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To: =?utf-8?Q?Abdul=20Malik=20wardak?= <dr.malik@jack.ngo>
Date: Thu,  6 May 2021 15:11:19 +0000
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AFGHANISTAN
COVID-19
Strategic Situation Report No. 96 | 06 April 2021
https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/=
files/documents/files/strategic_sitrep_covid-19_6_may_2021_final.pdf
The next Strategic Situation Report will be released on 20 May 2021
Download the full update =C2=BB (https://www.humanitarianresponse.info/sit=
es/www.humanitarianresponse.info/files/documents/files/strategic_sitrep_co=
vid-19_6_may_2021_final.pdf)

** Situation Overview: UPDATED
------------------------------------------------------------
Global Update: According to John Hopkins University (https://gisanddata.ma=
ps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ec=
f6) =2C more than 3.2 million people across the world have now died due to=
 COVID-19. As of 6 may=2C the pandemic is affecting 192 countries with som=
e 154 million confirmed cases globally. WHO reports (https://reliefweb.int=
/report/world/coronavirus-disease-covid-19-weekly-epidemiological-update-4=
-may-2021) that for the second successive week=2C the number of COVID-19 c=
ases globally remains at the highest levels since the beginning of the pan=
demic with over 5.7 million new cases. For the seventh consecutive week=2C=
 new global deaths are on the increase=2C with more than 93=2C000 deaths r=
ecorded.  WHO report (https://reliefweb.int/report/world/who-urges-greater=
-surveillance-new-covid-19-variants-emerge) s that while the emergence of=
 new virus variants is common=2C those with higher speed of transmission o=
r potentially increased pathogenicity (i.e. the capacity
of a microbe to cause damage in a host) are very concerning. Crucial inves=
tigations are underway to comprehensively understand the behaviour of the=
 new virus mutation (B117) and steer the response accordingly.

https://moph-dw.gov.af/dhis-web-commons/security/login.action#/

MOPH Figures: As of 6 May=2C MoPH data (https://moph-dw.gov.af/dhis-web-co=
mmons/security/login.action#/) shows that 61=2C162 people across all 34 pr=
ovinces in Afghanistan are confirmed to have had COVID-19. Some 53=2C750 p=
eople have recovered=2C and 2=2C664 people have died =E2=80=93 at least 91=
 of whom are healthcare workers. Since the start of the pandemic=2C only 4=
12=2C798 tests have been conducted for a population of 40.4 million. While=
 numbers currently remain below those seen during the peak of the first an=
d second waves=2C recent official MOPH figures indicate a deterioration of=
 the situation=2C potentially signalling a third wave. According to WHO=2C=
 the east in particular has recently witnessed a sharp increase in COVID-1=
9 cases and hospitalisations. Between 25 April and 1 May=2C 1=2C279 new ca=
ses and 50 new deaths were reported which is a 14 per cent increase in the=
 cases and 4 per cent increase in deaths compared to the previous week. Af=
ghanistan now has a test-positivity-rate =E2=80=93 positive tests as a per=
centage
of total tests =E2=80=93 of 15 per cent=2C suggesting overall under-testin=
g of potential cases. The majority of confirmed cases were men between the=
 ages of 15 and 30=2C whereas the majority of recorded deaths were men bet=
ween the ages of 50 and 79. Men account for more than 66 per cent of the t=
otal COVID-19 confirmed cases in the MoPH data=2C although this may be the=
 result of over-representation of men in testing. Due to limited public he=
alth resources=2C lack of people coming forward for testing=2C as well as=
 the absence of a national death register=2C confirmed cases of and deaths=
 from COVID-19 are likely to be under-reported overall in Afghanistan. Sti=
gma is considered a major factor in people choosing not to get tests and r=
isk communications work is critical to turning this around. WHO warns that=
 widespread complacency and failure to follow public health advice in Afgh=
anistan is creating grave risks in the community with people generally not=
 observing physical distancing or mask-wearing protocols. WHO
Afghanistan remains concerned about mutations of the virus=2C cases of whi=
ch have been confirmed in Afghanistan. There is a significant increase in=
 cases of the new=2C more infectious variant in neighbouring Pakistan and=
 Iran. MOPH is preparing for a third wave including scaling-up surveillanc=
e at borders and improved testing.

More than 7 per cent of the total confirmed COVID-19 cases are among healt=
hcare staff and ensuring these groups are vaccinated is of critical import=
ance. Among the provinces=2C Hirat=2C Kabul=2C Nangarhar and Balkh reporte=
d the highest number of cases among healthcare workers. There is an urgent=
 need to ensure continued distribution of medical and protective equipment=
 to frontline workers all corners of the country. 26 laboratories are now=
 operating in Afghanistan =E2=80=93 with plans to scale-up to at least one=
 laboratory per province by June 2021. National laboratories are testing 7=
=2C500 samples a day. WHO reports that laboratories have capacity to test=
 up to 8=2C500 samples but low demand means technicians are currently work=
ing reduced hours.

Vaccination: The first batch (https://reliefweb.int/report/afghanistan/cov=
id-19-vaccines-shipped-covax-arrive-afghanistan) of 468=2C000 COVID-19 vac=
cination doses through the COVAX facility arrived in Afghanistan on 8 Marc=
h. In total=2C Afghanistan has received 968=2C000 doses of the vaccine =E2=
=80=93 468=2C000 from the COVAX facility and 500=2C000 directly from the g=
overnment of India -- enabling the vaccination for some 484=2C000 people.=
 COVID-19 vaccination through MOPH has now been opened to all those above=
 18 years of age. Vaccination is currently available in select health faci=
lities and through mobile vaccination teams. More than 448=2C000 have been=
 vaccinated in Afghanistan through the MOPH programme to date=2C including=
 some 100=2C000 health workers=2C 50=2C000 teachers=2C 25=2C000 people wit=
h co-morbidities and 18=2C000 prisoners. Of those vaccinated=2C 66 per cen=
t were men and 34 per cent women. Around 10 per cent of those vaccinated h=
ave received both doses of the COVID-19 vaccine.

Overall=2C however=2C there remains some concern around low demand among h=
ealthcare workers and equitable access to vaccines for Afghans=2C especial=
ly vulnerable groups such as IDPs=2C returnees and nomadic populations and=
 people living in hard-to-reach areas. IOM reports that vaccination covera=
ge is extremely limited among all migrant populations due to negative perc=
eptions and barriers to accessing care. Much more focus is needed to ensur=
e migrants are vaccinated on pace with settled populations given the impac=
t mobility has as a vector for transmission=2C especially with the more co=
ntagious viral variants now in Afghanistan. Additional efforts are also ne=
eded to reach women and people living in non-government-controlled areas w=
ith vaccines. Vaccine uptake remains slow and continued risk communication=
 and community engagement efforts are needed to ensure high-risk populatio=
ns and frontline staff understand the benefits of the vaccine and can effe=
ctively dispel misinformation. Countering negative
rumours about the vaccine is a priority. As cases increase=2C humanitarian=
 partners continue to urge the Government to ensure laboratories and front=
line staff are appropriately equipped and that procured supplies =E2=80=93=
 including vaccines =E2=80=93 go to under-resourced health centres across=
 the entire country in a transparent manner=2C so that life-saving support=
 can be delivered to those most in need. WHO reports that additional deliv=
eries from the COVAX facility will likely be delayed due to global shortag=
es however=2C additional vaccines may become available through bilateral c=
hannels.

The UN has received 5=2C000 doses of the AstraZeneca vaccine for personnel=
 so they can continue to deliver life-saving services to people in Afghani=
stan. Eligible groups include UN and INGO staff. In order to access the UN=
 vaccination scheme=2C eligible individuals must register on the UN COVID-=
19 vaccine portal. In order to access the portal=2C INGOs are requested to=
 develop a sponsorship agreement with their main UN partner. NNGO staff ar=
e able to be vaccinated through the Government=E2=80=99s vaccination schem=
e. Please see the UN COVID-19 Vaccination page (https://www.un.org/en/coro=
navirus/vaccination) for more information. Vaccinations under the UN schem=
e began in Afghanistan on 13 April.

Response update: According to the WHO Weekly COVID-19 Response Update=2C 9=
25 health workers have received training on ICU care and 1=2C702 health wo=
rkers have been trained on case management by WHO between 29 April 2021 an=
d March 2020. Since the start of the pandemic=2C WHO has further provided=
 MOPH with almost 500=2C000 PCR tests=2C more than 5.7 million surgical ma=
sks=2C over 1=2C000 oxygen concentrators and 179 hospital beds =E2=80=93 w=
ith an additional 3=2C433 hospital beds in the pipeline. Close to 300 labo=
ratory staff have been trained on PCR testing. Almost 300=2C000 health wor=
kers (including polio workers)=2C NGO and government staff have been train=
ed on COVID-19 surveillance and some 250=2C000 health workers and mobilise=
rs have been oriented on delivering preventative COVID-19 messages. Since=
 the start of March 2020=2C WHO has medically screened almost 11 million p=
eople at points-of-entry.

Socio-economic impacts: The socio-economic impacts of COVID-19 in addition=
 to other factors have translated into a dramatic deterioration in food in=
security. An updated IPC analysis just released estimates that 14.1 millio=
n people =E2=80=93 more than one third of the population - are in crisis o=
r emergency levels of food insecurity. Cumulative precipitation has been b=
elow average over the wet season with reduced precipitation and higher tem=
peratures likely to affect farmers and pastoralists=2C as well as water av=
ailability over the next few months. Food prices are already higher than n=
ormal due to COVID-19 and are likely to increase further given the dry spe=
ll=E2=80=99s likely impact on first and second crops in 2021. These factor=
s=2C combined with COVID-19 related interruptions to informal employment a=
nd decreased remittances=2C are driving people into crippling debt. Data f=
rom the 2020 Whole of Afghanistan Assessment showed that the primary reaso=
n for taking on this debt last year was to pay for food (53 per
cent).

Humanitarian needs and response planning: The 2021 edition of the multi-ye=
ar revised Afghanistan HRP (https://www.humanitarianresponse.info/sites/ww=
w.humanitarianresponse.info/files/documents/files/afg_humanitarian_respons=
e_plan_2018_2021_jan_2021.pdf) identifies 18.4 million people in humanitar=
ian need in 2021 as a result of COVID-19=2C ongoing conflict and natural d=
isasters. Approximately six times the number of people are in need of huma=
nitarian assistance in 2021 compared to four years ago when the multi-year=
 HRP was first developed. Recognising the multiple=2C overlapping challeng=
es facing the people of Afghanistan over  spring =E2=80=93 including low r=
ainfall=2C intensifying conflict=2C and ongoing COVID-19 challenges =E2=80=
=93 the ICCT conducted a multi-sectoral analysis (https://reliefweb.int/re=
port/afghanistan/afghanistan-spring-disaster-contingency-plan-mar-jun-2021=
) of likely needs across highly-impacted provinces and has published a Spr=
ing Disaster Contingency Plan identifying the most urgent needs
from March-June=2C with $390 million required for response. Securing addit=
ional funding for this spring plan and the broader HRP is urgent with only=
 11.6 per cent of 2021 HRP requirements received to date.

Cross Border: UPDATED
Border Crossings: The Iranian Government has imposed an indefinite lockdow=
n with border closures starting from 29 April. The border will remain open=
 only to commercial traffic and movement of documented nationals returning=
 home to Afghanistan. According to the Border Monitoring Team of the Direc=
torate of Refugees and Repatriation (DoRR)=2C a total of 22=2C855 Afghanis=
tan nationals returned from Iran through the Milak and Islam Qala border c=
rossing sites between 23 and 29 April. 9=2C824 people returned voluntarily=
 and 13=2C031 were deported. Since the start of the year=2C a historically=
 significant influx of 363=2C941 people returned to Afghanistan=2C sparkin=
g new concerns about transmission of COVID-19 variants and overall absorpt=
ion capacity of existing health resources. A sharp drop in remittances to=
 Afghanistan has also been observed.

Pakistan has imposed a two-week lockdown between 5 and 19 May and closed i=
ts borders with Iran and Afghanistan for incoming people. The border will=
 only remain open to outbound commercial movements and for Afghan national=
s returning to Afghanistan. Between 23 and 29 April 2021=2C a total of 194=
 undocumented Afghans voluntarily returned from Pakistan through the Torkh=
am and Spin Boldak borders.

According to a recent IOM community-based needs assessment (https://relief=
web.int/report/afghanistan/afghanistan-community-based-needs-assessment-su=
mmary-results-round-11-jul-dec) =2C extremely high levels of unemployment=
=2C in combination with Afghanistan=E2=80=99s informal employment and agri=
culture-based economy=2C mean that only limited job opportunities are avai=
lable in urban areas hosting high number of IDPs=2C cross-border returnees=
 and other mobile populations=2C especially in overcrowded cities like Hir=
at=2C Kabul and Jalalabad. As a result=2C these increasingly dire economic=
 circumstances=2C which are exacerbated by the ongoing COVID-19 pandemic=
=2C are leading to significant outward migration to Iran=2C Turkey and bey=
ond.
------------------------------------------------------------
Download the full update =C2=BB (https://www.humanitarianresponse.info/sit=
es/www.humanitarianresponse.info/files/documents/files/strategic_sitrep_co=
vid-19_6_may_2021_final.pdf)
Click here to subscribe (http://eepurl.com/ydXVr) to future COVID-19 updat=
es and other OCHA products.
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                    <tbody><tr>

</td>
                    </tr>
                </tbody></table>
=09=09=09=09

</td>
                    </tr>
                </tbody></table>
=09=09=09=09

</td>
                    </tr>
                </tbody></table>
=09=09=09=09

=09=09=09=09
            </td>
        </tr>
    </tbody>
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00%" class=3D"mcnDividerBlock" style=3D"min-width: 100%;border-collapse: c=
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    </tbody>
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00%" class=3D"mcnImageBlock" style=3D"min-width: 100%;border-collapse: col=
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</td>
                        </tr>
                    </tbody></table>
                </td>
            </tr>
    </tbody>
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00%" class=3D"mcnDividerBlock" style=3D"min-width: 100%;border-collapse: c=
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    <tbody class=3D"mcnDividerBlockOuter">
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dding: 10px 18px;mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;=
-webkit-text-size-adjust: 100%;">
                <table class=3D"mcnDividerContent" border=3D"0" cellpaddin=
g=3D"0" cellspacing=3D"0" width=3D"100%" style=3D"min-width: 100%;border-t=
op: 5px solid #82B5E9;border-collapse: collapse;mso-table-lspace: 0pt;mso-=
table-rspace: 0pt;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100=
%;">
                    <tbody><tr>
                        <td style=3D"mso-line-height-rule: exactly;-ms-tex=
t-size-adjust: 100%;-webkit-text-size-adjust: 100%;">
                            <span></span>
                        </td>
                    </tr>
                </tbody></table>

            </td>
        </tr>
    </tbody>
</table><table border=3D"0" cellpadding=3D"0" cellspacing=3D"0" width=3D"1=
00%" class=3D"mcnTextBlock" style=3D"min-width: 100%;border-collapse: coll=
apse;mso-table-lspace: 0pt;mso-table-rspace: 0pt;-ms-text-size-adjust: 100=
%;-webkit-text-size-adjust: 100%;">
    <tbody class=3D"mcnTextBlockOuter">
        <tr>
            <td valign=3D"top" class=3D"mcnTextBlockInner" style=3D"paddin=
g-top: 9px;mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;-webki=
t-text-size-adjust: 100%;">
              =09
=09=09=09
=09=09=09=09
                <table align=3D"left" border=3D"0" cellpadding=3D"0" cells=
pacing=3D"0" style=3D"max-width: 100%;min-width: 100%;border-collapse: col=
lapse;mso-table-lspace: 0pt;mso-table-rspace: 0pt;-ms-text-size-adjust: 10=
0%;-webkit-text-size-adjust: 100%;" width=3D"100%" class=3D"mcnTextContent=
Container">
                    <tbody><tr>

</td>
                    </tr>
                </tbody></table>
=09=09=09=09

<a href=3D"https://humanitarianresponse.us4.li=
st-manage.com/track/click?u=3Dfe0746c970b6af5b85b9a5ef4&id=3Dec2dbb87b8&e=
=3D378d750ef4" target=3D"_blank" style=3D"mso-line-height-rule: exactly;-=
ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;color: #418fde;fo=
nt-weight: normal;text-decoration: underline;"><font face=3D"roboto=2C hel=
vetica neue=2C helvetica=2C arial=2C sans-serif"><span style=3D"font-size:=
14px">Download the full update&nbsp;</span></font>=C2=BB</a>
                        </td>
                    </tr>
                </tbody></table>
=09=09=09=09

<h2 style=3D"text-align: justify;display: bloc=
k;margin: 0;padding: 0;color: #222222;font-family: Helvetica;font-size: 34=
px;font-style: normal;font-weight: bold;line-height: 150%;letter-spacing:=
 normal;"><span style=3D"color:#0066cc"><strong style=3D"font-size:13px"><=
u>Situation Overview:</u></strong><span style=3D"font-size:13px"> </span><=
/span><span style=3D"color:#FF0000"><strong style=3D"font-size:13px">UPDAT=
ED</strong></span></h2>

<hr>
<div style=3D"text-align: justify;"><a href=3D"https://humanitarianrespons=
e.us4.list-manage.com/track/click?u=3Dfe0746c970b6af5b85b9a5ef4&id=3D57a50=
23f31&e=3D378d750ef4" target=3D"_blank" style=3D"mso-line-height-rule: ex=
actly;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100%;color: #41=
8fde;font-weight: normal;text-decoration: underline;"><span style=3D"font-=
size:12px">Download the full update&nbsp;=C2=BB</span></a></div>

</td>
                    </tr>
                </tbody></table>
=09=09=09=09

=09=09=09=09
            </td>
        </tr>
    </tbody>
</table><table border=3D"0" cellpadding=3D"0" cellspacing=3D"0" width=3D"1=
00%" class=3D"mcnDividerBlock" style=3D"min-width: 100%;border-collapse: c=
ollapse;mso-table-lspace: 0pt;mso-table-rspace: 0pt;-ms-text-size-adjust:=
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    <tbody class=3D"mcnDividerBlockOuter">
        <tr>
            <td class=3D"mcnDividerBlockInner" style=3D"min-width: 100%;pa=
dding: 30px 18px;mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;=
-webkit-text-size-adjust: 100%;">
                <table class=3D"mcnDividerContent" border=3D"0" cellpaddin=
g=3D"0" cellspacing=3D"0" width=3D"100%" style=3D"min-width: 100%;border-t=
op: 1px solid #82B5E9;border-collapse: collapse;mso-table-lspace: 0pt;mso-=
table-rspace: 0pt;-ms-text-size-adjust: 100%;-webkit-text-size-adjust: 100=
%;">
                    <tbody><tr>
                        <td style=3D"mso-line-height-rule: exactly;-ms-tex=
t-size-adjust: 100%;-webkit-text-size-adjust: 100%;">
                            <span></span>
                        </td>
                    </tr>
                </tbody></table>

            </td>
        </tr>
    </tbody>
</table><table border=3D"0" cellpadding=3D"0" cellspacing=3D"0" width=3D"1=
00%" class=3D"mcnTextBlock" style=3D"min-width: 100%;border-collapse: coll=
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        <tr>
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g-top: 9px;mso-line-height-rule: exactly;-ms-text-size-adjust: 100%;-webki=
t-text-size-adjust: 100%;">
              =09
=09=09=09
=09=09=09=09
                <table align=3D"left" border=3D"0" cellpadding=3D"0" cells=
pacing=3D"0" style=3D"max-width: 100%;min-width: 100%;border-collapse: col=
lapse;mso-table-lspace: 0pt;mso-table-rspace: 0pt;-ms-text-size-adjust: 10=
0%;-webkit-text-size-adjust: 100%;" width=3D"100%" class=3D"mcnTextContent=
Container">
                    <tbody><tr>

</td>
                    </tr>
                </tbody></table>
=09=09=09=09

=09=09=09=09
            </td>
        </tr>
    </tbody>
</table><table class=3D"mcnTextBlock" style=3D"min-width: 100%;border-coll=
apse: collapse;mso-table-lspace: 0pt;mso-table-rspace: 0pt;-ms-text-size-a=
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              =09
=09=09=09
=09=09=09=09
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n=3D"left">
                    <tbody><tr>

</td>
                    </tr>
                </tbody></table>
=09=09=09=09

=09=09=09=09
            </td>
        </tr>
    </tbody>
</table><table class=3D"mcnFollowBlock" style=3D"min-width: 100%;border-co=
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    <tbody><tr>
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                                                                         =
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rget=3D"_blank" style=3D"mso-line-height-rule: exactly;-ms-text-size-adjus=
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                                                                         =
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                                                                    </tbod=
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                                                                </td>
                                                            </tr>
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                                                    </td>
                                                </tr>
                                            </tbody></table>

=
       <td class=3D"mcnFollowIconContent" width=3D"24" valign=3D"middle" a=
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rget=3D"_blank" style=3D"mso-line-height-rule: exactly;-ms-text-size-adjus=
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"24"></a>
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ck/click?u=3Dfe0746c970b6af5b85b9a5ef4&id=3D7a6963cace&e=3D378d750ef4" ta=
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=3D"24"></a>
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=
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                                                                         =
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                                                                         =
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</td>
                            </tr>
                        </tbody></table>
                    </td>
                </tr>
            </tbody></table>
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</tbody></table>

</td>
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</table></td>
                                        </tr>
                                    </table>
                                    
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                            <tr>
                                <td align=3D"center" valign=3D"top" id=3D"=
templateFooter" data-template-container=3D"" style=3D"background:#418fde n=
one no-repeat center/cover;mso-line-height-rule: exactly;-ms-text-size-adj=
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und-image: none;background-repeat: no-repeat;background-position: center;b=
ackground-size: cover;border-top: 0;border-bottom: 0;padding-top: 45px;pad=
ding-bottom: 63px;">
                                    
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