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The United States launched the war in Afghanistan following the September 11, 2001 terrorist attacks.The conflict lasted two decades and spanned four U.S. presidencies, becoming the longest war in American history.

By August 2021, the war began to come to a close with the Taliban regaining power two weeks before the United States was set to withdraw all troops from the region. Overall, the conflictresulted in tens of thousands of deaths and a $2 trillion price tag.Here's a look at key events from the conflict.

Investigators determined the 9/11 attacksin which terrorists hijacked four commercial airplanes, crashing two into the World Trade Center towers in New York City, one at the Pentagon near Washington, D.C., and one in a Pennsylvania fieldwere orchestrated by terrorists working from Afghanistan, which was under the control of the Taliban, an extremist Islamic movement. Leading the plot that killed more than 2,700 people was Osama bin Laden, leader of the Islamic militant group al Qaeda. It was believed the Taliban, which seized power in the country in 1996 following an occupation by the Soviet Union, was harboring bin Laden, a Saudi, in Afghanistan.

In an address on September 20, 2001, President George W. Bush demanded the Taliban deliver bin Laden and other al Qaeda leaders to the United States, or "share in their fate." They refused.

On October 7, 2001, U.S. and British forces launched Operation Enduring Freedom, an airstrike campaign against al Qaeda and Taliban targets including Kandahar, Kabul and Jalalabad that lasted five days. Ground forces followed, and with the help of Northern Alliance forces, the United States quickly overtook Taliban strongholds, including the capital city of Kabul, by mid-November. On December 6, Kandahar fell, signaling the official end of Taliban rule in Afghanistan and causing al Qaeda, and bin Laden, to flee.

During a speech on April 17, 2002, Bush called for a Marshall Plan to aid in Afghanistans reconstruction, with Congress appropriating more than $38 billion for humanitarian efforts and to train Afghan security forces. In June, Hamid Karzai, head of the Popalzai Durrani tribe, was chosen to lead the transitional government.

While approximately 8,000 American troops remained in Afghanistan as part of the International Security Assistance Force (ISAF) overseen by NATO, the U.S. military focus turned to Iraq in 2003, the same year U.S. Secretary of Defense Donald Rumsfeld declared "major combat" operations had come to an end in Afghanistan.

A new constitution was soon enacted and Afghanistan held its first democratic elections since the onset of the war on October 9, 2004, with Karzai, who went on to serve two five-year terms, winning the vote for president. The ISAFs focus shifted to peacekeeping and reconstruction, but with the United States fighting a war in Iraq, the Taliban regrouped and attacks escalated.

In a written statement released February 17, 2009, newly elected President Barack Obama pledged to send an extra 17,000 U.S. troops to Afghanistan by summer to join 36,000 American and 32,000 NATO forces already deployed there. "This increase is necessary to stabilize a deteriorating situation in Afghanistan, which has not received the strategic attention, direction and resources it urgently requires," he stated. American troops reached a peak of approximately 110,000 soldiers in Afghanistan in 2011.

In November 2010, NATO countries agreed to a transition of power to local Afghan security forces by the end of 2014, and, on May 2, 2011, following 10-year manhunt, U.S. Navy SEALs located and killed bin Laden in Pakistan.

President Barack Obama, Vice President Joe Biden, Secretary of State Hillary Clinton and members of the national security team receive an update on the mission against Osama bin Laden in the Situation Room of the White House May 1, 2011, Washington, D.C.

Pete Souza/The White House via Getty Images

Following bin Laden's death, a decade into the war and facing calls from both lawmakers and the public to end the war, Obama released a plan to withdraw 33,000 U.S. troops by summer 2012, and all troops by 2014. NATO transitioned control to Afghan forces in June 2013, and Obama announced a new timeline for troop withdrawal in 2014, which included 9,800 U.S. soldiers remaining in Afghanistan to continue training local forces.

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In 2015, the Taliban continued to increase its attacks, bombing the parliament building and airport in Kabul and carrying out multiple suicide bombings.

In his first few months of office, President Donald Trump authorized the Pentagon to make combat decisions in Afghanistan, and, on April 13, 2017, the United States dropped its most powerful non-nuclear bomb, called the "mother of all bombs," on a remote ISIS cave complex.

In August 2017, Trump delivered a speech to American troops vowing "we will fight to win" in Afghanistan. "America's enemies must never know our plans, or believe they can wait us out," he said. "I will not say when we are going to attack, but attack we will."

The Taliban continued to escalate its terrorist attacks, and the United States entered peace talks with the group in February 2019. A deal was reached that included the U.S. and NATO allies pledging a total withdrawal within 14 months if the Taliban vowed to not harbor terrorist groups. But by September, Trump called off the talks after a Taliban attack that left a U.S. soldier and 11 others dead. If they cannot agree to a ceasefire during these very important peace talks, and would even kill 12 innocent people, then they probably dont have the power to negotiate a meaningful agreement anyway, Trump tweeted.

Still, the United States and Taliban signed a peace agreement on February 29, 2020, although Taliban attacks against Afghan forces continued, as did American airstrikes. In September 2020, members of the Afghan government met with the Taliban to resume peace talks and in November Trump announced that he planned to reduce U.S. troops in Afghanistan to 2,500 by January 15, 2021.

The fourth president in power during the war, President Joe Biden, in April 2021, set the symbolic deadline of September 11, 2021, the 20th anniversary of the 9/11 attacks, as the date of full U.S. withdrawal from Afghanistan, with the final withdrawal effort beginning in May.

Facing little resistance, in just 10 days, from August 6-15, 2021, the Taliban swiftly overtook provincial capitals, Kandahar, Mazar-e-Sharif and, finally, Kabul. As the Afghan government collapsed, President Ashraf Ghani fled to the UAE, the U.S. embassy was evacuated and thousands of citizens rushed to the airport in Kabul to leave the country.

By August 14, Biden had temporarily deployed about 6,000 U.S. troops to assist in evacuation efforts. Facing scrutiny for the Taliban's swift return to power, Biden stated, I was the fourth president to preside over an American troop presence in Afghanistantwo Republicans, two Democrats. I would not, and will not, pass this war on to a fifth.

During the war in Afghanistan, more than 3,500 allied soldiers were killed, including 2,448 American service members, with 20,000-plus Americans injured. Brown University research shows approximately 69,000 Afghan security forces were killed, along with 51,000 civilians and 51,000 militants. According to the United Nations, some 5 million Afghanis have been displaced by the war since 2012, making Afghanistan the world's third-largest displaced population.

The U.S. War in Afghanistan, Council on Foreign Relations

Costs of the Afghanistan war, in lives and dollars, Associated Press

Who Are the Taliban, and What Do They Want?, The New York Times

Operation Enduring Freedom Fast Facts, CNN

Afghanistan: Why is there a war?, BBC News

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Afghanistan War - Key Events, Facts & Combatants - HISTORY

On Sunday, as the Taliban entered Kabulthe last remaining major Afghan city not under the groups controlthe President of the country, Ashraf Ghani, fled to Tajikistan, making clear that the U.S.-backed Afghan government had collapsed. Five months ago, in April, President Joe Biden announced that all U.S. and NATO troops would be withdrawn from Afghanistan by the twentieth anniversary of the 9/11 attacks. Critics have accused the Administration of conducting a rushed, poorly planned, and chaotic withdrawal since then. On Thursday, the U.S. government announced that it would be sending in marines and soldiers to help evacuate embassy personnel. But the speed of the Taliban advance has stunned American officials and left desperate Afghans trying to flee the country. Responding to criticism about his plan, Biden has sought to shift blame to the Afghan government and its people, saying, They have got to fight for themselves.

I spoke by phone with my colleague, the New Yorker staff writer Steve Coll, about the situation in Afghanistan. The dean of Columbia Journalism School, Coll is the author of Ghost Wars and Directorate S, which together chronicle much of the history of the past several decades in Afghanistan and Pakistan. During our conversation, which has been edited for length and clarity, we discussed why it has been so hard for the United States to train the Afghan army, the different humanitarian crises facing the country, and the Biden Administrations outrageous callousness toward a situation America played a role in creating.

What about the events of the past few weeks has surprised you, and what was the predictable result of Bidens policy announcement in April?

I think the speed of the political collapse in Afghanistan surprised a lot of people. The pathway of the collapse was predicted and predictable. This has happened in Afghan political and military history a couple of times before. But there was a speed and momentum of people recalculating where their interests lay, and switching sides, and capitulating without violence that I dont think the Biden Administration had expected when it announced its timetable in the spring.

You could argue that this shows the Biden Administrations policy was a mistake, but you could also argue that, if this was going to happen so quickly after two decades of American troops in Afghanistan, there was no way to make this work without pledging to stay forever. How do you think about those two ways of looking at the situation, or do you think that dichotomy isnt helpful?

I think that dichotomy describes two poles that represent the range of choices that the Biden Administration faced, and in between those poles had been, more or less, the policy going back to the second term of the Barack Obama Administrationwhich was a smaller, sustained deployment. There were twenty-five hundred troops there when the Biden Administration came to office. The rate of casualties incurred by NATO forces was almost at the level of traffic accidents for much of the past couple of years. So a sustained, smaller deploymentnot free, but nothing like the expenditures of the pastlinked to a search for some more sustainable political outcome had been visible. The Trump Administration followed that path, too, picking it up from the Obama Administration, and the Trump White House had become quite ambitious about it. It had negotiated with the Taliban an agreement that had a timetable, including regarding American withdrawal. But, until the Trump Administration got to that point, it had been following the same pathway as its predecessor.

I think in between was this question of whether the benefits of a messy degree of stability justified having the small-to-medium deployment that America has in other parts of the world. That is what you are going to hear in Washington. The counter-argument to the Biden Administrations policy is not going to be forever war and the defeat of the Taliban; it is going to be a critique of the haste with which it pulled the plug on what was not a large deployment, and one that was not incurring a lot of casualties.

Why, ultimately, was it so hard to stand up the Afghan military to a greater extent than America did? Was it some lack of political legitimacy? Some problem with the actual training?

I dont know what proportion of the factors, including the ones you listed, to credit. But I think that the one additional reason it didnt work was the sheer scale of the ambition. And this was visible in Iraq as well. Building a standing army of three hundred thousand in a country that has been shattered by more than forty consecutive years of war and whose economy is almost entirely dependent on external aidthat just doesnt work. What did work was what at various stages people thought might be possible, which was to build a stronger, more coherent, better-trained force, which has effectively been the only real fighting force on behalf of the Kabul government over the past few years. This force is referred to as commandos or Special Forces, but it is basically twenty or thirty thousand people. That you can build with a lot of investment and hands-on training. But you cant just create an army of three hundred thousand. I remember talking to the Pakistani generals about this circa 2012. And they all said, You just cant do that. It wont work. They turned out to be right.

The writer Anand Gopal, who has reported extensively from Afghanistan, wrote, The US designed the Afghan state to meet Washingtons counterterrorism interests, not the interests of Afghans, and what we see today is the result. Do you agree?

I assume what that means is that the state-building project, such as it wasand about which there were varying degrees of commitment, including very little at the very beginning, after the fall of the last Taliban governmentwas undermined by the dependence on independent militias and commanders whose role in security was seen as necessary, especially early on, because the main U.S.-led NATO agenda in Afghanistan and the region was counterterrorism. The men under armsthe power brokers or warlordswere seen as essential to that agenda, and it was very difficult to build a normal state when the militias were beyond political accountability (never mind the rule of law) and dominating so many regions of the country.

Over time, there was a recognition that this was not sustainable, and there were efforts to try to fold them into a more normal-looking state and constitutional military, but that project was never accompanied by a push for accountability or an end to the effective independence and corruption associated with those regional militias. I assume you can say that is all the fault of the Western design, but I am not sure I buy that. Afghanistan had these fighting forces on its soil on 9/11 because of the continuous war that had been triggered by the Soviet invasion in 1979, and they didnt require a U.S.-dictated constitutional design to persist. Of course, they persisted. The real complication about the design of the Afghan state that is now collapsing has at least as much to do with Afghans coming into the country from exilethe same dynamic that we saw in Iraq. Often, very talented and committed people who had been forced out of the country by the wars going back to the late nineteen-seventies tried to bargain with the leaders in Afghanistan about what kind of constitutional and power-sharing system should be designed. They were trying to create a system that would accommodate the power of the militias who had never left, in a very centralized constitutional design.

President Bidens attitude toward Afghanistan of late has seemed to be one of annoyance, while hes also putting a strong emphasis on the need for Afghans to stand up and fight for their country. How do you feel about an American President putting that forward after the U.S. has been intimately involved in that country for decades?

I try to tamp down my emotions about it, because I think it is an outrageous critique. I can understand the frustration that American decision-makers have had with their partners in the Kabul government for the past twenty years. It has been a very rocky road, and it isnt all the fault of U.S. Presidents and Vice-Presidents and national-security advisers. But to suggest that the Afghan people havent done their bit is a kind of blame-shifting that I think is not only unjustifiable but outrageous. The Afghans now have suffered generation after generation of not just continuous warfare but humanitarian crises, one after the other, and Americans have to remember that this wasnt a civil war that the Afghans started among themselves that the rest of the world got sucked into. This situation was triggered by an outside invasion, initially by the Soviet Union, during the Cold War, and since then the country has been a battleground for regional and global powers seeking their own security by trying to militarily intervene in Afghanistan, whether it be the United States after 2001, the C.I.A. in the nineteen-eighties, Pakistan through its support first for the mujahideen and later the Taliban, or Iran and its clients. To blame Afghans for not getting their act together in light of that history is just wrong.

See the article here:
How America Failed in Afghanistan | The New Yorker

Commentary

The first case of the Corona Virus Disease-2019 (COVID-19) in Afghanistan was detected on 22 February 2020 in a person who had returned from Qom city, Iran.1 As of 30 May 2022, a total of 180,176 confirmed cases, including 7701 deaths, were reported to the World Health Organization (WHO). The recovery rate is reported to be around 90% and Case Fatality Rate to be 4.29%.2 However, it is said that the actual figures of the infected cases might be much higher than the reported numbers.3

Meanwhile, a total of 6,118,557 doses of the COVID-19 vaccine have been administered to the residents in the country.2 Afghanistan is the lowest among many nations in terms of the COVID-19 vaccine coverage. As per the official reports, around 10% of the total population are vaccinated thus far, which is way behind the proposed target for 2022, ie 60%.

Since the beginning of the pandemic, the COVID-19 has spread throughout the country in four waves. The first wave was reported to span from the end of April to June 2020; the second wave began by October 2020 and lasted until the end of December 2020; the third wave reportedly began by April 2021 and lasted until mid-August 2021.2

An analysis of the recent data uploaded by the District Health Information Software-2 (DHIS2) reveals that the fourth wave of the COVID-19 passed in March 2022. As shown in Figure 1, the peak numbers were reported during the month of February 2022 with highest confirmed cases in the first and second weeks, ie 3850 and 3847 cases, respectively. By March 2022, the cases began to decline until the curve almost fattened in April 2022.

Figure 1 The trend of the COVID-19 confirmed cases during JanApr 2022 (fourth wave).

The COVID-19 pandemic hit Afghanistan at a time when the country was politically undergoing changes, with a fragile healthcare system which was unable to respond to the emergence of COVID-19 and to the needs of the most vulnerable people. The government lacked the means to communicate adequately with the citizens, trace contacts, collect and test samples. In the beginning of the fight against COVID-19, the government had only one dedicated hospital, the Afghan Japan Hospital, for the provision of COVID-19 related services, including sample collection. A few months later, Ali Jinnah Hospital was also designated to treat COVID-19 patients in Kabul. In both these hospitals, the outpatient and inpatient clients were very high, making it almost impossible to provide the needed health services and case detection.

Before August 15, 2021, overall, a total of 38 COVID-19 hospitals were operating throughout the country, all of them funded by international donors. Alongside these, Rapid Response Teams (RRTs) and District Centers (DCs) were also established as part of the Emergency Response to COVID-19 to conduct risk communication sessions, collect samples of suspected cases, trace contacts and advice on mild and moderate cases to be treated at home. These actions were vital in helping to reduce the burden of the COVID-19 designated hospitals, and thus enabled them to focus on the management of severe and critical cases. After the collapse of the previous government, all funding and supports to the COVID-19 emergency response were reduced and most of the hospitals were forced to stop their operations due to lack of funds, doctors, medicine, and even heating.4

The lack of healthcare personnel to collect the samples of suspected individuals and the shortage of kits for laboratory diagnostic tests are still the major challenges in most districts of Afghanistan. High levels of financial insecurity in several parts of the country have had a large and direct negative effect on the provision and coverage of healthcare services for the general public.5 Unfortunately, many people who have received their first shots of the COVID-19 vaccine have not received the next dose due to shortage or unavailability of vaccine.6

Although the fourth wave of the COVID-19 passed with no clear and accurate data of the mortality and morbidities, it is assumed that the next wave might not be too far. Challenges such as the lack of or insufficient donor funds, unstable political situation, inadequate healthcare services, insufficient healthcare workers and diagnostic capacity, illiteracy of people, poor economy and shortage of the COVID-19 vaccine are threatening to push the nation towards a devastating stage. The de facto authority also does not seem to have a clear plan to fight against the pandemic. Therefore, the international community, civil societies, healthcare workers and other stakeholders should pool their efforts immediately to improve and restore the health system.

Fortunately, many COVID-19 hospitals resumed their operations with the funds provided by international donors; however, for the long term, the COVID-19 services should be integrated in the countrys existing healthcare services framework, ie the Sehatmandi project. Moreover, awareness campaigns should be continued to keep the most vulnerable groups safe and protected. Vaccination services also need to be speeded up to have a significant portion of people immunized. Public willingness towards getting the vaccine should be increased through awareness campaigns mostly conducted by social media volunteers and healthcare workers.

The authors would like to sincerely thank Dr. Pakeer Oothuman, a former professor of parasitology at the University Kebangsaan Malaysia and International Islamic University Malaysia, for editing the manuscript.

The authors declare no conflicts of interest in relation to this work.

1. Mousavi SH, Shah J, Giang HTN, et al. The first COVID-19 case in Afghanistan acquired from Iran. Lancet Infect Dis. 2020;20(6):657658. doi:10.1016/S1473-3099(20)30231-0

2. World Health Organization. COVID-19 dashboards - Afghanistan situation. Available from: https://covid19.who.int/region/emro/country/af. Accessed May 31, 2022.

3. Nemat A, Asady A. The third wave of the COVID-19 in Afghanistan: an update on challenges and recommendations. J Multidiscip Healthc. 2021;14:20432045. doi:10.2147/JMDH.S325696

4. Al-Jazeera. COVID surge batters Afghanistans crumbling healthcare. Available from https://www.aljazeera.com/gallery/2022/2/10/photos-covid-surge-batters-afghanistans-crumbling-healthcare. Accessed February 11, 2022.

5. Shah J, Karimzadeh S, Al-Ahdal TMA, et al. COVID-19: the current situation in Afghanistan. Lancet Global Health. 2020;8(6):e771e772. doi:10.1016/S2214-109X(20)30124-8

6. World Health Organization (WHO) Regional Office for the Eastern Mediterranean. COVID-19 vaccines shipped by COVAX arrive in Afghanistan, Available from: http://www.emro.who.int/afg/afghanistan-news/covid-19-vaccines-shipped-by-covax-arrive-in-afghanistan.html.Accessed June 23, 2022.

Original post:
The fourth wave of the COVID-19 in Afghanistan | IDR - Dove Medical Press

The overall security situation across Afghanistan, including Save the Children impact areas, is challenging. Armed conflict continues in Panjsher, Baghlan, Takhar and Badakhshan provinces, and for the first time after the takeover, armed conflict occurred in Samangan province.

The World Bank says incomes are likely to have fallen by around a third in the last months of 2021. Across the country four out of five people (83%) are unemployed. In some provinces, unemployment rates are as high as 95%.

Living costs and food prices have skyrocketed over the last several months, with a kilogram of wheat now costing almost 55% more compared to June 2021.

Even before the fall of the previous government the impacts of drought, COVID-19 and ongoing conflict had already left millions facing severe hunger across the country. But since August 2021, financial collapse triggered by global economic sanctions and international funding cuts has driven hunger to unprecedented levels. Many families are surviving only on stale bread that they soften with water and eat.

The health system is collapsing at a time when children and their families need support the most. As well as soaring rates of hunger and malnutrition, Afghanistan is also contending with four major disease outbreaks: dengue fever, COVID-19, acute watery diarrhoea and measles. Measles is of particular concern with the number of cases having increased almost five-folds since the end of last year. Since the outbreak started, more than 54,386 cases have been detected and more 321 deaths since Jan-2022.

On 22 June 2022, the deadliest earthquake to hit Afghanistan in two decades struck at a depth of 10km in the countrys south-east in the early hours while most people were asleep. Its estimated more than 1,000 children and adults have lost their lives and approximately 1,600 people have been injured.

Read more here:
Save the Children's Response in Afghanistan (May Update) [EN/PS/Dari] - Afghanistan - ReliefWeb

Emergency kits for skin grafts and basic bone surgery are part of 24.5 tonnes of medical aid being sent by the World Health Organisation from its logistics hub in Dubai on Tuesday to assist victims of the earthquake in Afghanistan.

The $330,000 worth of aid was loaded on to lorries at WHO warehouses in Dubai's International Humanitarian City (IHC) on Monday to be flown to Kabul, from where it will be distributed to assist people in the eastern provinces of Khost and Paktika where a 6.1-magnitude earthquake last Wednesday killed more than 1,000, injured at least 1,400 and left thousands homeless.

It includes non-communicable disease (NCD) kits and testing equipment for cholera, the potentially fatal gastrointestinal infection that officials fear could spread rapidly amid a lack of safe water supplies and proper sanitation.

We are in co-ordination minute-by-minute with our team in Afghanistan, who are the ones who requested the items. Once the items have arrived the charter will be offloaded immediately and lorries will be ready to take the different supplies to clinics and hospitals in Afghanistan, Nivien Attalla, operational manager of the WHO Logistics Hub in Dubai, told The National as the aid was being loaded.

This is the WHO's first shipment from Dubai for the earthquake victims, but only a small part of the global relief efforts carried out by the UN agency and the IHC.

Nivien Attalla, operational manager at the WHO Logistics Hub in Dubai's International Humanitarian City. Suhail Akram / The National

Last year we shipped to 129 countries, which means we're a global responder, Ms Attalla said. Most of the shipments go to the EMRO region that is, Afghanistan, Yemen, Sudan, Libya, Pakistan and Somalia, which are among the top countries we're responding to.

Tuesday's shipment of aid is likely to be followed by more, IHC chief executive Giuseppe Saba said.

Once a full assessment of the situation is done, everybody knows therell be a second wave of humanitarian aid that will be moved, he said.

Afghanistan is currently the IHC's number one priority, Mr Saba said.

As of today, Afghanistan is the first country thats being served by the IHC community, while the second one is Yemen and then on the number three we have the critical situation in Europe with the Ukraine crisis, he said

In a year, the IHC sends out about 1,000 to 1,300 shipments.

Giuseppe Saba, chief executive of Dubai's International Humanitarian City, at the World Health Organisation warehouse Suhail Akram / The National

As of today were almost at 400 shipments through IHC [this year], Mr Saba said.

IHC is the largest humanitarian hub in the world with 80 different organisations.

Besides WHO, others include the World Food Programme, the UN's refugee agency (UNHCR) and Unicef (United Nations Children's Fund), Mr Saba said.

Last week, the UAE sent food, aid and medical supplies to Afghanistan after President Sheikh Mohamed ordered an air bridge to be established for the relief effort.

A medical team and field hospital were also sent to south-east Afghanistan, state news agency Wam reported.

Updated: June 28, 2022, 5:00 AM

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WHO readies shipment of emergency supplies from Dubai to Afghanistan - The National