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Afghanistan: Strategic Situation Report: COVID-19, No. 94 (8 April 2021)

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Situation Overview: UPDATED

Global Update: According to John Hopkins University, almost 2.9 million people have now died with COVID-19 across the world. The pandemic is affecting 192 countries with some 133 million confirmed cases globally, as of 8 April. WHO reports that while the emergence of new virus variants is common, those with higher speed of transmission or potentially increased pathogenicity (i.e. the capacity of a microbe to cause damage in a host) are very concerning. Crucial investigations are underway to comprehensively understand the behaviour of the new virus mutation (B117) and steer the response accordingly.

On 7 April 2021, World Health Day was commemorated globally, under the theme “Together for a fairer, healthier world”. On this occasion, WHO is calling for urgent action to eliminate health inequities and attain better health for all, leaving no one behind. The COVID-19 pandemic has had grave consequences for people already experiencing inequities. The pandemic has disproportionately impacted those people who are already socially, economically, or geographically disadvantaged, and evidence shows a worsening trend of disparities and inequity across the Eastern Mediterranean Region. On World Health Day 2021, WHO is calling on leaders to monitor health inequalities and address their root causes to ensure that everyone has access to the living and working conditions that are conducive to good health and to quality health services where and when they need them. WHO is also calling for increased investment in primary health care to achieve health for all, by all.

MOPH Figures: As of 8 April, MoPH data shows that 56,945 people across all 34 provinces in Afghanistan are confirmed to have had COVID-19. Some 51,940 people have recovered, and 2,516 people have died – at least 91 of whom are healthcare workers. Only 361,751 people out of a population of 40.4 million have been tested. Afghanistan now has a test-positivity-rate – positive tests as a percentage of total tests – of close to 16 per cent, suggesting overall under-testing of potential cases. The majority of recorded deaths were men between the ages of 50 and 79. Men account for almost 67 per cent of the total COVID-19 confirmed cases in the MoPH data, although this may be the result of overrepresentation of men in testing. Due to limited public health resources, lack of people coming forward for testing, as well as the absence of a national death register, confirmed cases of and deaths from COVID-19 are likely to be under-reported overall in Afghanistan.

Stigma is considered a major factor in people choosing not to get tests and risk communications work is critical to turning this around. WHO warns that widespread complacency and failure to follow public health advice in Afghanistan 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, cases of which have been confirmed in Afghanistan. There is a significant increase in cases in Pakistan and Iran with the new variant which is potentially more infectious and can affect younger people. The Ministry of Public Health is preparing contingencies for a potential third wave which includes scaling up surveillance at borders and improving testing.

Almost 8 per cent of the total confirmed COVID-19 cases are among healthcare staff and they are currently the highest priority for vaccination. There is an urgent need to ensure continued distribution of medical and protective equipment to all corners of the country. While 23 laboratories are now operating in Afghanistan – with plans to scale up to at least one laboratory per province by June 2021 – the capacity of these facilities remains limited and stocks of supplies have periodically run out. National capacity for COVID-19 testing is 7,200 samples a day however these laboratories are not being fully utilised. WHO reports that while the national testing capacity stands at 8,500 samples a day, it is only utilised up to 7,200 samples a day as laboratory technicians are working less hours due to lower demand for testing.

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