Like the rest of the world, Afghanistan experienced an unprecedented health crisis when the COVID-19 pandemic hit the country. The pandemic has had drastic impacts in Afghanistan due to its fragile healthcare system that is largely dependent on support from international donors. About 40% of the population does not have access to primary healthcare within thirty minutes of walking distance, and advanced healthcare is only limited to a few major urban centers.
The first COVID-19 case was reported late February in Herat province, which has since been the epicenter for the virus. As of 12th December, Afghanistan has officially recorded 48,826 positive COVID-19 cases out of more than 160 thousand tests across the country costing 1,949 lives. However, the total number of positive cases and actual death toll could be much higher as the country lacks a comprehensive surveillance system to record cases, and the population remains largely unaware of the risks and reluctant to visit health facilities when they show symptom.
With limited capacity in the system and the unique nature of the pandemic, the surveillance system and emergency response mechanisms were not enough to cope with the epidemic and capture the required data to provide a timely response to the needs of the public.
Considering these limitations, UNDP pledged support to the Ministry of Public Health (MoPH) regarding the pandemic response. The support to COVID-19 response was in April 2020, when MoPH requested UNDP to assist the establishment of 15 fixed centers and 13 rapid response teams in Kabul. The initial pledge was for six months which ended in September. Through these interventions, more than 31,000 samples were collected, and 7563 positive cases were detected. Moreover, the project also provided risk communication sessions and provide advices and care for more than 30,000 suspected cases for home quarantine. In addition to this, through its rapid response fund, UNDP also supported the establishment of rapid response teams and fixed centers in Kandahar, Herat and Nangarhar provinces, where the support was provided from June to November 2020.
In July 2020, the MoPH modified its strategy for the fight against COVID-19 pandemic. One of the major interventions defined under the new strategy was home-based care, community involvement and contact tracing. Following the successful experience of the first phase of the project, MoPH requested for UNDP’s support in implementing home-based care interventions in Kabul city. The support was granted in October and the home-based care interventions started through 18 mobile teams comprising a medical doctor and a qualified nurse providing medical care for people in need.
"I appreciate the timely support from UNDP for the establishment of 118 Rapid Response Teams and home - based care teams. Based on the lessons learned from the first wave, these teams help us provide home based care for the mild and moderate cases and restrict them at home with provision of medical advice, health education and risk communication” said Afghanistan’s Minister of Public Health Dr. Ahmad Jawad Osmani.
“We are satisfied with the performance of the RRTs and expect UNDP to continue their support for at least three more months as we go through the second wave of the pandemic."
Apart from home-based support in Kabul, UNDP also supports the health system in responding to the pandemic in several other provinces of the country, where COVID-19 cases are rising. To ensure on time service delivery and prepare for the second wave of the pandemic, UNDP supported establishment of 100 extra rapid response teams in Kabul, Balkh, Kandahar, Herat, Ghazni, Bamyan, Nangarhar and Daikundi provinces.
To date, the teams have conducted a total of 1919 risk communication sessions in education facilities, mosques and community councils. Through these sessions more than 520,000 individuals were informed about COVID-19 prevention measures and treatment by home-based care and rapid response teams. These individuals were comprised of 198,775 women and 97,999 children under 18. The teams detected 1,606 COVID-19 cases based on clinical definition guideline for COVID-19 and referred them to home quarantine or hospitals depending on the severity of the disease.
UNDP’s support to the health system in Afghanistan is not limited to providing emergency support to respond to COVID-19. With financial support from the Global Fund, UNDP has supported the country to strengthen its healthcare sector to fight HIV/AIDS, TB and malaria. UNDP has also assisted MoPH in strengthening the capacity of the laboratory sector at the Central Public Health Laboratory (CPHL), five regional reference laboratories and provincial diagnostics centers which proved vital during the pandemic.
“While our emergency support to the people and government of Afghanistan to respond to the pandemic is vital, we will continue with our programmes to strengthen and improve the health system in the country” said Abdallah Al Dardari, UNDP Resident Representative for Afghanistan.
“We are providing the government with socioeconomic impact assessments of the pandemic and working together with all partners on an integrated post-pandemic recovery programme to minimize the severity of the pandemic on the citizens.”
While the second wave of the pandemic is underway, UNDP will continue to support the people and government of Afghanistan to strengthen the health system and provide essential support. At the same time, as the ‘integrator’ of SDGs, UNDP will coordinate the UN system in post-COVID-19 socioeconomic recovery phase.