Since late 2021, money has instead been channeled through aid agencies and the United Nations, bypassing the new regime.
Vickie Hawkins, executive director of MSF UK, said: “Governments, donors need to find ways to provide support to vital sectors such as healthcare.
“The real concern for us is that as donors talk about restoring support or restoring funding, all of that support is centered on channels through the humanitarian system. That just simply cannot substitute for state infrastructure.
“The humanitarian system cannot be a substitute, because the capacity does not exist and it’s just not designed to do that, it’s designed to meet the most immediate needs, not to try and prop up entire sectors, when the funding just isn’t there .”
Battered by Covid
A report published this week by the Afghanistan Analysts Network said the crumbling health system was now being battered by a new wave of Covid-19 infections.
The report said the halting of aid had “a devastating impact on the country’s already ailing health system, leaving fewer hospitals and clinics open.
“Those still running often lack the necessary medical supplies or equipment to deal with the pandemic or money to pay staff. With qualified medics fleeing the country, the outlook for the health sector is bleak.”
“Despite efforts by NGOs and international agencies to provide stopgap help to a handful of hospitals around the country, Afghanistan’s healthcare needs are vast and immediate and will not end with the waning of this latest wave of Covid-19.”
The burden on hospitals has also increased because the end of fighting following the defeat of the internationally-backed government has improved security, doctors say. While fighting raged, many families were wary of taking to the roads to seek treatment. The collapse of the economy has also meant few people can afford private treatment, placing a greater strain on overstretched public hospitals.
The World Bank last week said the precipitous cut in foreign funding was due to reverse all economic growth for the past 15 years, with GDP per head falling a third from the end of 2020 to the end of 2022. Afghan public spending was due to be down 70 per cent.
While the Afghan government received roughly $9bn (£7bn) a year in a mixture of military and civilian aid before the Taliban took over, that will now fall to around $3bn (£2bn) of humanitarian aid.
The bank sees little prospect of improvement in the short term and said that donors had no intention of switching funding so that it goes back directly into the Afghan government coffers.
“One of the poorest countries in the world has become much poorer,” said Tobias Haque, the bank’s senior economist for Afghanistan. Incomes have fallen by a third, while 70 per cent of households cannot afford basic needs.
He said: “Under current conditions we see few prospects for recovery even over the medium term. Humanitarian support will remain critical, but it is no substitute for a functioning economy.”
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