COVID-19 in Afghanistan: Compounding Crises

Men wearing facemasks queue up to receive free wheat from the government emergency committee in Kabul, 21 April 2020. AFP/Wakil Kohsar
Men wearing facemasks queue up to receive free wheat from the government emergency committee in Kabul, 21 April 2020. AFP/Wakil Kohsar

In late March, Afghanistan’s minister of public health publicly shared estimates that up to 25 million Afghans could eventually be infected with the novel coronavirus. This is out of a population of about 36 million. The Afghan government has announced a wide range of measures to contain the virus, mirroring global practices of physical distancing. But the weaknesses of health care infrastructure in a country weighed down by poverty and four decades of conflict render Afghanistan especially challenged to manage any major outbreak. Reports of COVID-19-related deaths remain low, but hospitals are straining and are beginning to lose staff: staff are not only falling ill, with some even dying of the disease, but many are simply refusing to work under conditions they deem hazardous. Health care data in Afghanistan is historically unreliable, and the government has only managed to test around 100 people per day – all of which leaves enormous uncertainty as to the ultimate scope of the problem in a country where roughly only one in four people has access to quality health care.

The return of nearly 300,000 Afghan migrant workers since February from Pakistan and Iran, one of the virus’ global epicentres, appears to have overwhelmed the government’s attempts to contain an outbreak. The Afghan health ministry assessed that the virus has spread to 29 of 34 provinces, first as a result of these mass returns but now organically within communities, too. Herat, a province bordering Iran, has been hardest hit by reported cases and hospitalisations. Iran’s border with Afghanistan remains open and while Pakistan’s closed for several weeks, tens of thousands have rushed across, as the border has opened sporadically, a few days at a time. Humanitarian organisations have advised against border closures in Afghanistan’s case. Indeed, large populations of migrant workers continue to seek to cross borders in and out of Iran and Pakistan, and closures at borders with limited state capacity will likely lead to population build-up in makeshift camps; not only could these crossing points serve as hubs for infection, but there are serious human rights and health concerns – even claims of several dozen migrants being drowned by Iranian border guards.

As yet the toll on Afghans from COVID-19 remains unclear; the World Health Organisation admits there “is no model” for how the virus may impact a country with Afghanistan’s vulnerabilities. But regardless of how severe the toll, the public health crisis is not the only – and may not even be the gravest – challenge the pandemic poses.

Food scarcity and insecurity might pose greater threats, as shortages fuel rising prices of basic foodstuffs, urban lockdowns cripple informal and day labour employment, and remittances from abroad plummet. Even before the pandemic, Afghanistan was home to 14 million people with insufficient access to or resources to afford food, many of whom depend on international assistance.

Food Insecurity in a Landlocked Country

Already there are worrying signs. The Afghan government anticipated the economic strain of its pandemic response, quickly initiating emergency grain distribution in Kabul and across the country. But strategic reserves are not sufficient to cover the population’s urgent needs, and reports show scenes of panic and rising resentment. The UN and humanitarian actors have begun to raise the alarm about the potentially massive scope of starvation and are scrambling to augment government efforts, but lockdowns have restricted their ability to provide aid. Experts are eying a transition to cash-based assistance, anticipating protracted difficulties in actually distributing food, but currency exchanges and money transfer services have been shuttered under lockdown, and more adaptive measures, such as smartphone money transfers, would have limited reach.

In many respects, Afghanistan’s ability to mitigate food scarcity will hinge on how its neighbours, many of whom face their own dire circumstances, react to the pandemic. Afghanistan depends on imports for most basic food commodities, including wheat flour, which makes up nearly three quarters of poor Afghans’ diet. Most of the country’s wheat imports, which have doubled over the last decade, originate in Kazakhstan. But unlike in Iran and Pakistan, COVID-19 has prompted Afghanistan’s Central Asian neighbours to tightly clamp shut their borders. Afghan officials have attempted to reassure the public that commercial traffic will not be interrupted, but it takes two to trade: Kazakhstan halted all wheat exports in March when it grew concerned about domestic stocks. Export flows have since resumed, but under strictly limited quotas – limitations that are currently set to continue until at least September. More broadly, Central Asian states are likely to be preoccupied with domestic concerns for some time. Russia’s coronavirus response has left many migrant workers from Central Asia temporarily out of work, shrinking the normal flow of billions in remittance revenues. A regional economic squeeze will have ripple effects on Afghanistan: Uzbekistan has recently pressured Kabul into paying its overdue bill for the nation’s electricity, for instance.

In the meantime, Kabul is looking to India as an immediate substitute provider of wheat, which requires transporting the goods via Iran’s Chabahar port. Yet India’s own grain harvest this year is reportedly in jeopardy due to that country’s lockdown, and current arrangements between Kabul and Delhi fall far short of the more than two million metric tonnes Afghanistan requires in imports this year. Moreover, the full fallout from Iran’s COVID-19 outbreak could be catastrophic, and the ability of Chabahar port to operate at peak efficiency should not be assumed.

Any uptick in tensions among Afghanistan’s neighbours and other regional powers could make things more complex still. Potential triggers of cross-border crises remain unpredictable. Even when regional dynamics are calm, fits and starts in Afghanistan’s commercial routes are routine. In the case of any flare-ups, the flow of goods could be slowed deleteriously. Pakistan, which sits between Afghanistan and India, has severed trade between the countries in the past when its relations with India grew strained, as it did last year during tensions over Kashmir (these tensions continue to simmer even amid the pandemic). Chabahar is a node in a politically contentious trade route. It is rivalled by Pakistan’s Gwadar port, a joint Chinese-Pakistani project, and, at the same time, has precarious status as a rare exception to U.S. sanctions on Iran. In the short term, regional competition has some potential to impact Afghanistan positively. Days after Indian donations of wheat arrived at Chabahar, headed for Kabul, Pakistan, eager not to be outdone by Indian generosity, announced that Gwadar would reopen for massive humanitarian shipments as well. But the country’s largest commercial border crossings have already proven tenuous since the pandemic began to spread, and even slight delays could jolt food supply lines.

All this means that both city-dwelling Afghans and those in the countryside risk losing access to food and income. With lockdowns of urban centres leaving hundreds of thousands of day labourers out of work, and rising food prices prompting panic and desperation, there is potential for increased crime. Criminality has already been steadily worsening in Kabul over the last year, carried out by organised enterprises and petty thieves alike. Politically connected citizens are killed in broad daylight by unknown actors, while businessmen, medical professionals and aspirational middle-class families are targeted for ransom kidnapping. It is openly reported that the gangs responsible are affiliated with (and enjoy protection from) high-level political figures. Several residents told Crisis Group they worry that groups that operate with impunity, even under lockdown conditions, will take advantage of the fearful atmosphere the pandemic has instilled. Fewer people on the street may make it easier for kidnappers to conduct surveillance on and seize targets, given fewer bystanders. During the initial weeks of Kabul’s movement restrictions, several conflict monitors told Crisis Group that crime rates had dropped – but as restrictions are increasingly being dodged, opportunistic crime is expected to rise. Moreover, gender-based violence and other chronically underreported criminality has been expected to worsen under lockdown conditions.

Civil unrest is also a worry. Some Afghans voice concerns about increased danger to the Hazara ethnic minority, a common target of discrimination, as slurs and racially charged conspiracy theories about the origins of the virus are repeated across the country. Some officials fear that hungry crowds could gather to protest or even riot over perceived inequalities in food distribution – scattered protests have already taken place in the cities of Herat, Jalalabad, Mazar-e Sharif and Kabul. Some internationals also relayed concerns to Crisis Group about urban unrest. Humanitarians have been mulling over global precedents for aid workers and their resources being targeted in times of scarcity; one aid worker noted that out of more than a thousand international humanitarian staff usually based in Kabul perhaps only 300 remained as of mid-April. Limited oversight and management capacity will further limit aid delivery when it is needed most.

Rural populations, including those who live in areas under Taliban influence, will also be affected by the pandemic, if not in precisely the same ways as those in urban areas. Although rural spaces, where intergenerational family units reside in walled compounds, face the potential for rapid spread within families, they may in fact experience far slower rates due to sparse population density. But market shock waves will impact the entire country at once: an average rural diet consists of as much imported wheat, sugar and cooking oil as in cities, and the country’s more remote regions are already precariously on the edge of near-starvation (as the drought of 2017-2018 highlighted). While the government has moved to provide free bread to a quarter-million people in need in Kabul, this initiative already faces planning and logistical difficulties, which are likely to multiply if attempted across the countryside – not to mention the potential for bread queues to spread the virus further.

The Taliban, the Pandemic and Peace

The Taliban, in spite of a rather well-organised public relations campaign addressing COVID-19, appear to have mandated very few sweeping public health measures, and reports suggest that some of their preventive activities are fraudulent. The poppy harvest, much of which takes place in areas under Taliban control, seems to have progressed as usual this spring – potentially an additional vector for spread of the virus to rural populations. As in previous natural disasters and humanitarian crises, the Taliban’s call for heightened international support is strongly linked to their quest for both greater resources and international legitimacy as a government-in-waiting. In recent years, the insurgent group has increased the attention it pays to public messaging and has organised a “shadow government” commission on public health, but it devotes few resources of its own to the woefully under-resourced medical services in areas it controls.

Yet while the Taliban’s public health scramble may be more window-dressing than substance, several interlocutors relayed that the movement’s leaders have slowly realised the gravity of the virus. The Taliban’s own website has called it a “serious global challenge … never seen previously”. The group’s concern likely extends to the impact of COVID-19 on its fighting strength. Although the pandemic may creep into the barracks of Afghan security forces much faster than among cells of Taliban fighters, insurgents will not necessarily be spared. They often eat and sleep communally, and in some locations move among various residences of supporters. Moreover, even though fighting forces on the two sides may be affected at different speeds, areas under Taliban control rely on market provisions with the same supply lines as the rest of the country. Hunger will strike everywhere.

The Taliban have thus far ignored calls for a comprehensive humanitarian ceasefire, even as they seem to have grasped the potential for catastrophe. These calls have now been issued by the UN Secretary-General, the UN Security Council, Afghanistan’s neighbours and other international bodies, along with the Afghan government and much of Afghan civil society. Sceptics of peace efforts have pointed to the group’s dismissal of these calls as further evidence that it is not serious about ending the war.

In reality, the Taliban have never halted violence nationwide for the sake of humanitarian considerations, in spite of numerous reasons to do so in the past: annual flooding, harsh winter weather, devastating drought or displacement due to conflict. There is little reason to expect the group to change its calculus on violence and human suffering now. From the Taliban’s perspective, their ability to threaten and cause violence is the group’s primary leverage against the U.S. and Afghan governments. The Taliban have expressed mistrust of calls for a humanitarian ceasefire, in part because the Afghan government had preconditioned taks on a ceasefire long before the pandemic struck. Fundamentally, the Taliban see the same risks in a COVID-19-related ceasefire as they do in any other lull in fighting; in addition to mistrust, there is evidence that the group worries a lengthy halt in fighting could cripple its hard-fought cohesion and strategic momentum.

While this stance reflects poorly on the Taliban, it does not necessarily mean that the movement is turning its back on genuine peace negotiations. The group insists that the path to a ceasefire lies in observing the terms of its agreement with the United States. That deal, signed on 29 February in Doha, Qatar, includes a timeline for the withdrawal of U.S. forces in exchange for Taliban assurances that the movement will renounce international terrorism – with the further intent to quickly initiate peace talks among Afghans. The Taliban expect some of the terms of that deal – prisoner releases in particular – to be implemented before a ceasefire is discussed.

Health calamities and other human suffering do not always prompt conflict actors to pause violence, much less come to the peace table – and even when they do, that is not always enough to make peace last. A ceasefire will probably only come as a result of progress in the peace process. Parties to the conflict should press forward with the initiation of intra-Afghan peace talks, which were supposed to start on 10 March, according to the U.S.-Taliban deal.

Pragmatic Way Forward

At the same time, international and regional actors should recognise the potentially massive scale of both food shortages and the public health emergency and commit to the unhindered flow of food and medical aid. Earlier in April, the Taliban made ambiguous claims that health services, including international organisations, would be able to treat COVID-19 unhindered in areas of their control. To hold them to that, the Taliban could plausibly be called upon by the U.S. and engaged actors to refrain from fighting on major roadways – on the grounds that it would interfere with the transport of essential goods, including coronavirus-related food and medical aid, into areas they control. Indeed, securing commercial traffic should be made a top priority by both sides – as reprobate Taliban commanders or even some militias aligned with government forces may turn predatory as their resources begin to dwindle. Meanwhile, the Afghan government can prioritise smoothing the way for international and local relief efforts; Crisis Group spoke to several humanitarians who described confusion and coordination difficulties between NGOs and government authorities early on, which led to delays in program planning as well as the ability of staff to travel and deliver aid.

Regional powers should keep trade flowing smoothly and coordinate to ensure the stability of Afghanistan’s supply lines for basic goods, and should make exceptional efforts to prevent persistent tensions between some of them from coming to a boil. The U.S. has already begun encouraging the steady flow of wheat and other imports into Afghanistan; early signs of some reopening may illustrate neighbours’ desire to keep their agricultural sectors robust. The European Union is closely monitoring the country’s food security, as are the World Bank and UN agencies. China should follow its decision in January to push shipments to Kabul through Gwadar, after several years of delay in operationalising the port, with continued assistance for Afghanistan.

Strengthening Afghanistan’s health care infrastructure fast enough and dramatically enough to cope effectively with the public health consequences of COVID-19 is probably unrealistic, even with lockdowns and social distancing measures, which themselves come at high costs. Even before the pandemic, Afghanistan’s health care capacity was falling short. But mitigating the effects of the pandemic on Afghanistan’s food security could be possible through a major food-based relief effort and (limited) progress on conflict resolution. At a moment when the country’s window of opportunity for peace seems to be narrowing, keeping Afghans from starving is one commitment all parties should be able to make.

Andrew Watkins, Senior Analyst, Afghanistan.

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