Afghanistan: Oxygen and vaccines urgently needed as Covid-19 infections surge

The Afghan Government must immediately address oxygen shortages and procure adequate Covid-19 vaccines and other essential medical supplies with support from the international community, said Amnesty International, with the war-torn country showing worrying signs of a steep surge in infections.

On 7 June, the Afghan authorities reported that out of a total of 4,671 Covid-19 tests taken over the previous 24 hours, 1,582 (almost 34 percent) had returned positive results.

“Afghanistan’s Covid-19 case numbers have been steadily increasing and these latest figures are of grave concern. It’s clear that the country has been hit by the third wave of Covid-19 and without urgent international support to contain this surge, the situation could quickly spiral out of control, with existing shortages of life-saving supplies posing serious challenges,” said Zaman Sultani, South Asia Researcher at Amnesty International.

Afghanistan’s Covid-19 case numbers have been steadily increasing and these latest figures are of grave concern

Zaman Sultani, South Asia Researcher at Amnesty International

“At the same time, Afghanistan’s vaccination drive has also been held up due to supply shortages. We have seen a similar situation unfolding in Nepal and India and one of the main lessons is to learn from their mistakes and be prepared for the worst before it’s too late.”

Lack of Preparation by the Afghan Government

More than a year into the pandemic, the government’s emergency preparedness remains inadequate. According to the Ministry of Public Health (MoPH), Afghanistan currently has only around 2,000 oxygen concentrators and 1,063 hospital beds dedicated to Covid-19 treatment to service a population of 39 million.  According to MoPH, the country only a total of 1,500 ICU beds.  

On 4 June, the MoPH reported that the country was facing an oxygen shortage and appealed for support from other countries in the region. Local media has reported that more than 50 percent of those hospitalized with Covid-19 are requiring oxygen. On 8 of June, an official at the MoPH told Amnesty: “I do not want to give any false hope. We have managed the situation for now, but if the situation gets worse it would be really difficult [without oxygen].”

This situation is more challenging at the provincial level. According to Zaman Muradi, a human rights activist from Daikundi province, the province only has one Covid-19 treatment centre and no Covid-19 testing facility. Muradi said that it takes about a day to travel to Bamiyan or Kabul to obtain a test. According to the WHO, only 22 of Afghanistan’s 34 provinces have laboratory facilities for Covid-19 testing.

On 10 June, the UN Secretary General`s Deputy Special Representative for Afghanistan announced on Twitter that the World Health Organization (WHO) and UNICEF had provided Afghanistan with 3750 ‘oxygenators’ and that ten oxygen plants would also to be given to Afghanistan by UN agencies.

“The lack of emergency preparedness and the state of Afghanistan’s public health infrastructure means the country is not equipped to deal with the type of surge we have seen elsewhere in the region. Afghanistan must make diagnostics widely accessible to effectively detect outbreaks and proactively address an imminent outbreak of cases,” said Zaman Sultani.

On 6 June, an official from the public health department in Balkh province, home to one of Afghanistan’s largest cities and a population of 1-1.3 million people, told Amnesty that the province has about 140 dedicated beds for Covid-19 patients.

The current wave poses an even greater risk of infection for Afghanistan’s four million internally displaced people (IDPs), who are living in overcrowded conditions, with insufficient access to water, sanitation, and health facilities. In March 2021, Amnesty International published a briefing calling on the Afghan government and the international community to urgently scale up targeted support efforts to this highly vulnerable group.

“During this crisis, the Afghan government must ensure that IDPs can access healthcare, sanitation and clean water and develop a plan that prioritises vaccinating IDPs, whose living conditions leave them extremely vulnerable to a highly infectious virus like Covid-19,” said Zaman Sultani.

Shortage of Vaccines

According to a World Bank announcement, sufficient budget should already exist to vaccinate 40 percent of the population, with 50 percent of that covered by the COVAX Facility – a global initiative to help low- and middle-income countries access vaccines – and the other half covered by funds from the World Bank and the Afghanistan Reconstruction Trust Fund. The Asian Development Bank has also committed around $50m USD to support vaccinations and other Covid-19 related programs.

However, to date, Afghanistan has received 968,000 vaccine doses from the Indian Government and the COVAX Facility, which can fully inoculate only 484,000 of Afghanistan’s 39 million people, representing only 1.24% of its population.

The lack of emergency preparedness and the state of Afghanistan’s public health infrastructure means the country is not equipped to deal with the type of surge we have seen elsewhere in the region.

Zaman Sultani

Local media reported on 10 June that Afghanistan had received 700,000 doses of vaccines from China. However, Amnesty International spoke to an official at the MoPH, who could not provide an exact date for the next delivery of vaccines shipment from COVAX. The next shipment is tentatively scheduled to arrive by August.

On 3 June, President Ghani belatedly announced that the Afghan government would purchase further supplies but provided no details on when these would be secured and delivered. Given the current global shortage of vaccines and COVAX’s inability to deliver to other countries according to schedule, there are major concerns around if and how quickly any more doses will arrive in Afghanistan.

According to the WHO, as of 29 May 2021, 609,440 people had been vaccinated in Afghanistan. Of this figure, 480,709 persons had received their first jab and 128,731 people had received both doses.  

“The Afghan authorities, with support from the international community and the COVAX program, must work to procure the required vaccines either through existing funding and support mechanisms or through the government budget,” said Zaman Sultani.