Report

Afghanistan’s Aid Infrastructure Is Unraveling

Famine and destitution loom, yet more aid could strengthen the Taliban.

By , the social media editor at Foreign Policy.
Dozens of internally displaced Afghan families collect food in Kabul, Afghanistan.
Internally displaced Afghan families who fled Kunduz and Takhar provinces due to battles between Taliban and Afghan security forces collect food in Kabul on Aug. 9. Wakil Kohsar/AFP via Getty Images

As acting president of the Afghan Midwives Association, Fahima Naziri is a sounding board and triage center for fellow midwives across the country.  

One told her how her hospital had to deliver the babies of five mothers with just one pair of gloves. Another described how they had to deliver several babies using the flashlights of their mobile phones due to a lack of stable electricity. Others have shared their worry over a lack of oxytocin to induce labor and control bleeding, oxygen, and other basic supplies such as masks, soap, and clean water. Still others have asked expectant fathers to scrounge for firewood to keep rooms warm as winter approaches. Record keeping over the last three months has been scanty, at best, but Naziri believes the rate of infant and maternal mortality in Afghanistan—already among the highest in the world—just keeps climbing. 

“Sometimes I think, how many mothers are dying because their death was preventable but there is no support for them? These are the things that we are facing every day in Afghanistan,” Naziri said.  

As acting president of the Afghan Midwives Association, Fahima Naziri is a sounding board and triage center for fellow midwives across the country.  

One told her how her hospital had to deliver the babies of five mothers with just one pair of gloves. Another described how they had to deliver several babies using the flashlights of their mobile phones due to a lack of stable electricity. Others have shared their worry over a lack of oxytocin to induce labor and control bleeding, oxygen, and other basic supplies such as masks, soap, and clean water. Still others have asked expectant fathers to scrounge for firewood to keep rooms warm as winter approaches. Record keeping over the last three months has been scanty, at best, but Naziri believes the rate of infant and maternal mortality in Afghanistan—already among the highest in the world—just keeps climbing. 

“Sometimes I think, how many mothers are dying because their death was preventable but there is no support for them? These are the things that we are facing every day in Afghanistan,” Naziri said.  

The travails in maternity wards are a microcosm of what the whole country is facing—with little prospect of relief from the outside. In 2018, Afghanistan had more than 3,135 functioning health facilities, the World Health Organization found. Since the Taliban took over Kabul and the country in August, they’ve closed left and right; Naziri figures as many as 2,500 may have shut down.

It’s not just the health care system that is faltering: Babar Baloch, a spokesperson for the Office of the United Nations High Commissioner for Refugees (UNHCR), said nearly 19 million Afghans are food-insecure. That number is estimated to rise to some 23 million by this winter, with 8.7 million nearing famine, according to a joint report by the United Nations World Food Program (WFP) and Food and Agriculture Organization. The U.N. Development Program (UNDP) estimates that as many as 97 percent of Afghans could sink below the poverty line by the middle of next year. The WFP warned in September that Afghanistan was “on the brink of economic collapse.” 

And there’s little help in sight. Humanitarian actors argue that international sanctions on the Taliban are halting the crucial flow of aid into a country that has historically been dependent on it.

“Our business is humanitarian work,”  UNHCR spokesperson Babar Baloch said. But “some of the situations we have to deal with are the outcome of politics—or the failure of politics.”

Dozens of lawmakers in the United States have urged the Biden administration to release aid frozen because of sanctions to U.N. agencies to pay for basic services, including teachers’ salaries and meals for children in schools—as long as girls are allowed to attend. In a letter to Secretary of State Antony Blinken and Treasury Secretary Janet Yellen, lawmakers also urged the administration to support multilateral organizations attempting to pay salaries for civil servants and to make it clear to financial institutions that they can fund humanitarian aid programs without breaching sanctions.

“Doing so will make financial institutions more comfortable processing aid transactions without fear of violating U.S. sanctions,” according to the letter, which was co-sponsored by Reps. Jason Crow, Tom Malinowski, and Peter Meijer and signed by 36 others.

“The sense of destitution is increasing day by day. Even those people who had a living, who had a salary, they don’t have it anymore,” said Baloch, the UNHCR spokesperson. “How do we expect Afghans to survive a severe winter for the next three months without having enough to eat, without having enough to survive on and sustain themselves?”

“Our business is humanitarian work,” Baloch said. But “some of the situations we have to deal with are the outcome of politics—or the failure of politics.”

The biggest obstacle is that international donors who had previously kept the Afghan government afloat and its population alive are hesitant to meet the intensifying humanitarian need out of fear that any aid they provide will indirectly empower the Taliban, who are busy fighting among themselves, reimposing an austere vision of Islam, and welcoming terrorist groups rather than tackling the country’s massive problems.

On Wednesday, the U.S. Treasury Department issued new carve-outs to allow greater humanitarian assistance to Afghanistan in the form of three general licenses that broadly allow the U.S. government, international organizations, and NGOs to do business with the Taliban and the Haqqani network in the course of their normal activities without violating existing U.S. sanctions. The allowed activities include humanitarian aid, programs promoting human rights and the rule of law, good governance and transparency, and environmental protection.

The Afghan central bank has about $10 billion in assets in the United States that is, for now, still off limits to Afghanistan’s new rulers. The International Monetary Fund has kept a freeze on Afghanistan’s access to its $440 million worth of reserves. A country that received more than $15 billion in international aid as recently as 2016 is now scrabbling for a few hundred million dollars from organizations such as the UNDP, the World Bank, and the European Union.

While the United States has a pathway to allow humanitarian exemptions on its sanctions, which would allow aid to be given directly to those in need despite the limits placed on the target government—like those Taliban leaders under sanction for terrorism—the United Nations does not, nor do several other countries that once provided aid to Afghanistan. 

In New York, the United States has been struggling to rally support for a U.N. Security Council resolution that would provide legal assurances that humanitarian aid could be delivered in Afghanistan without fear of violating U.N. sanctions.

Afghanistan—and the aid agencies that are trying to keep Afghans alive—still has almost no access to the money that could save lives.

Washington has faced resistance from China and Russia, which disagree on the legal interpretation surrounding the provision of humanitarian aid: Whereas the United States and the United Kingdom take the position that a humanitarian exemption is required to provide aid to Afghanistan right now, China and Russia assert that an exemption is not needed because the sanctions apply only to individuals, not the government, even if that government is currently run by sanctioned individuals. Council diplomats have suggested that China and Russia disagree on the legalese so they can continue to provide their own assistance to the Taliban and make headway on their own projects in the country.

But Washington has also encountered push back from allies such as Britain and France, which on Monday blocked the approval of a U.S. draft that would have granted the Taliban government an open-ended humanitarian exemption from sanctions. The European position, which was backed by Estonia and India, reflected concern that the Taliban leadership might abuse the aid exemption, steering assistance to their political and ethnic allies. They argued that it was necessary to place a time limit on the aid exemption so they could review compliance, and preserve the ability to reimpose the sanctions if necessary.

On Wednesday, the U.N. Security Council voted unanimously to adopt a U.S.-drafted resolution creating a permanent humanitarian exemption to Taliban sanctions, ending weeks of tense negotiations that at times pitted the United States against China and its own European allies.

“The Security Council’s decision to introduce a humanitarian exception to sanctions on the Taliban is a critical step that will help support humanitarian actors … to scale up and deliver lifesaving services to Afghans in need without fearing legal repercussions,” David Miliband, president and CEO of the International Rescue Committee (IRC), said in a statement.

But the agreement masked sharp differences among the 15 nations on the council, which held differing views on the risks of rewarding Taliban officials under U.N. sanctions who now hold critical positions in government agencies responsible for responding to the humanitarian crisis. Britain and France wanted to retain the power to snap back sanctions if the Taliban abused the new exemptions, but the United States agreed to the open-ended exemption to secure Chinese support, a move French diplomat Sheraz Gasri called a “mistake.”

The upshot is that Afghanistan—and the aid agencies that are trying to keep Afghans alive—still has almost no access to the money that could save lives. The banking system is catatonic, and bank transfers are a thing of the past. This forces humanitarian organizations to resort to informal measures such as money exchangers, or hawalas, just to keep their operations running.

“Everybody in country is fully relying on hawalas for every aspect of our operations: to pay our staff, to buy the goods that we need to do cash distributions, to pay our rent,” said Vicki Aken, the Afghanistan country director at the IRC, who is based in Kabul. “So what we would have in the past done as an exchange from our bank account to theirs is no longer possible.”

Some countries providing aid don’t recognize the informal hawalas as legitimate money exchanges, and have held back aid provisions, even though that has been the only way to move money since the Taliban takeover.

“There’s no other way. There is literally no other way,” Aken said. “We can’t wait three months for supplies to come in from another country. We have to address the crisis now. And even if we could wait for supplies, we still need to pay staff.” Aken’s team in Kabul finally got their August and September salaries at the end of September—but only after swallowing money exchange rates of between 5 and 12 percent, she said.

Since the Taliban took over, the international community has been loath to engage with the group, even as the risk of a humanitarian crisis becomes clearer.

There are some small bright spots. In October, the United States announced that it would contribute an additional $144 million in humanitarian assistance for Afghanistan, bringing its commitment to $474 million total this year, according to a spokesperson for the U.S. Agency for International Development. The Afghanistan Reconstruction Trust Fund—once the largest source of development funds to the country but which later halted all in-country operations once the Taliban took Kabul—agreed to repurpose $280 million in funds to UNICEF and the WFP by the end of the month. In November, UNHCR provided 33 tons of winterization resources. The U.N. agency has also established routes through Pakistan, Iran, and Uzbekistan to transport relief supplies and has a new logistical hub in Termez, Uzbekistan, to bring aid through Mazar-e-Sharif in Afghanistan.

None of this aid measures up to the amount Afghanistan used to receive when U.S. troops were still on the ground. From 2001 to the end of the war, the United States spent a total of $146 billion on Afghanistan’s reconstruction.

In recent weeks, Taliban officials have indicated they are willing to roll back some red tape that the former Afghan government instituted on humanitarian organizations. This move underscores how desperate Afghanistan’s new rulers are to avert the most disastrous humanitarian crisis.

In 2019, then-Afghan President Ashraf Ghani endorsed amendments to the 2005 Law on NGOs, which would have made it almost impossible for organizations like the IRC to operate in Afghanistan. These amendments sought to impose new hoops, including a new set of requirements for organizations’ physical offices and their assets, as well as the ways they report benchmarks and correspond with the government. The Taliban leadership has conveyed that they plan to scrap the proposed amendments and allow NGOs to operate with greater ease, Aken said. But even with these shifts in operational measures by the Taliban, experts agree that the steps pale in comparison to the Taliban’s draconian approach to governance, including its brutal rollback of human rights, especially women’s rights. 

Since the Taliban took over, the international community has been loath to engage with the group, even as the risk of a humanitarian crisis becomes clearer. Now, the calls for some sort of engagement with the Taliban, however unpleasant, are growing more urgent.

In her most recent U.N. Security Council briefing, Afghanistan envoy Deborah Lyons emphasized the need for the international community to help the country cultivate a kind of “modus vivendi,” one that could rebuild the economy and provide safeguards to prevent misuse of any aid financing.

“We are under an obligation to consider the end user,” said Azza Karam, a professor of religion and development at Vrije Universiteit in Amsterdam. “We would do well to figure out what it is that’s going to be helpful for the Afghan people, and then work backwards to negotiate with the Taliban on that basis.”

FP reporter Colum Lynch contributed to this report.

Update, Dec. 22, 2021: This article has been updated to address developments at the United Nations and new general licenses issued by the U.S. Treasury Department.

Kelly Kimball is the social media editor at Foreign Policy. Twitter: @kellyruthk

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