- The loss of foreign aid has severely damaged Afghanistan’s health care system and worsened malnutrition and disease resulting from inadequate medical care.
- The Taliban’s restrictions on women and girls have prevented access to health care, jeopardizing their right to health; Education bans guarantee future shortages of female health workers.
- The meeting of special envoys in Doha on February 18, 2024, should condemn Taliban abuses while supporting resources for the health care system and essential services such as banking, water management and electricity.
(New York) – Sharp reductions in foreign aid to Afghanistan’s public health system, coupled with the Taliban’s serious abuses of women and girls, have jeopardized the right to health for millions of Afghans, Human Rights Watch said in a report published today. The health care crisis has made the Afghan population increasingly vulnerable to severe malnutrition and disease.
The 38-page report, “‘A disaster for the foreseeable future’: Afghanistan’s health care crisis,” describes how the collapse of Afghanistan’s economy after the Taliban took power in August 2021 caused severe damage to the health care infrastructure of the country. Donor decisions to reduce humanitarian aid have further weakened access to health care, destabilized the economy and exacerbated food insecurity. Abusive policies and practices of the Taliban have greatly worsened the crisis. Bans on education for women and girls have blocked most training for future health care workers, ensuring shortages for the foreseeable future.
“The loss of foreign development aid and the Taliban’s rights abuses have caused a catastrophic health crisis in Afghanistan that is disproportionately harming women and girls,” said Fereshta Abbasi, Afghanistan researcher at Human Rights Watch. “The Taliban have severely prevented women from providing or accessing health care, and the cost of treatment and medicine has put care out of reach for many Afghans.”
Human Rights Watch interviewed Afghan and foreign aid officials, health care workers, and people seeking health care in 16 of Afghanistan’s 34 provinces between February 2023 and January 2024.
At a scheduled February 18 meeting of special envoys from key countries hosted by the United Nations, governments should pressure Taliban leaders to lift restrictions that prevent people from accessing health care, including bans on education and employment of women. The special envoys must also address the structural problems that have undermined Afghanistan’s economic stability, including those affecting water management, electricity supply and the banking system.
For the previous two decades, the Afghan government had depended on international development support from donors to fund essential services such as primary health care, even though Afghans paid most of the health care costs out of their own pockets. The previous government’s contribution to the public primary care system was negligible, leaving the system vulnerable to collapse as aid was withdrawn. Taliban authorities have also allocated little funding to health care, and humanitarian organizations have struggled to fill the gap amid funding cuts that threaten this lifeline.
While Afghans living in poverty have always faced difficulties in obtaining health care due to costs, a growing number of Afghans now struggle to pay for food and are often unable to cover the price of medicine and transportation to reach services. health.
A 54-year-old man living with a kidney infection said: “Since the Taliban took over, the price of my medicine has almost doubled. That’s a lot for anyone who doesn’t have a job.”
The United Nations estimates that 23.7 million people – more than half of Afghanistan’s population – will need humanitarian assistance in 2024. While humanitarian agencies provide life-saving assistance, they cannot replace all the essential services that most first depended on donor support.
As a Mercy Corps official said in September 2023, “The humanitarian response in Afghanistan simply cannot keep pace with the country’s deteriorating conditions.”
The Taliban’s ban on the employment of women in humanitarian agencies has compounded the crisis by creating additional barriers to equitable delivery of aid and depriving women and their families of income. Strict hijab and mahram Regulations (male guardian) have prevented women from traveling for work or receiving treatment.
A doctor in Samangan said: “The Taliban have instructed us not to treat any female patient who is not accompanied by a mahram or is not wearing a full hijab.”
Among those most affected by Afghanistan’s health care crisis are people with disabilities. Due to decades of conflict and poor maternal health care, Afghanistan has one of the world’s largest populations of people with disabilities. Because of the lack of help, the few services for people with disabilities, including physical rehabilitation and mental health support, have largely disappeared.
A Kabul-based counselor said that “even before the Taliban took over, there were few donors to provide mental health services in the big cities. Now most of them are gone, while people are in greater need.” The Taliban’s restrictive policies further impede access to services for women and girls with disabilities.
“The unprecedented economic crisis in Afghanistan has meant that millions of people are facing life-threatening conditions,” Abbasi said. “The situation requires more than humanitarian aid, it requires sustained efforts to avoid further economic collapse and alleviate the endless suffering of the Afghan population.”