Afghanistan: Humanitarian Update, December 2024

Afghanistan’s Humanitarian Needs and Response Plan 2025: A call for action

Every year, the United Nations Office for the Coordination of Humanitarian Affairs, in collaboration with humanitarian partners, prepares Afghanistan’s Humanitarian Needs and Response Plan (HNRP). This vital document assesses the country’s most pressing challenges, identifies the needs of vulnerable populations and outlines strategies to save lives and support communities in times of crisis. On 19 December 2024, the 2025 HNRP was launched, marking an urgent call to action.

In 2025, an estimated 22.9 million people, more than half of Afghanistan’s population will require humanitarian assistance. This is the second-largest number of people in need globally in 2025, second only to Sudan and highlights the extent to which Afghanistan remains one of the world’s largest humanitarian crises. Among those in need, 21 million people will lack access to adequate water and sanitation, 14.8 million will face acute food insecurity, 14.3 million will struggle to access basic healthcare and 7.8 million women and children will need nutrition support.

These staggering figures highlight the deepening challenges in Afghanistan, compounded by stubbornly high-levels of food insecurity and malnutrition, economic stagnation, widespread unemployment, and high-levels of household debt and poverty. Women and female-headed households face disproportionate hardships due to restrictions imposed by the de facto authorities. The recent ban on Afghan women attending public and private medical institutes, the last remaining option for them to pursue higher education, will only worsen the situation in a country where two-third of births are attended by a skilled health professional and maternal deaths occur every two hours.[1]

Afghanistan’s vulnerability to climate change further adds to the humanitarian crisis. Seasonal challenges, coupled with the anticipated La Niña phenomenon in early 2025, are expected to reduce snowfall and rainfall while bringing higher temperatures. These conditions could lead to droughts in rain-fed agricultural areas, threatening food security and livelihoods.

Political developments in neighboring countries also raise concerns about a renewed returnee crisis, which could place additional strain on already overstretched host communities, especially in the eastern, northern and western regions.

In response to the large-scale needs, humanitarian actors aim to reach 16.8 million people in 2025, requiring US$2.42 billion to deliver life-saving aid. This assistance will encompass food, emergency shelter, healthcare, nutrition, education, safe drinking water, hygiene supplies and cash assistance.

In 2024, despite immense challenges, humanitarian actors in Afghanistan made significant progress, reaching 19.8 million people by November with at least one form of assistance. However, the response has been hampered by critical funding gaps, with half of the required US$3.06 billion provided.

As humanitarian partners begin to implement the 2025 HNRP, their commitment to addressing the most acute needs in Afghanistan remains unwavering despite the challenging road ahead. Meeting needs, safely, comprehensively and meaningfully requires global solidarity and collaboration. With US$2.42 billion needed to assist the most vulnerable, we urge the international community to provide the necessary support to ensure life-saving aid reaches those who need it most.

Ban on Afghan women attending medical institutes deepens Afghanistan's existing healthcare crisis

Since the ban on Afghan women attending universities came into effect in December 2022, the healthcare sector has remained one of the few fields where Afghan women could pursue advanced studies. However, the 2 December 2024 announcement by the Ministry of Public Health (MOPH) that female students were prohibited from attending public and private medical institutes with immediate effect will have severe consequences for generations to come if not reversed. Not only will this ban threaten women’s access to healthcare education in critical fields such as midwifery, nursing, dental prosthetics and laboratory programmes, but it will also pose a serious threat to women’s healthcare in Afghanistan and jeopardize the implementation and sustainability of health programmes in the longer-term.

The decision directly impacts approximately 45,000 female students, including 4,600 who have graduated by end of 2024 and 9,800 who were nearing completion. It will worsen the shortage of female medical professionals, further restricting women’s access to healthcare.[2] This is particularly concerning given the strict interpretation of Sharia law enforced by the de facto authorities (DfA), in a context where male doctors cannot conduct medical examinations on women due to local culture and customs. According to the Health Cluster, the ban will severely impact maternal, newborn and child health, as well as gender-based violence (GBV) counseling and psychosocial support, deepening health inequities and worsening the public health crisis.

Moreover, during emergencies, midwives are among the first responders, addressing urgent reproductive health needs and helping to prevent maternal and newborn deaths. Humanitarian partners rely on midwives for life-saving interventions, not only in static health facilities like family health houses and basic health centres but also as essential members of Mobile Health Teams. These teams deliver maternal and newborn care to isolated communities across Afghanistan’s 34 provinces.

In the medium to long term, the ban on midwifery and other medical education will likely have catastrophic consequences for maternal and newborn mortality and morbidity, in a context which already has among the highest rates of maternal mortality in the world, standing at 620 per 100,000 live births.[3] Additionally, Afghanistan’s under-five mortality rate is 55 per 1,000 live births and the neonatal mortality rate is 24 per 1,000 live births.[4] Currently, only 67.5 per cent of deliveries are attended by skilled birth attendants and just 18.9 per cent of women of reproductive age have access to contraception. The adolescent pregnancy rate is also concerning, with 16.3 per cent of women aged 20-24 having given birth by age 18.[5] Pregnancy complications and unsafe abortions account for 64 per cent of female deaths among 15-19-year-olds and 70 per cent among 20-24-year-olds.[6]

Immunization rates are alarmingly low, with only 36.6 per cent of children aged 12-23 months receiving basic immunizations and just 16.2 per cent of children aged 24-35 months being fully immunized. Non-communicable diseases account for 52 per cent of all deaths in the country.[7]

The situation is even more dire for vulnerable groups, including women, children, displaced populations and persons with disabilities. Their growing healthcare needs, particularly those of women, underscore the urgency of improving healthcare infrastructure, increasing access to services and ensuring tailored responses for these populations.

According to the 2025 Humanitarian Needs and Response Plan (HNRP), 14.3 million people in Afghanistan require healthcare services, with 9.3 million expected to receive assistance. Of this population, 23.2 per cent are women, 53 per cent are children and 9.9 per cent are persons with disabilities. The estimated cost for comprehensive healthcare interventions stands at $279.7 million.[8] These funds are essential for addressing urgent healthcare needs, strengthening the sector’s resilience and ensuring life-saving services reach the most vulnerable.

As this healthcare crisis escalates, the world observes International Universal Health Coverage Day (UHC Day) on December 12 each year, emphasizing the importance of universal health coverage (UHC) and resilient health systems.[9]

In Afghanistan, the need for healthcare professionals, particularly female healthcare workers, as well as stronger healthcare infrastructure and affordable healthcare, is more urgent than ever. The ban on women’s education in the health sector will only exacerbate the already fragile situation, eliminating opportunities for female healthcare professionals and further undermining the country’s ability to address its health crises. It is essential that the de facto authorities and the global community take urgent action to ensure that every individual in Afghanistan, regardless of gender, has access to the healthcare services they need.

The path forward requires a commitment to investing in education, particularly for women, and building a healthcare system capable of meeting the needs of the most vulnerable. Without such investment, the already struggling healthcare system will continue to deteriorate, putting countless Afghan lives at risk.

Only through concerted and coordinated efforts can Afghanistan hope to move closer to achieving Universal Health Coverage by 2030.

Collaborative efforts by the United Nations Mine Action Service and UN Central Emergency Response Fund bring hope to Afghan communities by addressing explosive risks

Decades of conflict have left Afghanistan with one of the highest levels of Explosive Ordnance (EO) contamination in the world, with landmines, explosive remnants of war (ERW) and improvised explosive devices (IEDs) affecting two-thirds of the Afghanistan’s 401 districts. Approximately 3.3 million people live within 1 km of identified contaminated areas, with children particularly at risk due to their curiosity and limited awareness of these dangers. Tragically, poverty has pushed many children into hazardous work, such as scrap metal collection, which further increases their exposure to the threat of explosive ordnance.[10]

Between January and November 2024, Afghanistan recorded 483 civilian casualties due to explosive ordnance, with children accounting for 83 per cent—equivalent to eight out of every ten victims. Of these incidents, 51 per cent occurred while children were playing, and an additional 9 per cent were linked to scrap metal collection. Notably, 91 per cent of these casualties resulted from explosive remnants of war, rather than landmines or IEDs.[11]

A heartbreaking incident occurred on 5 December in Badghis Province's Ab Kamari District, when a 5-year-old girl suffered severe injuries and lost her right hand after discovering the fuse of a grenade in a ruined building next to her home and played with it, underscoring the urgent need for clearance operations and risk education across the country.

In response to these challenges, the United Nations Mine Action Service (UNMAS), with support from the UN Central Emergency Response Fund (CERF), are partnering with the Demining Agency for Afghanistan (DAFA) to address EO contamination in some of the most affected areas. Their efforts have brought hope and safety to communities that had long lived under the shadow of fear.

Transforming communities through clearance operations

In May, DAFA began demining operations in Kunduz and Faryab provinces. By September, the teams had cleared 3,675,084 square meters of land and destroyed 1,129 ERW. This included clearing areas around 10 schools, significantly reducing risks for children and educators.

For residents of Naseri 1 village in Kunduz, the impact has been transformative. Once paralyzed by the threat of explosives, the village is now safe, with families returning to agriculture, reestablishing orchards and rebuilding infrastructure.

Reflecting on the period before the clearance, local shepherd Enayatullah, 43, recalled, “This area was extremely dangerous due to explosive ordnance. We couldn’t use it for grazing or agriculture, and there were many accidents, making it unsafe for people and livestock.” He recounted a tragic incident involving a relative and his son. While herding sheep, the young boy unknowingly threw a small ERW at a sheep, killing it instantly.

Enayatullah described the relief: “Thanks to your efforts, we can now use this land for agriculture, grazing and other activities without the constant fear of explosives. This project has already begun to improve our lives and we are hopeful it will pave the way for reconstruction and development in our community.”

The clearance has also improved access to schools, healthcare and other essential services, with safer routes for villagers and children walking to school without fear.

Building awareness through education

In addition to clearance operations, DAFA conducted 310 Explosive Ordnance Risk Education (EORE) sessions, reaching over 7,300 villagers in Kunduz and Faryab provinces. These sessions equip residents, especially children, with the knowledge to identify and report dangerous objects. Villagers were encouraged to use the mine action programme hotline or AWAAZ Afghanistan for prompt assistance with suspected EO.

For residents like Enayatullah, the EORE sessions have been invaluable. He expressed gratitude for the information provided, noting how it has enhanced the community's safety by teaching them to recognize and report suspicious items, significantly reducing the risk of future incidents and saving lives.

Creating safe spaces and opportunities

The successful clearance of EO in Naseri 1 has laid the groundwork for economic growth and long-term food security. With safe land now available, families are investing in agriculture, rebuilding homes and creating new opportunities for their children.

The collaboration between UNMAS, CERF and DAFA is overcoming the legacies of war. As demining operations continue, the hope is to replicate the success of Naseri 1 in other communities still grappling with EO contamination.

Reflecting on the transformation of his village, a local shepherd shared:
“Before, I feared that each step could be our last. Now, I can confidently take my sheep to graze, knowing the land is safe. This project has truly given us our freedom back.”

With continued support and dedication, Naseri 1 stands as a beacon of what can be achieved. Together, UNMAS, CERF and DAFA are helping Afghanistan move closer to a future where no village is left behind, a future where every child can play, every family can thrive and every community can prosper.

However, continued success relies on sustained funding and support. The need for demining, risk education, and community revitalization remains urgent. It is imperative that donors, partners, and stakeholders join this critical effort to ensure that more villages like Naseri 1 can experience this transformation, free from decades of contamination, where communities can consolidate peace through the safe restoration of their livelihoods, unhindered by the remnants of war.

[1] Afghanistan, UNICEF, www.unicef.org/afghanistan/stories/delivering-love-and-light-mothers-afghanistan

[2] WHO, data as of end 2024. All institutes are currently closed for winter break and are expected to reopen in March 2025.

[3] UN Maternal Mortality Estimation Interagency Group [MMEIG] 2020

[4] Afghanistan Multiple Indicator Cluster Survey [MICS] Summary Findings Report (March 2023).

[5] Multiple Indicator Cluster Survey (2022-2023)

[6] World Health Organization. Summary Report of the WHO AYSRHR Technical Assistance Coordination Mechanism’s Assessment of the Health of Adolescents and Youth in Afghanistan. 2021.

[7] Institute for Health Metrics and Evaluation (IHME)’s Global Burden of Diseases

Study 2019 (GBD 2019).

[8] Afghanistan Humanitarian Needs and Response Plan 2025 (December 2024)

[9] International Universal Health Coverage Day, 12 December

[10] Afghanistan Humanitarian Needs and Response Plan 2025

[11] Afghanistan, UNMAS, www.unmas.org/en/programmes/afghanistan.