The development came as the United Nations’ top humanitarian official, Martin Griffiths, announced the release of $45 million from an emergency fund to support Afghanistan’s crumbling healthcare system.

“Allowing Afghanistan’s healthcare delivery system to fall apart would be disastrous,” said Griffiths. “People across the country would be denied access to primary healthcare such as emergency caesarean sections and trauma care.”

Kabul crisis

Echoing that message from the Afghan capital, Kabul, WHO Director-General Tedros Adhanom Ghebreyesus said that international funding cuts had forced health providers to decide “who to save and who to let die”.

After meeting senior Taliban figures, medical professionals and patients, Tedros explained that a lack of financial support for the country’s largest health project, Sehetmandi, had left thousands of facilities unable to buy medical supplies and pay salaries.

Fewer than one in five of the country’s Sehetmandi facilities remained open, the WHO chief explained, although he said that access to all communities was “no longer impeded”.

Medicine shortages

“This breakdown in health services is having a rippling effect on the availability of basic and essential health care, as well as on emergency response, polio eradication, and COVID-19 vaccination efforts,” Tedros said, amid reports that cold chain medical storage has been compromised.

COVID-19 risk

The WHO chief also noted that nine of 37 COVID-19 hospitals have already closed, and that “all aspects” of the country’s COVID-19 response have dropped off, from surveillance to testing and vaccination.

Among its operations in Afghanistan, WHO supports an extensive trauma programme that includes training, the provision of supplies and equipment for 130 hospitals and 67 blood banks.

COVID-19 vaccine challenge

Data from WHO indicated that before the Taliban takeover on 15 August, 2.2 million people had been vaccinated against the new coronavirus in Afghanistan.

“In recent weeks, vaccination rates have decreased rapidly while 1.8 million COVID-19 vaccine doses in the country remain unused,” Tedros said. “Swift action is needed to use these doses in the coming weeks and work towards reaching the goal of vaccinating at least 20 per cent of the population by the end of the year.”

The WHO top official also urged renewed action to eradicate polio in Afghanistan - one of two countries where the disease remains endemic.

Measles is also spreading, the WHO Director-General warned, but he said that access to all communities was now possible. “With only one case of wild poliovirus reported so far this year, compared to 56 in 2020, there has never been a better time to eradicate polio,” Tedros said. “However, the polio programme will struggle to respond if the basic immunization infrastructure begins to collapse around it.”

This meant that WHO and partners can begin a country-wide house-to-house polio vaccination campaign, combining measles and COVID vaccination too, he explained.