplies Afghanistan has received to date. The vaccination campaign was launched on Tuesday, 23 February and has as of 25 February had started reaching people in 27 provinces across the country. A small buffer of about five per cent of the total number of available doses procured through the COVAX facility has been earmarked for humanitarian caseloads although details on how the logistics costs of distribution will be managed are still under discussion. The first batch of COVID-19 vaccinations through the COVAX facility – consisting of 468,000 doses – is anticipated to arrive during the first week of March. UNICEF will be notified in the coming days about the total allocation of doses to Afghanistan through the COVAX facility for the first half of 2021. Further discussions are also underway with China on potential donation of additional vaccines. To support the vaccination campaign, UNICEF has developed and printed registration (vaccine card, recording and reporting formats) and communication material for some 1.5 million COVID-19 vaccine doses. In addition to registration and communication material, UNICEF has distributed vaccines, syringes and safety boxes to all 34 provinces.

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 in crisis or emergency levels of food insecurity through until March and the next food security analysis is expected to be available in April. 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 18 per cent between 14 March 2020 and 24 February 2021, while the cost of pulses, sugar, cooking oil and rice (low quality) increased by 24 per cent, 22 per cent, 53 per cent, and 20 per cent, respectively, over the same period. Sharp rises over the last few weeks are thought to be connected with transport interruptions in various part of the country. These price increases are accompanied by declining purchasing power for casual labourers and pastoralists – which has deteriorated by almost 20 per cent (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 shows that the primary reason for taking on this debt last year was to pay for food (53 per cent).

Humanitarian Needs and Response Planning: The newly 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 COVID19 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.

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. While details on the degree of impact on agricultural and hydrological environments is still being evaluated, the 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.
In response to the COVID-19 outbreak, the United Nations launched the Global Humanitarian Response Plan (GHRP) for COVID-19 on 25 March 2020 to address the immediate humanitarian consequences of the pandemic.

This was just two weeks after WHO's announcement of a global pandemic. A joint effort by the Inter-Agency Standing Committee and coordinated by OCHA, the GHRP was the humanitarian community’s first event-specific global appeal. The GHRP enabled the needs of the most vulnerable from the pandemic to be brought the forefront of the COVID-19 response. The unprecedented plan originally appealed for $2 billion to respond to urgent needs in 54 countries. As the humanitarian situation rapidly evolved and the full scale of the needs from the field, the response required and the challenges of delivering assistance were revealed, the GHRP was revised in May and July to 63 countries and the amount requested to $9.5 billion. As of 25 February 2021, reported funding for the GHRP was $3.79 billion. In 2020, humanitarians in Afghanistan reached 11.75 million people with some form of assistance across all 401 districts, exceeding planned reach.

Of those reached, 4.68 million people were provided with COVID-19 specific assistance.

UN Office for the Coordination of Humanitarian Affairs
To learn more about OCHA's activities, please visit https://www.unocha.org/.