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Afghanistan: Strategic Situation Report: COVID-19, No. 93 (25 March 2021)

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Situation Overview:

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).

UN Office for the Coordination of Humanitarian Affairs
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