UN agency pays Afghan health workers salaries to avert humanitarian crises

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Since the abrupt interruption of foreign funding since the Taliban came to power threatens Afghanistan’s economic collapse and jeopardizes the lives of many of its citizens and their livelihoods, a United Nations organization has found a way to maintain at least part of the flow of money.

The United Nations Development Program plans this week in a novel temporary solution to take over the administration of the system from the World Bank, which has provided hundreds of millions of dollars in aid to basic health services across Afghanistan over the past few years, including paying salaries of at least 25,000 doctors, nurses and other workers in thousands of hospitals and clinics.

Payments and other operational support for health services ceased when the World Bank, along with the International Monetary Fund, the United States, Europe and virtually all other donors and lenders, ceased paying the bills on August 15, Taliban Day. Enter Kabul .

UNDP’s assumption of responsibility for direct payments, a task outside of its normal development tax house, was eased last week when President Joe Biden’s administration granted special permits allowing “certain international organizations” to conduct “authorized transactions” in Afghanistan.

The first $ 15 million to fund the program in October was donated by the Global Fund, a separate global health partnership of public and private donors whose primary mission is to combat endemic diseases in sub-Saharan Africa.

The stopgap solution comes as the richest and most powerful nations grapple with how to help desperate people in one of the poorest places on earth, even if they refuse to recognize the government of the militant group that now leads them.

Without this recognition, neither the World Bank nor the International Monetary Fund – in which the United States and its allies hold a majority of the voting rights – can operate in Afghanistan. Although the IMF provided $ 440 million in interest-free drawing rights to Afghanistan prior to the Taliban, this money is now taboo.

Virtually all aid, which has covered up to 80% of all Afghan government spending for years, has been stopped, with the exception of a trickle of the most basic humanitarian supplies, including food and medicine, which have been distributed through local non-governmental organizations to which the Taliban grants some operational independence to have. The United States has frozen nearly $ 10 billion in Afghan Federal Reserve assets.

After trying for over two decades to keep the militants out of power with military might, the international community – led by the United States, the largest donor to Afghanistan – is now trying to subdue them to their will by using their most powerful remaining weapon uses: money.

The question arises, however, of how keeping the Taliban on its promises – establishing an inclusive government, safeguarding the rights of women and minorities, and preventing Afghanistan from being used as a launch pad for global terrorism – with the immediate needs of 40 million Afghans.

Both China and Russia, which continued to operate their embassies in Kabul without officially recognizing the Taliban government, took the opportunity to freely criticize US policies over the past 20 years.

What to do with Afghanistan is discussed almost constantly within the Biden administration, in bilateral talks between governments and in international forums. It will be a hot topic at the World Bank and IMF annual meetings in Washington next week and at the Group of 20 summit in Rome in late October. Some US allies, who, like the government, have set up offices in the Qatari capital Doha after the closure of their Afghan embassies, are already talking of reestablishing a presence in Kabul without diplomatic ties.

“Of course, things cannot go on like this,” said Kanni Wignaraja, UNDP’s Asia-Pacific Director, about the current situation.

“You won’t just have a complete meltdown very soon, before the end of the year. The fiscal cliff is right with us. … We are on the edge if we are not hanging by our fingernails, ”said Wignaraja in an interview.

The governments of the donor countries, she said, have to “wrap their heads around the policies of a government which they do not support and which is not recognized worldwide, including by the UN Security Council and the member states”.

“How does that combine with the fact that it is very difficult to bring back a whole nation of people who have starved and have no way of making a living?” Said Wignaraja.

European Union foreign policy official Josep Borrell agreed that disaster was imminent. “That is certainly a dilemma,” he said on Sunday during a visit to Saudi Arabia. “Because if you want to help prevent an economy from collapsing in a certain way, you can consider helping the government … depending on its behavior. And their behavior so far is not very encouraging. “

What the Taliban have said is an “interim government” appointed last month that includes no women and few non-Taliban. Many professionals, government bureaucrats and technical experts have either fled the country or went into hiding for fear of reprisals from the Taliban. Girls have so far been banned from education beyond sixth grade amid reports of the harsh treatment of civilians recalling the brutal rule of militants in the late 1990s.

The problem of the immediate future has also become a domestic football in the US after the loss of the war and the chaotic US exit in August.

In line with the government, the chairman of the Senate Foreign Affairs Committee, Robert Menendez, DN.J., said Monday that “no US foreign aid will go to a Taliban-controlled Afghan government.” But, he said after fending off a legislative challenge to any aid to Afghanistan, “that doesn’t mean we continue to feel less committed to helping the Afghan people.”

In addition to military resources and humanitarian and other aid from international organizations, Afghanistan has been the largest recipient of bilateral aid from the US Agency for International Development for years, with $ 19.5 billion spent since 2002 and nearly $ 500 million for the budget year 2020 has been promised.

But given the ongoing uncertainty about the direction of the Taliban, all US government workers have now been evacuated from the country and no direct funding has been granted, programs in agriculture, governance, education and other sectors have been suspended. EU development aid is also held in abeyance.

Last month, Foreign Secretary Antony Blinken announced an additional $ 64 million in humanitarian aid – mostly emergency food, in response to a global “flash appeal” from UN Secretary-General António Guterres, which was launched last month for an immediate US $ 606. Shelters, medicines and hygiene articles millions to avoid impending hunger and disease.

So far, the entire appeal has only been financed to 35%, Guterres spokesman Stephane Dujarric told reporters on Tuesday. “We’d love more money,” he said.

But the cash for emergency supplies is just a patch, said UNDP’s Wignaraja. Only about 17% of the 2,200 or so health facilities funded under the World Bank program – many single-room clinics – “are currently fully operational” and able to use any incoming humanitarian supplies, she said. No staff have been paid and those who are still working do so on a voluntary basis, Wignaraja said.

“There is a risk that the Afghan people have virtually no access to primary health services,” she said.

Three years ago, as part of a consolidation of a complex network of projects in Afghanistan, the World Bank administered a $ 600 million three-year program under the Afghanistan Reconstruction Trust Fund to provide basic health and hospital services to all of Afghanistan outside of Kabul and Surroundings. The aid, which was extended by at least another year in spring 2021, was distributed by 13 different non-governmental organizations – all but two of them Afghan – in the contract.

When the bank’s approval to continue operations in Afghanistan was frozen in August, it asked the Global Fund – whose global donors pay for the treatment and control of malaria, tuberculosis, HIV and now COVID-19 – to provide the money to use it to provide health services can be continued. The fund then asked the UNDP, the managing authority of its disease program in Afghanistan, to assume responsibility for the disbursement of the money.

The Taliban, Wignaraja said, have agreed not to have access to the funds to be deposited in an UNDP account with one of the few active Afghan commercial banks – a dollar transfer that the government’s newly issued special licenses now allow. The UNDP then transfers it in local currency to the accounts of the NGOs, which distribute it directly in cash to the recipients.

“They know very well that they cannot manage, in the sense that we cannot send money through them,” she said of the militants. “You know the plan very well.”

Wignaraja emphasized that UNDP, with money from the Global Fund, is only acting as a “temporary lifeline” to test whether the system is working. After October, other organizations such as the World Health Organization and the UN Children’s Fund are to step in for the rest of the year with funds from the United Nations central emergency account.

“Our duty is to step up cooperation and increase resources to ensure that the most vulnerable populations – especially women and girls – continue to have safe access to basic health services,” said Peter Sands, Executive Director of the Global Fund, in a for announcing the plan Wednesday.

By early 2022, Wignaraja said, it is hoped that the World Bank will regain member consent to return to Afghanistan.

Meanwhile, she said, such measures are only “micro-level solutions” to the “macro-level implosions” in a country where few have a way to make a living and the accomplishments of the last two Decades – including more than 60,000 women-run micro-businesses – are critically endangered.

“Some of these difficult decisions,” said Wignaraja, “have to be made sooner rather than later,” for both sides of the divide in Afghanistan.


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