On the Brink: The urgency of getting aid to Afghanistan

The growing risk of an unstable Afghanistan is not a new worry. Despite the fact that the Taliban regime is unable to bridge the gap between promises of inclusive governance, and a harsh counterfactual where girls are still stopped from secondary school, the truth is that the impact of a humanitarian catastrophe will fall exactly on those vulnerable citizens that the international community seeks to protect, but is unable to find routes to bypassing a government it cannot recognise.

The peril of an increasingly wiped-out Afghan economy and contracting trade lifelines from the region compounds the stark fact that 97 percent of Afghan citizens now face the very real risk of acute poverty by 2022, while the IMF estimates that the GDP may contract by 30 percent in the coming months.

The latest assessment of the UN predicts that the crisis could be worse than what was seen in Syria and Yemen, and that about 23 million Afghans will not have enough food to get through the winter unless aid is scaled up rapidly. Prolonged drought in parts of the country, Covid-19, and severe losses to this year’s wheat crop have contributed to this crisis. Desperate families are being forced to sell their babies for money to feed their starving families as food inflation has jumped by 50 percent, whereas other daily goods like petrol now cost 75 percent more.

Although the UN secretary-general’s appeal to overturn “Afghanistan’s most perilous hour” prompted world leaders to pledge more than a billion dollars in Geneva, the gap between pledges and cash streams may not bridge, nor may aid workers in Afghanistan manage doorstep delivery.

While ongoing cargo flights ferry in badly needed medical supplies and other relief, there is clearly a gaping deficit between need and aid. With limited resources, women and girls are at the frontline facing dire consequences as the UNFPA estimates that without immediate action there can be 51,000 maternal deaths, and 4.8 million unintended pregnancies.

Afghanistan already has the worst maternal mortality rate in the world, with 638 women dying per 10,000 live births. Ten million children need humanitarian assistance to survive, whereas two million children are already suffering from acute malnutrition in Afghanistan. Save the Children has also warned that the collapse of Afghanistan’s healthcare system will result in monthly deaths of thousands of children who are below the age of five as the winter season approaches.

While Afghan governance structures are broken, a lack of sustained aid flows and predictability of deliveries throws even the shaky Sehatmandi project in jeopardy – the country’s vital source of primary and secondary healthcare for 31 out of 34 provinces in Afghanistan, whose 2000 clinics and health facilities cater to millions of citizens. The WHO has revealed that currently only around 80 to 90 of the 2,300 healthcare facilities are functional, while healthcare providers are currently five times below the "threshold for the critical shortage” as only 4.6 doctors, nurses and midwives remain per 10,000 Afghans.

Restrictions on women’s mobility and fear among communities, along with the scarcity and unaffordability of medicines and medical supplies have further added to the scale and severity of the crisis in Afghanistan. Healthcare professionals have warned that thousands of preventable deaths will occur only on account of Covid-19 if the Sehatmandi project continues to face disruptions. So far only 2.8 million Afghans (3.8 percent of the population) have been inoculated.

Before the Taliban assumed power, Covid-19 had already contracted the Afghan economy and increased urban poverty to 45.5 percent from 41.6 percent in 2020, whereas 34.3 percent of the employed population lived below the $1.90 per day threshold. Forty percent of Afghanistan’s GDP came from foreign aid and with the dramatic economic shocks following the collapse of Ashraf Ghani’s government, poverty rates are expected to shoot up as much as 97 percent. There is a confluence of unfolding crises within this, including internal displacement, migration to cities, capital flight and the return of opium and other illicit trade that sustains a war economy.

The challenge of aid governance in Afghanistan is not new. Distribution mechanisms had become anaemic due to corruption and misgovernance well before the Taliban took over, but their inexperience has almost paralysed it. Many surveys by international auditors through the last two decades reported that Afghans saw their government as predatory, that corruption was endemic and public office was open for purchase. Afghanistan consistently ranked between 1 and 2 out of 100 for rule of law and political stability over ten years, and 64 out of 364 districts did not have any government civil office by 2019, as per the World Bank. Now, though, there is no semblance of any framework left.

As Afghanistan’s famous winter sets in, and Taliban capacity to manage predictability and aid supply chains continues to be in freefall, things look even worse. The Taliban may be learning the hard way that managing a resistance force is not the same thing as running a state; the interim cabinet is still unable to grapple with food and healthcare provision for a population of 40 million people, to name only two areas that need urgent intervention. Women, who remain at risk – like minorities – will be the worst hit if pledges don’t come through, or don’t reach rural Afghanistan.

Each day the numbers signalling distress get worse. Pictures of Afghan children starving to death on the cold streets of Kabul are as real as they are heartbreaking. Financial contributions, food and medical assistance must reach these Afghans.

As became especially evident during the Covid period, several provinces bordering Pakistan and large parts of the populace depend on the trade in consumer perishables coming in via Pakistan. This trade is slowly picking up once again, but in order to strengthen trade ties and an overall increase of trade volume between the two countries, structured bilateral agreements have yet to be reached. Easing logistical barriers such as increasing the number of border crossings and reducing trade restrictions can increase the total trade by more than $5 billion.

Western diplomats returning from Kabul seeking to find ways to deliver aid remain despondent about managing behavioural change in the Taliban. They see the Taliban regime as unresponsive to aid as a carrot, while the prospect of a sanctions stick is viewed as non-viable. The EU especially seems to be in a bind about how to deliver aid effectively to Afghanistan while not embracing the Taliban regime. Unlike the US, which seems to have no Afghan policy after their precipitous exit, most European countries are openly probing options after the UN chief Anthony Guterres’ cautionary words that “the Afghan people cannot suffer a collective punishment because the Taliban misbehave”.

Until today, it is literally only the UN, whose multiple agencies are looking for viable entry points into Afghanistan, as they continue to transmit some semblance of ground knowledge while prioritising Afghanistan’s humanitarian crisis over geopolitical considerations. Neighbouring countries including Pakistan remain engaged for food supplies but wary of endorsing the politics of the Taliban. The dilemma is as real as the worsening crisis.

The writer is chair of the Foreign Affairs Committee in the Senate of Pakistan, former ambassador to the United States, and president of Jinnah Institute in Islamabad.

Originally published in The News