Fate has been cruel to the average Afghan over the past four decades. The country’s story, from the Soviet invasion to today’s Taliban insurgency, is well-known. Now, as the United States is in the midst of a phased withdrawal and a civil war looms, so too does the Coronavirus pandemic. The effects could compound these challenges by an insurmountable magnitude.
Ravaged by war for four decades, Afghanistan is one of the world’s poorest countries. It lacks the public health infrastructure to adequately provide primary care, let alone the tertiary care necessitated by severe cases of the coronavirus disease. According to the World Health Organization, Afghanistan has less than three doctors per ten thousand people. Upwards of one hundred thousand Afghans seek medical care in neighboring Pakistan each year. And, like Pakistan, it is among the three countries in the world that have not stopped the transmission of the poliovirus.
The first confirmed case of coronavirus in Afghanistan was in the western city of Herat, located near the border with Iran. And it’s Herat that has remained the center of gravity. As of April 14, roughly 40 percent or 284 of the 714 confirmed cases are in Herat, driven by a surge in returnees from Iran as the virus plagued the country.
A total of 246,434 Afghans returned home from neighboring Iran and Pakistan this year as of early April, according to the International Organization for Migration. Approximately 99 percent of them were from Iran. And over 65,000, or a quarter of all returnees so far this year, came from Iran in just the third week of March alone.
After this reporting period, Pakistan temporarily opened border crossings to allow Afghans to return home. So the proportions will change once the IOM releases its latest data. While Pakistan could emerge as another vector for Coronavirus infections in Afghanistan, Iran will probably remain the primary external vector. Afghanistan’s Islam Qala border crossing with Iran in Herat remains open. And, according to the BBC, there are no quarantine facilities on either side of the border.
The virus has since spread to twenty-seven other provinces, with the bulk of the remainder in the Kabul and Kandahar provinces. Afghanistan’s national highway network is essentially a ring running across the country’s perimeter. And many returning to Kabul from Iran via Herat have to travel by road across the country’s southern belt through Kandahar.
The reported coronavirus infections in Afghanistan, of course, should be taken with a grain of salt. There is a shortage of testing kits in Herat. The proportion of cases there may be underestimated. And while testing in most countries has been woefully inadequate, it is particularly so in Afghanistan, where, as of April 13, only 4,470 tests have been conducted in a country of roughly 38 million people. That’s less than half the rate of neighboring Pakistan, where over 62,000 tests have been conducted.
Mass testing and tracking, as we’ve now learned, are critical to both containing the spread of the coronavirus and responsibly reopening economies. Again, these challenges are by no means unique to Afghanistan, but the problem there is more acute and exacerbated by its proximity to coronavirus vector states, low levels of socio-economic resilience, the prevalence of armed conflict, and growing political discord.
Afghanistan has imposed lockdowns of varying effectiveness in most of its provinces. But lockdowns also have negative economic and public health externalities. Ordinary Afghans, like the poor worldwide, face a choice between dying by the coronavirus or dying by poverty. The lockdown alone will push more Afghans below the poverty line, even with interventions by the Afghan government and world community, including the immediate debt relief recently announced by the International Monetary Fund (IMF).
While debt forgiveness gives the Afghan government more fiscal space to devote toward social safety net measures, the shutdown of a substantial portion of the Afghan economy will hurt both growth, which the IMF estimates will head into the negative territory this year after averaging only around 2 percent since 2014. Revenue collection as well as remittance flows from Iran and Pakistan will also drop precipitously.
One can hope and pray that demographics and weather may somehow help Afghanistan blunt the broader impact of the virus. As summer nears, warmer temperatures in the northern hemisphere could slow the spread of the coronavirus, bringing relief to many countries, including Afghanistan. Over sixty percent of Afghanistan’s population is below the age of twenty-five. Given that the disease is most fatal among the elderly, Afghanistan’s young demographics may work to its favor. But morbidities could offset Afghanistan’s possible demographic advantage.
The World Health Organization and regional and great powers are helping Afghanistan with supplies of personal protective equipment or PPE as well as therapeutic drugs and food supplies. It is vital that such support is sustained. The paucity of PPE puts medical health professionals at risk and could deplete their already meager numbers. Also, Afghanistan is dependent on imports from neighboring countries for major food staples, including wheat and sugar. A third of the country is food insecure.
Afghanistan’s political leaders and insurgents should have the good sense to end their conflicts as the coronavirus ravages the world. Sadly, the election dispute between Abdullah Abdullah and Ashraf Ghani continues. There are conflicting indications as to whether a deal between the two men is near. Some reports suggest that another unity government will be formed. At the same time, Ghani has unilaterally made political appointments, largely of ethnic Pashtuns, bringing in people like Hanif Atmar into his fold and weakening the hand of Abdullah.
Even if Abdullah and Ghani come to an agreement, it is unlikely to endure for long. Ghani is likely to use a cessation of hostilities—a ceasefire by the Taliban or Abdullah’s recognition of his presidency—to his advantage. The centralization of power will push non-Pashtun leaders left in the cold further to the periphery. Eventually, their games of political brinkmanship will take a deadly turn. That turn will hasten should the coronavirus result in large-scale deaths in Herat, a Tajik stronghold. The public as well as political leaders there could blame the central government, resulting in an intensification of the growing ethnic divide.
The United States should absolutely continue health and development assistance to Afghanistan. But the Trump administration should also sustain its withdrawal from Afghanistan, should the Taliban abide by their counterterrorism commitments. The threat of a full U.S. withdrawal last month made by Secretary of State Mike Pompeo to Afghanistan’s leaders must be credible. And it is part of the U.S.-Taliban agreement anyway.
The absence of a political settlement among Afghans is no reason for a continued U.S. military presence. An indefinite, unconditional U.S. commitment to sustain the current Afghan political system simply enables Ghani’s political games and risks luring America into a full-fledged Afghan civil war.
Now is the time for Afghans to rise to the challenge and not repeat their self-destructive mistakes of the past four decades, using foreign forces to seek advantage over their domestic foes. America and the world community should help the Afghans help themselves. But also, America, and much of the world, will be reeling from the disastrous effects of the coronavirus. The billions of dollars spent on Afghanistan should be redirected to home. America must put its own people first. And Afghanistan’s leaders must finally choose to do the same too.