KABUL, Afghanistan – Afghanistan, whose citizens have largely dismissed the coronavirus pandemic as either an exaggeration or an outright hoax, is now preparing to distribute its first batch of vaccines.
Half a million doses of the AstraZeneca-Oxford vaccine, produced by an Indian manufacturer, were delivered from India to the capital, Kabul, on Feb. 7. But the arrival was greeted with indifference by many Afghans, who have rejected government warnings that the virus poses a deadly public health threat.
The cheap and easy-to-store AstraZeneca-Oxford vaccine is provided as part of the Covax program, a global initiative to purchase and distribute vaccines to poor countries for free or at a lower cost. On February 15, the World Health Organization approved the use of the vaccine, requiring two doses per person, paving the way for Afghanistan to begin its vaccination campaign.
Worldwide studies have shown that the vaccine provided complete protection against serious illness and death. But its effectiveness against the virus variant first seen in South Africa is questionable, after the vaccine failed in a small trial to prevent study participants from developing mild or moderate Covid cases.
The vaccine arrives as Afghanistan fends off a second deadly wave, with most Afghans going about their daily lives as if the virus never existed. Many people refuse to wear masks and cluster in dense crowds in bazaars, supermarkets, restaurants and mosques, oblivious to the ubiquitous public health posters.
In an impoverished nation ravaged by war, hunger, poverty and drought, an invisible virus is considered a fake, or an afterthought.
"Of course I will not take the vaccine because I don't believe in the existence of the coronavirus," said Muhibullah Armani, 30, a taxi driver in the southern city of Kandahar.
Mr Armani expressed a sentiment shared by many Afghans, adding, "When I see people covering their mouths and noses, afraid of Covid, it makes me laugh."
And even among Afghans who believe the virus is real and want to get vaccinated, there is little confidence that the government, mired in ubiquitous corruption, will distribute limited vaccine supplies fairly.
"This vaccine will only be available to people of high status," said Khalil Jan Gurbazwal, a civil society activist in Khost Province in eastern Afghanistan.
Nizamuddin, a tribal elder in a Taliban-controlled district of Faryab province in northern Afghanistan, said he feared the vaccine would be usurped by well-connected politicians and warlords.
"It is common in Afghanistan for even food aid to be stolen by corrupt people," said Mr. Nizamuddin, who, like many Afghans, bears the same name.
The attorney general's office said on Thursday that 74 government officials from five provinces had been charged with misappropriating coronavirus response funds. The accused included former county governors and deputy governors.
In northern Afghanistan's Kunduz province, a hospital officer told authorities that hospital officials had collected medical costs for Covid-19 treatments for 50 beds in a hospital with only 25 beds. "Ghost Workers", the Special Inspector General for Afghanistan Reconstruction reported recently.
"This crime is costing Afghan citizens not only financially but also delayed access to potentially life-saving medical care," the US embassy said in a statement. But for many Afghans, the vaccine is a solution to a problem that doesn't exist.
When the vaccination program kicked off Tuesday, the first dose was administered at the presidential palace in Kabul to Anisa Shaheed, a television reporter who reported on the pandemic.
Distributing a vaccine in a desperately poor nation consumed by unrest is a huge logistical challenge. In addition to overcoming public suspicions and traversing dangerous areas, the Health Ministry 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 as it has made it more difficult for polio teams to reach remote areas, said Dr Osman Tahiri, the public affairs adviser to the Ministry of Health, who reported 56 cases in 2020. of polio. from 29 in 2019.
But equally worrying are the 305 cases of one variant of polio in Afghanistan in 2020, up from zero such cases reported in 2019, said Merjan Rasekh, head of public awareness of the ministry's polio eradication program.
Mr Rasekh attributed much of the increase in various polio cases to Afghan refugees returning from neighboring Pakistan, which has also fought to eradicate polio. The WHO. is expected to grant emergency clearance by the end of the year for a vaccine against the variant.
Although he faces an increase in polio cases, Dr. Tahiri said health workers would try to spread the coronavirus vaccine even in Taliban-controlled areas where the militants have allowed government clinics. The Taliban have set up public health programs to warn of the pandemic and have distributed personal protective equipment, while government health workers have been allowed into their areas.
But Dr. Tahiri admitted that vaccination teams will not be able to reach wide areas of the country where the fighting between the Taliban and government forces is fiercest.
Last week, a thousand vaccination teams were trained, said Dr. Tahiri. The ministry hopes to receive more donated vaccines; Afghanistan, he said, has a capacity of 20 million doses.
The first doses go to health workers and safety officers "who are at risk and work in crowded places," said Dr. Tahiri, although there isn't enough vaccine for everyone in this category yet. Journalists would also be eligible to apply for the vaccine, he added.
Afghanistan has more than 55,000 coronavirus cases and nearly 2,500 deaths from Covid, according to the Ministry of Health.
But due to limited testing and an inadequate public health system, experts say the true number of cases and deaths is exponentially higher. A W.H.O. Model estimated in May that more than half of Afghanistan's estimated 34 million people could become infected. The Ministry of Health estimated last fall that more than 10 million Afghans have contracted the virus.
Regardless of whether Afghans believe the virus is real, there is an enduring belief that Allah determines the fate of a believer.
Ahmad Shah Ahmadi, a resident of Khost province, said the vaccine is not needed. "Unbelievers do not believe in God, so they fear the corona virus. There is little danger for Muslims," he said.
But Imam Nazar, 46, a farmer in Kunduz province, said most of his village residents believe the virus is real because several villagers have died from Covid-19. He said he and other villagers were eager to get the vaccine, but doubted it would reach their remote town.
"This government is not living up to its promises," Nazar said.
Fatima Faizi and Fahim Abed contributed from Kabul; Farooq Jan Mangal from Khost province; and Taimoor Shah from Kandahar province.