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Amid brutal case surge, Afghanistan hit by a vaccine delay


“We are in the middle of a crisis,” health ministry spokesman Ghulam Dastigir Nazaree said this week, expressing deep disappointment over global vaccine distribution, which has left poor countries scrambling to find supplies for their people.

Nazari has approached several embassies, and so far, “I have received diplomatic answers” but there is no vaccine, he said.

Over the past month, the rising pace of new cases has put Afghanistan’s health system at risk, which is already grappling with the weight of relentless conflict. In part, the increase has been blamed on uninterrupted travel with India, bringing the highly contagious delta variant, which was first identified in India.

Furthermore, most Afghans still question the reality of the virus or believe their faith will protect them and rarely wear masks or social distancing, often mocking those who do. Until just a week ago, the government was allowing unrestricted mass gatherings.

The delta version has helped boost Afghanistan’s infection rate, hitting 16 provinces and the capital, Kabul, the hardest-hit. This week, the rate of new cases reported reached 1,500 per day, compared to 178 in a day on May 1.

Hospital beds are full, and it is feared the rapidly dwindling oxygen supply will be exhausted. Foreign Minister Hanif Atmar said in a tweet on Friday that Afghan ambassadors have been ordered to supply emergency oxygen to neighboring countries.

Afghanistan has reported a total of 78,000 cases and 3,007 deaths from the pandemic, according to official figures. But those figures are likely a massive understatement, which only records deaths in hospitals, not the greater number of those who die at home.

Testing is grossly inadequate. In the last one month alone, the percentage of positive COVID tests has increased from around 8% to 60% in some parts of the country. According to WHO recommendations, anything over 5% shows officials are not testing widely enough, allowing the virus to spread uncontrollably.

Only 3,000 tests a day are conducted, as Afghans oppose testing, even though the country has dramatically increased its capabilities to 25,000.

Recently, the government tried to take steps to stem the boom. It closed schools, universities and colleges for two weeks. It also closed the wedding halls, which had been running non-stop during the entire pandemic.

But it is rare to see someone wearing a mask on the streets, and even where masks are mandatory in government offices, it is rarely enforced. There are at least 10 flights a day from India, which are full of Afghans, especially students and people who had gone to India for medical treatment.

Nazri said banning flights was not an option as many Afghans cannot afford to be stranded in India and the government cannot prevent citizens from re-entering their country.

For vaccines, Afghanistan has so far relied on donations of AstraZeneca doses from India and then purchases of Sinopharm from China. About 600,000 people have taken at least one dose, about 1.6% of the population of 36 million. But the number of people taking the second dose is minute — “so low I couldn’t even tell a percentage,” Nazarey said.

Last month, the ministry received a letter from the WHO stating that the expected shipment of 3 million vaccine doses would not arrive until August due to supply problems, Nazary said. With only 35,000 vaccine doses remaining in the country, officials were forced to stop giving the first jab to use up the remaining supplies, he said.

Poor countries around the world are begging for vaccines, while developed countries are able to vaccinate a significant portion of their population. COVAX, set up with the help of the United Nations to try to stop vaccine disparities, has struggled to fill the gap. It faced a major setback when its biggest supplier, Serum Institute of India, announced last month that it would not export any vaccines until the end of the year due to the boom in that country.

“To be honest, I lost my faith in COVAX,” said Nazarey.

“Unfortunately, there are countries that vaccinated more than 50% or 60% of their population … and there are countries that have not received vaccines to vaccinate even 1% of their population.”

Hospital administrator Dr. Jalmai Rishtin said three or four people die of COVID every day in the Afghan-Japan hospital.

Doctors struggle with the public’s refusal to take precautions and follow safety protocols. “Our people believe it is fake, especially in rural areas,” Rishteen said. “Or they are religious and believe that God will save them.”

In the hospital’s intensive care unit, Dr. Rahman Mohtazir said this makes it more dangerous for him as he does his job. “I’m afraid I’ll catch it, but I’m here to help,” he said. “I listen to people and they say it’s fake. Then here they come.”

The health ministry has recruited clerics, prominent religious figures and local elders to encourage vaccination and anti-coronavirus precautions.

The worsening COVID situation prompted the US embassy on Thursday to issue a warning of a shortage of supplies, oxygen and beds in hospitals and to urge US citizens to “leave Afghanistan as soon as possible”.

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Associated Press Medical Writer Maria Cheng in London and Associated Press Writer Tamim Akhgar in Kabul contributed to this report.

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