The Afghan government must take immediate action to implement its revised national COVID-19 response plan to control the second wave of the virus. If it does not do this, Afghanistan’s communities will undoubtedly see an increase in transmissions of the virus with increased mortality rates. The Afghan government will also lose a golden opportunity to invest in the country’s health system.
At the beginning of the pandemic, the Afghanistan Ministry of Public Health (MoPH) took serious steps regarding the preparation and early implementation of the COVID-19 response plan. But the country’s health sector struggles with low quality of healthcare, poor accessibility for citizens and limited financing, so an effective response to the mammoth task of tackling COVID-19 was always beyond the capacity of the health ministry alone.
For months, Afghans have witnessed newly constructed hospital buildings specifically for coronavirus patients, lying empty due to challenges in the procurement of required resources, including trained staff.
Even hospitals with partial operations had shortages of essential supplies like oxygen as well as staff, which caused high death rates particularly among healthcare workers-- reported by Voice of America to be the highest in Asia.
Several cases of misuse and the inefficient use of resources because of poor governance have also been reported in national and international media.
In recent weeks, Afghanistan has seen a significant increase in the number of deaths reported on social media. But due to relatively poor surveillance systems, low utilization of diagnostic and treatment facilities in the public sector and the lack of integration between private and public health sector reporting, data produced by the public health sector does not depict the true picture of high risk areas in the country.
Therefore, the Afghan health ministry has not fully implemented all required measures in said high risk areas to reduce the transmission of the virus or to save the lives of people in need of advanced healthcare services.
The coronavirus national plan needs revisions, with a multi-sectoral approach and the remapping of all stakeholders from the UN to NGOs and the private sector, as well as relevant line ministries. Their roles and responsibilities must be clarified during the second wave of the virus, and subsequently, for the procurement and distribution of the vaccine.
Dr. Mohammad Nowroz Haqmal
Taking into account existing health system capacity and based on the lessons learned from the first coronavirus wave, there are a few things that should be implemented.
In the short term, the National COVID-19 Response Committee should be reinvigorated with a shift in the role of the committee from advisory to executive.
This will allow the committee to not only observe the situation as it evolves, but also to provide guidance and instruction on a regular basis. The committee should use all evidence available to make decisions regarding the COVID-19 response-- for instance the opening schools and universities under specific conditions, and likewise, the operations of public offices.
The coronavirus national plan needs revisions, with a multi-sectoral approach and the remapping of all stakeholders from the UN to NGOs and the private sector, as well as relevant line ministries. Their roles and responsibilities must be clarified during the second wave of the virus, and subsequently, for the procurement and distribution of the vaccine.
This will further help move sole responsibility for a coronavirus response from the health ministry to a more multi-sectoral approach.
To be effective, the national COVID-19 response plan must focus on the following: strengthening case detection and surveillance systems in public and private health sectors and communities, and ensuring the sustainability of healthcare provisions for non COVID-19 related health problems.
During the first wave of the virus, polio positive cases increased by 100 percent compared to last year and estimated numbers of maternal and child mortalities also went up due to the disruption of healthcare services for non coronavirus patients.
The response plan must be integrated into the system in all involved ministries to increase efficiency and ensure the sustainability of the response in future health emergencies. Transparency and accountability to maintain donor support to the Afghan health sector must also be ensured, and Afghans must be encouraged to trust their own health sector.
To effectively and efficiently mitigate the weaknesses observed during the COVID-19 pandemic response, the Afghan government needs to assign a team of experts from various fields of healthcare to conduct an in-depth review of the health system and to propose a reform framework.
This will assist the health sector and prepare strategies to overcome any future health emergencies, while bringing the quality of healthcare services up to safe economic levels.
- Dr. Mohammad Nowroz Haqmal is an award-winning public health expert and Chevening scholar. He is a lecturer at City, University of London. Tweets at @haqmal_n
