In Afghanistan, the Coronavirus Could Be Deadlier Than War

Until recently, billboards around Kabul were emblazoned with a simple phrase: “Imagine Peace.” Now, they instruct people to wash their hands.

Afghan security forces weren’t only armed with guns when they rushed to the scene of a brutal massacre of Sikh worshippers by an Islamic State-affiliated gunman on March 25; they also wore protective masks and gloves. Dreams of an end to violence are as distant as ever because Afghanistan now faces a more imminent and potentially deadly threat than terrorism or even the Taliban: COVID-19.

As of April 16, Afghanistan had 840 confirmed cases of COVID-19, with 30 deaths. If estimates released by the Ministry of Public Health are accurate, Afghanistan is heading for a catastrophe. Unless serious containment measures are enforced and adhered to throughout the country, the ministry anticipates that as many as 25 million Afghans will be infected with the coronavirus, leading to 110,000 deaths. In other words, if this model is correct, more people will die of COVID-19 in Afghanistan than the estimated 100,000 civilians killed since the conflict began more than 18 years ago.

The coronavirus crisis could not have come at a worse time for Afghanistan, which is on the brink of losing critical U.S. military and financial support. U.S. and NATO forces have already begun pulling troops from the country and will continue regardless of whether or not the Taliban and Kabul government make it to the negotiating table. The fragile U.S.-Taliban deal agreed in February is already fraying at the seams, while talks between the Taliban and Afghan government initially stalled amid an impasse over prisoner swaps. Prisoners have now been released from both sides, offering some hope that peace talks can progress, but if the precarious arrangement collapses, Afghan government forces will be left to fight the Taliban alone.

If estimates released by the Ministry of Public Health are accurate, Afghanistan is heading for a catastrophe.

Meanwhile, the Afghan government itself is on the verge of imploding. Following a contested election, both Ashraf Ghani and Abdullah Abdullah declared themselves president in February, and this leadership dispute has yet to be resolved. As punishment, the U.S. government cut $1 billion of aid and threatened to slash a further $1 billion in 2021. As Vanda Felbab-Brown, a senior fellow at the Brookings Institution, pointed out, these cuts will undermine not only the COVID-19 response but also Afghanistan’s military capability. “We all know that without foreign money, the Afghan military will buckle,” she warned, pointing out that some troops are already forging agreements with the Taliban, warning them of planned attacks, and refusing to fight. Without money to maintain unity in a military comprising multiple tribal factions, it will likely split up along ethnic lines, she said.

The country is now seeking to hold back a tide of new coronavirus cases. Afghanistan’s fragile health care system, creaking under the strain of extreme poverty and decades of war, lacks the capacity to adequately test or track cases. As of April 13, the Afghan government had tested just 4,314 people for the virus, with a further 542 tests announced in parliament on April 15.

“We have a shortage of resources. We have a shortage of funds. We have a shortage of equipment,” said Waheed Omar, an advisor to Ghani. “But what is important is that we understand the gravity of the situation and we are pulling all of our resources and capacities to deal with it.”

Few believe these resources and capacity will be enough. Speaking on condition of anonymity, one doctor in Kabul painted a bleak picture. “When I arrived here in the [dedicated coronavirus] hospital, there were no procedures,” he said. “I have been here for a month, during which time I have received no training on the coronavirus. For patients, there is no special preparation, not enough medicine and other equipment. Doctors purchase medicine from private pharmacies for themselves when they need it.”

Outside the capital, things are even worse. Only two health centers can process the results of testing kits provided by the World Health Organization (WHO), and in the western province of Herat, near the Iranian border, the epicenter of the crisis, testing stopped altogether when the kits ran out. Just 300 ventilators are available to treat those affected by the virus in a country of 38 million. Even the hand sanitizer procured and distributed to dedicated hospitals by the health ministry turned out to be fake, with zero alcohol content.

Clearly, Afghanistan cannot withstand a full-blown pandemic. The country’s best hope is to curb the spread of the virus by persuading everyone to stay home and reduce contact. But that is easier said than done.

In Kabul, going outside at all has long meant a gamble with death.

In Kabul, residents are better prepared than most for the demands of lockdown and self-isolation. Police checkpoints are an everyday occurrence. The capital has faced the daily risk of suicide attacks, car bombs, and military assaults for nearly two decades, meaning parts of the city are often abruptly shut down and people trapped inside homes and offices for extended periods of time. Many people steer clear of crowds and busy areas, having seen these targeted for violence over and over again, with mass casualties. Going outside at all has long meant a gamble with death.

But the three-week lockdown announced in Kabul (and several other provinces) presents a new set of challenges. Few Afghan people can afford to forgo their income for weeks on end, but those prevented from leaving their homes can’t work or provide for their families. International assistance barely scratches the surface of the problem; a World Bank grant of $100 million to fund the medical response pales in comparison with the lost $1 billion from the United States, and no donations have yet been earmarked to mitigate the economic impact or loss of wages for Afghans stuck at home.

Food prices are soaring, while aid packages in the capital have so far been limited to a one-time allocation of a few pounds of wheat and lentils per family. Desperate people still risk wandering the streets, looking for work. At night, the tension is palpable; frustrated residents, crowded in their homes, can be heard shouting “Allahu akbar” from their rooftops.

Officials are striving to educate people on the dangers of contagion through the channels available; when you make a phone call, for example, you must first listen to a prerecorded message of government advice in Pashto and Dari. Despite this, many Afghans struggle to buy basic supplies like face masks or are simply too preoccupied with other afflictions and day-to-day suffering to care about the threat of a new disease, said Noorullah Navayee, a researcher at the National Centre for Policy Research in Kabul. For vulnerable groups like internally displaced people, the homeless, and drug addicts, following official advice on social distancing is often impossible.

In Herat, the epicenter of the country’s outbreak, street vendors staged a protest against the daylight curfew outside the city governor’s compound on March 26, demanding the lockdown be rescinded to allow them to earn a living. Local community groups have mobilized to support one another, but government-issued food packages do not appear to have materialized, and it’s unclear how long this can sustain a population already plagued by poverty and drought. “Afghanistan’s informal sector dominates the entire economic structure of the country,” Felbab-Brown said. “So how can you tell people, ‘don’t go on the street to sell your kebab,’ when people will literally starve to death?”

Even if the authorities manage to contain people already in cities, tracking and restricting movement into and around the country is a formidable task. In recent weeks, at least 130,000 Afghan migrants returned from Iran, one of the world’s hardest-hit nations. Attention has focused on returnees to western Herat from Iran, where most cases have been detected, but according to Gul Ahmad Noorzad, a member of parliament, between 3,000 and 6,000 Afghans also return each day to the as-yet-neglected province of Nimruz, which borders southeastern Iran. The province’s capital, Zaranj, is less than an hour’s drive from the Iranian town of Zabol and three hours from Zahedan, both of which house prisons that human rights groups believe have hushed up riots over outbreaks of COVID-19.

What’s more, in a bid to stop the virus spreading in their own crowded prisons (as it has done elsewhere), the Afghan government now plans to release 10,000 inmates. For those already exposed to COVID-19, this could mean transporting the virus into their communities—and for those without family left to take them in, it’s unclear where they will go.

The one Afghan industry most likely to weather any crisis is also one positioned to spread the virus from region to region: poppy farming for the heroin trade. “The harvest takes place in different periods and different regions of the country, and they migrate with the harvest,” said Barnett Rubin, a former U.S. State Department official. “Obviously that’s not consistent with social distancing.” Felbab-Brown, too, expects the multibillion-dollar trade to grow as legitimate jobs fall away, exacerbating internal migration flows within Afghanistan.

And then, of course, there’s the biggest challenge of all: How do you maintain control in a crisis when a country is still at war? The government is not alone in calling for a truce to beat the virus. U.N. Secretary-General António Guterres has called for a global humanitarian cease-fire. Yousef al-Othaimeen, the secretary-general of the Organization of Islamic Cooperation, appealed to Afghan leaders to unite.

For a moment, it seemed the Taliban might actually be on board. The group announced, first, that it would give safe passage to WHO and the Red Cross and, later, that it would consider a cease-fire in areas hit hard by COVID-19. On March 26, it even disseminated images of mask-wearing militants and health workers in hazmat suits lined up (at socially distanced intervals) on either side of the Taliban flag in militant-held Kunduz. COVID-19 had, it seemed, momentarily achieved what years of fighting and negotiations had not: The Afghan government and the Taliban appeared to be working toward a common goal.

Any optimism was short-lived, however. In the week that followed those photos, at least 12 civilians and 75 pro-government police and soldiers were killed. On March 29, the militant group captured new territory, the Yamgan district in northern Badakhshan, a province that confirmed a case of COVID-19 a few days later. In northern Balkh province, which has seen 13 cases and four deaths from COVID-19, heavy fighting continues; on April 7, the Taliban executed seven civilian captives, including three children. There has been one glimmer of hope: Government health workers met with the Taliban on April 13 to coordinate a response to the pandemic in Faryab, but it remains to be seen if cooperation will extend beyond this one province or whether it will encourage fighting to stop elsewhere.

The very real prospect of a coronavirus outbreak eliminating aging power brokers on all sides could push an already precarious political situation into a new era of chaos.

For Taliban leaders, the weakness of Kabul’s position presents a quandary: Do they seize the strategic opportunity to step up aggression, even though this will inevitably spread the pandemic beyond their control? The choice is stark. Any leader or group considered by their supporters to fail them in this moment of crisis will weaken that support and, with it, hard-fought legitimacy and power. Many other nonstate actors around the world are jumping at the chance to position themselves as protectors against the pandemic. After all, it’s not only civilians who risk losing their lives to the virus but Taliban leaders and negotiators—many of whom fall squarely in the high-risk age bracket.

Indeed, the very real prospect of a coronavirus outbreak eliminating aging power brokers on all sides could push an already precarious political situation into a new era of chaos. “Imagine that everybody who is older than 50 dies of COVID-19 among the Taliban leadership,” Felbab-Brown said. “Will the rise of middle-level commanders in such a scenario change the attitudes toward negotiating? Will there be more calls for the fighting to end, or will they be more intransigent in the negotiation?” It’s a level of uncertainty for which neither side is prepared.

Harsh winter weather slowed fighting in much of the country, but as the snow melts, the Taliban will have to decide whether to intensify attacks. If they do, hopes of stability in Afghanistan will slip away—and with them, any chance of controlling the pandemic.

Correction, April 30, 2020: Government officials in Faryab met with the Taliban to discuss a coordinated approach to the pandemic on April 13. A previous version of this story mistakenly said they met on April 15.