KABUL, Afghanistan – Afghanistan, whose citizens have largely set aside the coronavirus pandemic as an exaggerated or blind joke, is now preparing to distribute the first batch of vaccines.
Half a million doses of the AstraZeneca-Oxford vaccine, manufactured by an Indian manufacturer, were delivered by India in the capital, Kabul, on February 7. But the arrival was greeted with indifference by many Afghans, who the government warnings about the virus are a deadly threat to public health.
The cheap and easy-to-store AstraZeneca-Oxford vaccine is delivered as part of the Covax program, a global initiative to buy and distribute vaccines for free or at a lower cost to poor countries. On February 15, the World Health Organization approved the use of the vaccine, which requires two doses per person, which should pave the way for Afghanistan to begin its vaccination campaign.
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Global trials have found that the vaccine provides complete protection against serious diseases and death. However, its efficacy against the virus variant first seen in South Africa is in question after the vaccine failed in a small trial to prevent participants from developing mild or moderate COVID cases.
The vaccine arrives because Afghanistan is repelling a second deadly wave, even though most Afghans live their daily lives as if the virus never existed. Many people refuse to wear masks and gather in a dense crowd in bazaars, supermarkets, restaurants and mosques, unaware of ubiquitous public health posters.
In an impoverished nation plagued by war, famine, poverty and drought, an invisible virus is considered false or an afterthought.
“Of course I will not take the vaccine because I do not believe in the existence of the coronavirus,” said Muhibullah Armani, 30, a taxi driver in the southern city of Kandahar.
Armani expressed a sentiment shared by many Afghans: “When I see people covering their mouths and noses, afraid of COVID, it makes me laugh at them.”
And even among Afghans who believe the virus is real and want to be vaccinated, there is little confidence that the government, caught up in pervasive corruption, will distribute a limited amount of vaccines.
“This vaccine is only available to people with high status,” said Khalil Jan Gurbazwal, a civilian activist in Khost province in eastern Afghanistan.
Nizamuddin, a tribal elder in a Taliban-controlled district in northern Afghanistan’s Faryab province, said he was afraid the vaccine would be appropriated by well-connected politicians and warriors.
“It is common in Afghanistan that even food aid is stolen by corrupt people,” said Nizamuddin, who, like many Afghans, calls one name.
The Attorney General’s Office said Thursday that 74 government officials from five provinces have been charged with embezzling coronavirus response funds. Among the accused were former provincial governors and deputy governors.
In Kunduz province in northern Afghanistan, a hospital administrator told authorities that hospital officials had collected medical costs for COVID-19 treatment for 50 beds in a hospital with only 25 beds, which reduced the cost of ‘ghost workers’, recently the Special Inspector General for the Reconstruction of Afghanistan, pocketed.
“This failure is costing Afghan citizens not only financially but also the delay in accessing potentially life-saving medical care,” the U.S. embassy said in a statement. But for many Afghans, the vaccine is a solution to a problem that does not exist.
When the vaccination program began on Tuesday, the first dose in the presidential palace in Kabul was administered to Anisa Shaheed, a television reporter who discussed the pandemic.
The distribution of any vaccine in a desperately poor country consumed by unrest is a daunting logistical challenge. In addition to overcoming public suspicion and traversing dangerous areas, the Ministry of Public Health must also navigate the delivery of vaccines in remote provinces with poor roads and primitive infrastructure.
The pandemic has led to an increase in polio cases in Afghanistan because it has made it more difficult for polio teams to reach outlying areas, Dr. Osman Tahiri, public affairs adviser to the health ministry, which reported 56 polio cases in 2020, said 29 in 2019.
But just as worrying are the 305 cases of a variant of polio in Afghanistan in 2020, compared to zero such cases reported in 2019, said Merjan Rasekh, head of public awareness for the polio eradication program.
Rasekh attributes much of the increase in the various polio cases to Afghan refugees returning from neighboring Pakistan, who have also struggled to eradicate polio. The WHO is expected to grant emergency approval for a vaccine against the variant by the end of the year.
While struggling with an increase in polio cases, Tahiri said health workers would try to spread the coronavirus vaccine, even in Taliban-controlled areas where the militants allowed clinics through the government. The Taliban set up public health programs warning of the pandemic and distributing personal protective equipment while allowing government health workers into their areas.
But Tahiri conceded that vaccination teams could not reach broad levels of the country where the battle between the Taliban and government forces is fiercest.
Tahiri trained a thousand vaccination teams last week. The ministry hopes to receive more donated vaccines; Afghanistan, according to him, has the capacity to store 20 million doses.
The first doses go to health workers and security officials “who are at risk and working in busy places,” Tahiri said, although there is not yet enough vaccine for everyone in this category. Journalists can also apply to receive the vaccine, he added.
According to the Ministry of Public Health, Afghanistan has recorded more than 55,000 cases of coronavirus and nearly 2,500 COVID-related deaths.
However, due to limited testing and an inadequate public health system, experts believe that the actual number of cases and deaths is exponentially higher.
A WHO model estimated in May that more than half of the estimated 34 million people in Afghanistan could become infected. The Ministry of Public Health estimated in the autumn that more than 10 million Afghans had contracted the virus.
Regardless of whether Afghans believe the virus is real, there is a lasting belief that Allah determines the fate of a believer.
Ahmad Shah Ahmadi, a resident of Khost province, said it was not necessary to take the vaccine. “Unbelievers do not believe in God, and therefore they fear the coronavirus. “There is little danger for Muslims,” he said.
But 46-year-old Imam Nazar, a farmer in Kunduz province, said most residents of his village believe the virus is real because several villagers died from COVID-19. He said he and other villagers were eager to get the vaccine, but doubted it would reach their remote city.
“This government is not keeping its promises,” Nazar said.
This article originally appeared in The New York Times.
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