COVID-19: the current situation in Afghanistan

On March 11, 2020, WHO declared the outbreak of coronavirus disease 2019 (COVID-19), which originated in Wuhan, China, and has since spread around the world, a global pandemic. As of March 25, 2020, 413 467 cases of COVID-19 have been confirmed in more than 180 countries and territories and at least 18 000 deaths have been reported from around the world. COVID-19 is now establishing a foothold in impoverished, war-torn nations, such as Afghanistan.¹Although the health-care system in Afghanistan has improved over the past 17 years, we question its preparedness for a prompt and functional response to the COVID-19 outbreak. Afghanistan is now seeing a rapid rise in COVID-19 cases. On Feb 24, 2020, the Afghanistan Ministry of Public Health reported on one individual with confirmed COVID-19 from the western province of Herat. The number of confirmed cases of COVID-19 in Afghanistan has since increased. As of March 25, 2020, there were 75 confirmed cases of COVID-19 across 12 provinces of Afghanistan, one death attributed to COVID-19, a 40-year-old man in Balkh province with no previous travel history, and two people reported to have recovered.²

The Ministry of Health and Education (Afghanistan) has suspended all schooling and restricted Nowruz (Persian New Year) celebrations to curb the pandemic. Controlling the epidemic in Afghanistan will be complicated by a diverse set of problems, including the influx of Afghan refugees from neighbouring Iran. Officials from the western province of Herat have documented thousands of people passing the border from Iran every day. Another concern is low public awareness of COVID-19 and low health literacy, exemplified by one individual with confirmed COVID-19, and 37 people with suspected COVID-19, leaving quarantine, risking the transmission of COVID-19 through communities. Furthermore, the cultural norms of shaking hands and hugging, community gatherings in mosques that still largely remain open, and the paucity of masks and effective handwashing technique will aggravate the crisis. Moreover, Afghanistan’s fragile economy and infrastructure relies heavily on imports from neighbouring countries. Because of this dependency, any border restrictions put in place will not be as effective in controlling transmission.