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How Trump Could Get Bagram Back

October 4, 2025

By

Foreign Policy

It’s not every day that a U.S. president publicly demands the return of a military base from a former adversary. But that’s exactly what happened last week, when President Donald Trump said that his administration is “trying to get” Bagram back from the Taliban.

The statement sparked a mix of surprise and skepticism. Once the nerve center of U.S. military operations in Afghanistan, the Bagram Airfield was abandoned during the messy 2021 U.S. withdrawal and quickly taken over by the Taliban. Now, four years later, it has resurfaced as Trump’s latest foreign-policy gambit, rekindling debate over the United States’ unfinished business in the Taliban-controlled Afghanistan.

Trump, who has repeatedly raised the issue of control of Bagram since the withdrawal, now appears to be ramping up his push. “We want it back and we want it back soon. Right away,” he warned on Sept. 20.

Media reports indicate that the White House is actively weighing options to reestablish a U.S. foothold at the base, citing both its counterterrorism value and its proximity to key Chinese nuclear facilities. Located 40 miles north of Kabul, the base remains fully capable of supporting large aircraft, drones and surveillance platforms, special operations forces, and rapid-response missions. Where its loss came to symbolize American retreat, regaining Bagram could mark a bold reassertion of U.S. power in a turbulent region.

While the Taliban quickly rejected Trump’s idea, the issue is far from settled. In recent years, internal fissures within the group have widened, driven by growing discontent over the emir’s consolidation of power and his merging of clerical authority with executive control over policy and personnel decisions.

Combined with mounting economic desperation and the escalating threat from the Islamic State-Khorasan (IS-K), fractures are reshaping the Taliban’s internal dynamics and creating potential openings for practical engagement. Given the regime’s obsession with survival and pressure from within its own ranks, Trump’s idea is not as far-fetched as it may seem. His team could exploit these cracks through a right mix of incentives, back-channel diplomacy, and pressure from regional actors. Both symbolically and operationally, Bagram remains one of the few fixed assets capable of reinserting U.S. influence across the South Asia and Central Asia regions.

“If Afghanistan doesn’t give Bagram Airbase back to those that built it, the United States of America, BAD THINGS ARE GOING TO HAPPEN!!!” Trump wrote in a Sept. 20 Truth Social post. That blunt threat signals a possible recalibration of U.S. posture in a region where U.S. influence has sharply declined. Since the withdrawal, IS-K has rapidly expanded operations, terrorist safe havens have resurfaced, and U.S. intelligence collection has weakened considerably. Meanwhile, China, Russia, and Iran have moved aggressively to fill the vacuum.

The case for returning to Bagram is driven by urgent security requirements. U.S. government assessments warn that IS-K could rebuild its external operations capabilities within months if left unchecked. With no physical U.S. presence in Afghanistan, the current over-the-horizon model, which relies on distant bases in the Gulf, is a poor substitute for the proximity and on-the-ground visibility needed for effective counterterrorism.

The administration now faces several potential pathways, each fraught with risks and trade-offs. The real challenge lies in structuring an arrangement that delivers meaningful value without inviting mission creep or open-ended commitments. Trump’s penchant for transactional diplomacy could give him a unique advantage in striking such a deal.

The most direct route forward would be a negotiated agreement with the Taliban, either as a stand-alone deal or an expansion of the existing U.S.-Taliban Doha framework. In exchange for partial or full access to Bagram, Washington could offer what amounts to a survival package that includes economic assistance, counterterrorism cooperation, and gradual steps toward political normalization and easing sanctions. The Taliban would almost certainly demand international legitimacy, starting with a seat at the United Nations, as well as relief from financial and travel restrictions. A more distant but significant opportunity lies in potential U.S. investment in a lithium mine in Afghanistan. If included in the broader deal, it could deliver substantial benefits for both sides and plug Afghanistan into global supply chains.

While hard-liners, especially the emir in Kandahar, are expected to resist any accommodation with Washington, other factions within the Taliban’s uneasy coalition may privately favor such a deal as both tolerable and profitable. The emir, however, is neither untouchable nor invincible, particularly if he refuses to compromise and faces dissent from within his own ranks. Although direct dialogue with the emir remains largely untested, the regime’s broader reality as an isolated, cash-strapped hermit state increasingly vulnerable to IS-K offers meaningful leverage. These conditions may make a negotiated opening more plausible than it might appear.A more politically acceptable alternative could involve a third-party arrangement, potentially outsourcing Bagram’s management to a Gulf intermediary such as Qatar or the United Arab Emirates, a NATO member such as Turkey, or even a Central Asian partner such as Uzbekistan. These countries maintain close ties with the Taliban, have accepted regime-appointed ambassadors, and remain close security partners of Washington.

Under such an arrangement, Bagram could be repurposed as a joint counterterrorism hub and training facility, technically overseen by an external partner but functionally enabling U.S. access for intelligence collection, surveillance, and operations.

Qatar, for instance, already hosts a U.S. interests section within its embassy in Afghanistan and facilitates back-channel talks with the Taliban. Uzbekistan, which shares a border with Afghanistan, still houses dozens of U.S.-supplied combat helicopters and other military equipment previously provided to the former Afghan government, assets that the Taliban are eager to recover. But more importantly, Uzbekistan faces serious threats from at least four Uzbek jihadi groups, all of which enjoy Taliban sanctuary and maintain operational ties with al Qaeda, IS-K, and Hayat Tahrir al-Sham in Syria. These concerns have pushed Uzbekistan to seek a closer counterterrorism partnership with Washington.

Meanwhile, the United Arab Emirates manages four of Afghanistan’s main airports, including Kabul International Airport. It oversees systems and technology, terminal operations, and ground services, giving it considerable visibility into Taliban logistics and movement. This role, combined with the UAE’s deepening technological footprint in Afghanistan’s telecommunications and energy sectors, further enhances its insight into the regime’s internal workings. The UAE has also hosted Taliban dissenters and enjoys high-level, direct access to senior Taliban leadership, including during sensitive engagements such as hostage negotiations.

Such a third-party arrangement could provide Washington both legal and diplomatic cover while minimizing the optics of direct engagement with the Taliban. For the Taliban, it could provide a face-saving narrative by allowing them to present the partnership as engagement with a fellow Muslim nation rather than with the United States itself. While they may demand some visibility into U.S. activities at the base or seek to limit certain operations, especially those targeting al Qaeda, a workable compromise could still preserve the United States’ core counterterrorism capabilities on the ground.

A third option could draw on the post-9/11 precedent with Pakistan, where the United States operated for years from airfields in Jacobabad and Pasni under the nominal control of the Pakistani government. That arrangement showed how even adversarial or uneasy partners can collaborate when the right incentives or threats are on the table. A similar low-visibility setup at Bagram could enable U.S. personnel to operate discreetly in designated zones, possibly with Taliban-appointed liaisons serving as intermediaries. Though politically delicate, such quiet engagement would mirror existing forms of U.S.-Taliban interaction, ranging from back-channel coordination on migration and humanitarian aid to limited dialogues on counterterrorism and narcotics issues, including the sharing of actionable targeting information. If the Taliban were to refuse such an arrangement, Pakistan could once again emerge as a fallback partner by providing U.S. access to facilities within its own territory.

Another alternative could involve a hybrid civilian-military consortium, a joint venture between select Gulf, Taliban, and U.S. stakeholders. In this version, Bagram could be rebranded as a civilian logistics, maintenance, and aviation hub with embedded security and intelligence components managed by American personnel. While unconventional, similar gray-zone basing arrangements have proven effective in places such as Somalia, Iraq, Djibouti, and the Sahel.

If formal channels fail, the United States could opt for a covert presence by leveraging intelligence networks, paramilitary units, or private contractors. This approach could build on existing relationships with former Afghan strike units, regional intermediaries, or even Taliban defectors. It could resemble the CIA-run Counterterrorism Pursuit Teams, who were recruited in the early days of the Afghan campaign and remained active in Afghanistan until the Taliban takeover. Many of the units’ members have since been resettled in the United States and partner countries.

While the risks of exposure and Taliban retaliation would be significant, this approach is consistent with the U.S. track record of operating in hostile environments through deniable means. However, such efforts could face serious challenges, including the growing threat of Taliban hostage-taking involving U.S. dual nationals, a recurring issue that has already entangled Washington in ransom-driven hostage diplomacy with the regime.

Beyond counterterrorism, the big-picture rationale for the United States wanting Bagram back is just as compelling. China is rapidly deepening its footprint in Afghanistan, pursuing rare-earth minerals and embedding itself in critical infrastructure. Russia, having moved early to formally recognize the Taliban government, is expanding its security engagement. Iran continues to move weapons, fighters, and currency across Afghan borders with little resistance. India, though sidelined, is watching with concern. And Pakistan—long a disruptive player in Afghan affairs—is readjusting its position amid rising instability inside Pakistan and growing tensions with the Taliban over cross-border sanctuaries involving the Pakistani Taliban.

To be sure, any U.S. return to Bagram would be seen by China and Russia as a direct challenge to their regional influence, likely prompting them to pressure the Taliban to resist such a move. Iran would oppose any U.S. reentry outright. Pakistan would be forced to balance its ties with the Taliban and its dependency on China to reap potential gains from renewed cooperation with Washington. India, though unlikely to say so publicly, would quietly welcome it. Ultimately, the Taliban understand that no country can, nor would, outmatch the scale of U.S. investment or rival its influence.

In the end, getting Bagram back won’t be easy. But if the Trump administration embraces a pragmatic bargain and explores creative basing arrangements, it could secure a meaningful foothold without slipping into another costly entanglement. In a region where the United States’ absence has created a dangerous vacuum—and where the Taliban have now held power for the full length of a U.S. presidential term—reestablishing access to Bagram under new terms and for new priorities could represent a significant foreign-policy win for the administration. It’s an opportunity worth seizing.

Javid Ahmad is a counterterrorism research scholar and author of the Taliban Leadership Tracker at the Middle East Institute. He also teaches at George Washington University.

How Trump Could Get Bagram Back
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A Forgotten Crisis—Mass Forced Returns Are Pushing Afghanistan to a Breaking Point | Opinion

October 3, 2025
By
Newsweek
October 2, 2025

The Islam Qala reception center is a pit stop for exhausted and disoriented Afghan families. Many are still in shock—unable to understand why they have been uprooted from their lives in Iran, forced to board buses with their children and their belongings, and brought to this gateway point to Afghanistan with little to no money in their pockets and no shortage of worries.

There is nothing voluntary about their return. The overwhelming majority of Afghans say they are being forced to return to Afghanistan for political reasons. After decades of living in Iran and Pakistan, they are being expelled.

Danish Refugee Council Secretary General Charlotte Slente speaks to Afghans on September 2, 2025, after their arrival from Iran to the Islam Qala rece…| Esmatullah Habibian/Danish Refugee Council

This year alone, more than 2 million Afghans have been forced to return to Afghanistan. What awaits is a country facing multiple overlapping crises.

If only Afghanistan was not in the middle of a crippling humanitarian crisis in which half of the population, or 22.9 million people, is in desperate need of aid and 3.5 million children are acutely malnourished.

If only Afghanistan was not sorting through the rubble of deadly earthquakes in recent weeks that flattened entire mountain villages in the country’s east and killed thousands.

If only Afghanistan was not dealing with sweeping aid cuts and an international community experiencing “Afghanistan fatigue” and turning its back on Afghans.

Afghanistan is simply not ready to handle forced mass returns; they place a burden on a country already at breaking point. Returning families face bleak economic prospects, severe lack of health care, and lack of shelter. Returning women and girls face barriers to study, work, and safe movement.

At the Islam Qala reception center, carts laden with boxes and suitcases pulled by young men under the sweltering September sun zigzag across the courtyard, as Afghan families follow their belongings closely behind.

Zahra, 25, is wearing a black dress and green scarf while clutching her smartphone and blue plastic folder with paperwork. Around her, other Afghan families that have been forced by Iran to return to Afghanistan crowd around private buses for onward journeys to Herat city and beyond.

Zahra’s father is sick and cannot work, and she is responsible for her brother. In Iran, she worked and provided for the family. Now, in Afghanistan, she faces a stark reality: She was a baby when her family took her to Iran in 2000. “This is my first time seeing Afghanistan,” she told me. “I have no shelter; I don’t know anyone.”

Surveys and interviews with more than 700 Afghan returnees in March 2025 by the Danish Refugee Council’s Mixed Migration Centre showed that 65 percent of women reported receiving no assistance—a reminder that in an era of mass expulsions, women and girls are hardest hit, putting their lives at risk and pushing them deeper into despair.

Afghanistan’s crisis intensifies their struggles: Strained resources make it difficult for women and girls to access food, clean water, health care, and education. Female-headed families face extreme poverty, exclusion, and higher risk of exploitation.

“We are happy to return [to Afghanistan], but if we can’t find work what are we to do?” asked Zahra.

DRC is helping Afghans with cash assistance to meet their immediate needs, including food, shelter, and travel. In addition, our staff educate returning Afghans at key border crossings about the silent threat of explosive remnants of war in one of the most contaminated countries in the world.

This assistance is a drop in the ocean of needs.

My biggest worry is that the international community has cut and run at a moment when Afghans need our help. Western funding cuts, including sweeping U.S. reductions, will result in 2.5 million fewer people reached in Afghanistan, according to DRC analysis using the AI-powered Foresight model.

For Zahra, what comes next is a struggle for survival and hard choices. She must choose where to head, find a roof for the night, and come up with a plan. She needs to enroll her brother in school and get her father seen by a doctor and treated.

Most of all, Zahra needs to find work and start earning money. Starting over requires legal identity documentation that many people forced to return to Afghanistan simply do not have. There will be fees to pay for new documents, appointments to attend, and potential delays. Women cannot travel freely to appointments or be served without a male relative.

There is no escaping the heavy truth: Women like Zahra carry the weight of the world on their shoulders. But wealthy nations can lighten that load and still make a difference in the lives of people—including women and girls—by staying committed for the long haul and helping sustain dignified lives for men, women, and children. That is what standing in solidary with Afghans looks like.

Charlotte Slente is the secretary general of Danish Refugee Council (DRC).

A Forgotten Crisis—Mass Forced Returns Are Pushing Afghanistan to a Breaking Point | Opinion
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Why reclaiming an Afghan air base is in America’s national interest

October 2, 2025
Luke Coffey
Opinion contributor
The Hill
10/02/25 

When President Trump announced during a press conference in London that he was in the process of trying to regain access to Bagram Air Base, it came as a surprise for some — especially judging by the look on United Kingdom Prime Minister Keir Starmer’s face.

But for those who have followed President Trump’s remarks on Afghanistan, his comments were not unexpected. On several occasions, he had called it a strategic mistake to hand over Bagram to the Taliban in 2021 and has even suggested that the United States should take it back.

That said, President Trump also bears responsibility. His deal with the Taliban during his first term set the stage for America’s full withdrawal. President Biden could have changed course but chose not to.

And now the United States is left with a resurgent Taliban that controls more of Afghanistan than it did on the eve of 9/11 and an al-Qaeda and ISIS that operate freely across the country. President Trump now has an opportunity to correct Biden’s mistake and reestablish America’s position in Afghanistan.

At the press conference, he said one of the reasons Bagram mattered is because it is “one hour away from where China makes its nuclear missiles.” While this may be an exaggeration, Bagram’s strategic location in the 21st century is undeniable.

Within an eight-hour flight of Bagram lies roughly 85 percent of the world’s population and more than half of the Earth’s landmass. Inside this radius are many of the world’s major trade and transit routes, along with the bulk of its strategic resources: an estimated 75 percent of global rare earth mineral reserves, 70 percent of proven oil reserves and 65 percent of proven natural gas reserves.

For the U.S., a foothold in Bagram brings major benefits in the era of great power competition. Afghanistan borders both Iran in the west and China in the east, while to the south lies Pakistan and then India. To the north is Central Asia, where Russia seeks to expand influence.

Bagram’s location has been important since antiquity. When Alexander the Great came through in 329 BC, he established Alexandria in the Caucasus where Bagram is today — so named because he mistakenly believed the nearby mountains were the Caucasus. In fact, they are the Hindu Kush.The Macedonian warrior knew he needed a well-fortified outpost to govern his newly conquered lands, and the terrain made Bagram the best location.

For the Soviets, Bagram’s location was equally critical. Its proximity to Kabul and to the eastern part of the country — one of the main battlegrounds during the Soviet war — made it a centerpiece of their presence. Many of the facilities on the base trace to Soviet construction.

After 9/11, the U.S. modernized and expanded them, including a second 11,800-foot runway designed to handle even the largest and heaviest military transport aircraft.

This layered history underscores why Bagram remains one of the world’s most valuable airfields.

Trump claims that he and his officials are already in contact with the Taliban. The Taliban, however, deny this — likely because of internal infighting. Any hint that one faction is talking to the U.S. would raise suspicions among internal rivals. If an arrangement with the Taliban to access the base fails, the U.S. should consider all options to reestablish a presence in Bagram.

After more than two decades of operations there, U.S. forces know the base and surrounding terrain intimately. It is worth noting that anti-Taliban forces such as the National Resistance Front, led by Ahmad Massoud, maintain a stronghold in the Panjshir Valley less than 50 miles away.

While reentry will be difficult and not without risk, it is certainly doable. Once reestablished, operating and defending the base could be modeled on the U.S. presence at al-Tanf in Syria, where a deconfliction zone ensures safe and secure operations.

Since the early 19th century, there have been 19 instances of American or European intervention in the region, whether militarily or diplomatically — roughly once every decade.

Nobody expects U.S. troops to return anytime soon, but nobody expected an intervention in August 2001, either. Should circumstances require America to reengage, it would be invaluable to have a presence on the ground.

Luke Coffey is a senior fellow at Hudson Institute.

Why reclaiming an Afghan air base is in America’s national interest
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New documentary scrutinizes the lies that fueled the war in Afghanistan

September 29, 2025

By

The Washington Post

A scene from “Bodyguard of Lies,” which chronicles years of U.S. failure in the Afghanistan conflict. (CBS/Paramount+)

“Bodyguard of Lies,” a documentary examining the deceit that drove the longest war in American history, takes its title from a Winston Churchill line: “In wartime, truth is so precious that she should always be attended by a bodyguard of lies.”

It’s difficult to say whether truth was considered precious, during the decades that the United States was mired in military conflict in Afghanistan. As the film demonstrates, it was certainly in short supply.

The film adapts a 2019 investigation in The Washington Post, “The Afghanistan Papers,” which uncovered hundreds of firsthand accounts from generals, diplomats and other government officials about what went wrong in the conflict. In their reporting, The Post’s Craig Whitlock, Leslie Shapiro and Armand Emamdjomeh found that those unvarnished remarks often directly contradicted statements made by those same leaders to the American public — adding up to decades of deliberate deception. (Whitlock was also executive producer on the film and appears in it.)

In the movie, director Dan Krauss draws on the revelations from that cache of documents, interviewing a number of people involved in the conflict, including John F. Sopko, special inspector general for Afghanistan reconstruction; Gen. David McKiernan, the four-star general fired during the Obama administration; and Maj. Gen. Edward M. Reeder, who commanded the U.S. Army Special Forces for much of the war.

Krauss and I spoke over Zoom a few days after the documentary’s Sept. 23 streaming premiere. Our conversation has been edited for length and clarity.

I mostly ran into a lack of interest, to be honest. I think even before the war was over, the American public had really tuned out. Now — what is it, four years after the war has ended? — Afghanistan feels really distant in the minds of the American public. It feels like a lifetime ago, to many.

Can you tell me about how you identified and recruited some of the on-camera interview subjects? Especially when it came to senior military officials, I was curious about why you chose the people you did — and whether there were people you wanted to get but couldn’t.

I said early on to the team, it’s not about the war, it’s about words. There’s been so much terrific landmark reporting about the war itself, and I didn’t want to repeat the work that had come before us. I wanted to keep a very tight focus on the lies — on the differences between what the American public was being told and what those same officials knew to be true behind closed doors.

So who do you recruit to tell that story? There are some obvious players, the big-hat, brand-name players that we could’ve tried to get. It didn’t seem to me that we would learn anything new by putting them in front of the camera again. So I was really focused on handing the microphone to people who hadn’t already spoken at length on this subject — and also people who could speak most directly, and most honestly, to their own role in propagating this rosy picture of the progress being made in Afghanistan.

For my money, General David McKiernan, the four-star general who was fired, is really the hero of the film. He’s deeply introspective and honest about his own experience. He said he’s seen it twice now and each time he’s been very bothered — I think he said troubled — by the film. He was one of the only people who spoke up and said the solution to Afghanistan was going to be a political solution, not a military solution. But there were times, as you saw in the film, whereas he said — you don’t lie, but you maybe don’t say as much as you could, about how difficult the road ahead is going to be. He has a certain amount of regret, I think, for doing that. He acknowledges a certain degree of complicity.
Retired Gen. David McKiernan in “Bodyguard of Lies.” (Jigsaw Productions/Paramount+)

The documentary grew out of the revelations of the Afghanistan Papers, which were published in late 2019. Do you think their publication significantly changed the way the war was conducted?

I have no idea. I mean, I have to — I would like to think that kind of reporting would have an impact. I can’t think of Craig’s reporting without thinking about the Pentagon Papers and Daniel Ellsberg and the Vietnam War. The lies that were told during that war are very like the ones we were being told during this one.

The heart of the film is, as you say, words and deception from the government. Do you think the American public believed the deception?

Certainly, in my neck of the woods and maybe yours, too, I don’t think anyone ever believed that the war was going as well as they were telling us. I don’t know that the sales pitch was really thoroughly effective, at least for people who had a critical eye.

But it’s one thing to sense that, and it’s another thing to read it or to hear it. And that’s what the Afghanistan Papers did, at least for me. … Craig asks in the film, how do you prove that someone’s not telling the truth? Well, in the case of his reporting, you get the receipts.

Right, and then how do you prove that the person isn’t just self-deluded, but is actively telling you something they know to be untrue?

There was a certain degree of self-delusion that went into the lies, and there was also this very American brand of can-do optimism — that if you say something out loud, you will it into being. We are going to win. We are going to create a democracy in Afghanistan. You have to say it out loud in order for it to happen — and if you say it out loud then it puts an enormous amount of pressure and responsibility on the people beneath you.

A scene from “Bodyguard of Lies.” (Danfung Dennis/Paramount+)

By that token, do you think the Biden administration deserves more credit for, in some sense, dispensing with these illusions? The U.S. withdrew from Afghanistan within his first year in office, at some political cost.

I don’t know. I think what’s not discussed, and what I felt was important to include in the film. is the fact that the Trump administration negotiated an agreement with the Taliban, essentially in secret, without input from the U.S. Congress or the Afghan government. Biden inherited that agreement. So there’s certainly a legitimate debate to be had about whether the withdrawal was accomplished as effectively as it would’ve been under another government — who’s to say? Certainly there are strong feelings on all sides of that. But what’s not acknowledged as much is the agreement that led to that withdrawal.

I ask because while watching this documentary, I imagined some theoretical young person who might be getting their first real education about the war. They learn about the lies that got us into, and prolonged, this conflict — then all of a sudden it’s over, and that’s also a calamity. But at some point there must have been a pivot. Some leaders, somewhere — during either the Trump or Biden administrations — took a different course of action and dropped the illusion that we should stay in Afghanistan.

The war ended so disastrously that giving credit to anybody seems really daunting. It’s less about giving credit than reminding people how the end of the war came about: that it was not Biden deciding on his own, unilaterally, to end the war, and it was not Trump actually going through the difficult task of logistically pulling our military out of the country, which is a very, very difficult and dangerous thing to do.

At one point, John F. Sopko, the special inspector general for Afghanistan, almost lays down a gauntlet for the viewer: We should learn our lesson, so we don’t screw up if some president someday promises us a splendid little war. Do you think there are also lessons specifically for the American press corps, especially as they navigate a much more hostile environment? To cite just one example, the Pentagon recently demanded that journalists pledge not to obtain any unauthorized information.

I remember when we bombed the nuclear facilities in Iran and reporters were asking questions about the effectiveness of those strikes — very fair questions, given that American service members were put at risk, and taxpayer dollars and political capital were expended. But there was this sense in the briefing room at the Pentagon that it was unpatriotic to ask questions about the effectiveness of that military strike.

That was one example; the pledge is another. When I see the briefing room at the Pentagon now, I don’t think we’ve learned any lessons, and that things have gotten, in fact, much worse.

The American public has a right to know what’s being done in their name. The idea that it’s unpatriotic to demand answers from our political and military leadership — that’s really scary.

Sophia Nguyen is the news and features writer for the Books section at The Washington Post. She previously served as assistant editor on the National Politics desk and as an assistant editor for Outlook.

New documentary scrutinizes the lies that fueled the war in Afghanistan
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Is maternal mortality on the rise in Afghanistan? No official data, but much cause for concern

September 28, 2025

Jelena Bjelica • AAN Team

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Afghanistan’s maternal mortality rate was already among the ten highest in the world, but it has come under further pressure. The United States’ decision to entirely cut aid to Afghanistan earlier this year has led to the closure of over 400 health facilities and that is likely to have particularly affected women during the most precarious events in their lives — pregnancy and childbirth. Coupled with that, there is a shortage of female doctors and midwives, likely to worsen as midwifery and female nurses’ training are now banned, along with all higher education for girls, including as doctors. Jelena Bjelica and AAN’s team have been trying to get a clearer sense of Afghanistan’s maternal mortality rate. They found quantitative data was scarce, but midwives, doctors and health officials in different provinces said they think the rate is increasing. They also heard from one Afghan who described how his family lost a female family member in childbirth due to poor healthcare. 
It was nine o’clock in the morning when we took her to the clinic in our village. It was her fourth pregnancy. Her husband is my relative. He doesn’t have a car, so he called me to come to his house and help him take her to the clinic. … When we got there, the midwife was present. My relative’s wife went into labour, but the baby was stillborn. The midwife told us to wait a while for her to check my relative’s wife. … 

When she finally gave us permission to leave, the women in our group noticed that my relative’s wife was still bleeding. We asked the midwife if we should take her to the Bost Hospital in Lashkargah city. The midwife said there wasn’t a problem, that it was normal to bleed after childbirth. … After we got her home, the bleeding increased. By the late afternoon, she grew weaker. We finally took her to Bost Hospital, but the doctor told us she had already lost a lot of blood and that the midwife couldn’t have been properly trained because the placenta had not been entirely removed. The doctor said we had got her to hospital too late. We donated blood, but on the third day, late in the afternoon, she passed away in the hospital. 

This incident occurred in Marja district of Helmand province in June 2025.

In an earlier AAN report on rural women’s access to health (published in March 2025, based on 22 interviews conducted in 19 provinces between September and November 2024), we found that the picture was already bleak: women spoke about the prohibitive cost of travel, when household incomes had fallen, the difficulty of independent travel following Emirate restrictions and declining standards in the facilities themselves. For this report, we wanted to really scrutinise the situation of pregnant women and those who have recently delivered and, in particular, try to get a clearer picture about the current maternal mortality rate in Afghanistan. We interviewed nine Afghan health professionals or health officials from eight provinces – Takhar, Jawzjan, Samangan, Balkh, Badghis, Paktika, Zabul and Kabul – as well as one international health expert, regarding the state of maternity care in the country. They also discussed the underlying causes for the apparent rise in maternal mortality, mentioning a decline in foreign support to health care, shortages of medicine, worsening poverty and Emirate restrictions on women’s professional medical training.

What is maternal mortality?

Maternal mortality, also known as maternal death, is defined as when a woman dies due to complications during pregnancy or childbirth or within six weeks of the end of her pregnancy, from any cause related to or aggravated by the pregnancy or its management (WHO). The most significant causes of maternal mortality are: severe bleeding, infections, pre-eclampsia and eclampsia, delivery complications and unsafe abortions.

The rate of maternal mortality is measured as the number of maternal deaths per 100,000 live births. Afghanistan saw a huge reduction in maternal mortality between 2000 and 2023, from 1,372 to 521 deaths per 100,000 live births (World Bank).[1] However, to give a sense of just how high even the 2023 figure is by global standards, some other countries’ rates are: Pakistan 155 deaths of mothers per 100,000 live births; Bangladesh 115; India 80; Uzbekistan 26; US 17; Iran 16; Tajikistan 14; France 7; Norway 1.

There have been no recent surveys on maternal mortality. A government official with the Ministry of Public Health, who wished to remain anonymous, told AAN that due to the US cutting all aid, a health survey had not been completed. He said the whole-country survey had been indirectly funded by USAID and added that 85 per cent of the survey had been finished when Trump issued his order to stop aid. Some of the healthcare professionals we spoke to also pointed to the lack of data, but all thought maternal mortality was rising.

One tiny statistical indication of an increase in the rate came from Deputy Representative of the World Health Organisation (WHO) for Afghanistan, Makta Sharma, who told Salam Watandar on 7 April 2025 that there were currently 620 maternal deaths per 100,000 live births. If correct, that is much higher than the 2023 rate of 521 deaths per 100,000. Apart from that one figure, one is left to anecdotal evidence, which, however, all points to maternal mortality being on the increase. One forecast, from the leading UN agency for sexual and reproductive health, the United Nations Population Fund (UNFPA), was also stark. The closure of health facilities caused by the end of US funding, it said in February 2025, would “likely result in 1,200 additional maternal deaths and 109,000 additional unintended pregnancies” between 2025 and 2028 (UN News).

Maternal health in the provinces: eyewitness accounts

Our interviewees all agreed that the deterioration in the healthcare system in their provinces was driving an increase in maternal mortality. The medical professionals cited several reasons for that deterioration, with the most prominent being the shortage of professional staff and the lack of health facilities in remote areas of the country due to funding shortfalls. Some also spoke about poverty making it impossible for families to pay for medicine or even getting transport for a woman in difficult labour to the nearest clinic. Poverty also means women are weak or malnourished during pregnancy or have to engage in hard labour during it, both factors adding to the risk of maternal death. The dire economic outlook in Afghanistan since 2021 is part of the story of increasing maternal mortality.[2] Some of our interviewees also drove home how dire they believed the situation had become by relaying instances of women dying in childbirth.

In Takhar province, the head midwife of a clinic said that many pregnant women were dying due to a lack of prenatal and postnatal care, because there were no facilities providing these services, or there was a shortage of medicine, money for transport, or the means to pay staff. Healthcare facilities had closed, she said, and a significant number of midwives and doctors had left Afghanistan.

Women continue to die from high blood pressure, heavy blood loss, and lack of medical attention. One of my close friends gave birth in a hospital. She was discharged too soon due to the overwhelming pressure on doctors and staff. They couldn’t attend to her after delivery, so as soon as she delivered, she was discharged. On the way home, she started bleeding heavily. She was brought to our clinic from the provincial hospital, but despite our best efforts, we couldn’t save her. She died from a heart attack due to the massive blood loss, leaving behind three children. She died and left three children. She was my close friend.

Such deaths were preventable, she said and should have been avoided.

Tragically, half of the women die on the way to hospital or to a clinic. Staff shortages exacerbate the situation. For example, a healthcare worker may see up to 300 patients in a single day and will just not have the capacity to see the 301st patient. It makes it impossible to treat the patients properly. I’ve also seen patients die because they could not afford medicine or get blood.

The head midwife also said that amr bil-maruf officials, tasked with enforcing the law promoting virtue and preventing vice, sometimes make the situation worse. “They sometimes enter delivery rooms during labour, forcing us to leave while they ‘inspect’ the room, claiming we might be hiding our corruption,” she said. “On one occasion, they were physically present in the delivery room when we were actually delivering the baby.”

Another midwife, also in Takhar, said she had left her hospital job after the fall of the Republic because of declining standards in hygiene and management, as many of her colleagues had left the country and others had lost their jobs. However, she said former colleagues told her things had got even worse this year:

The closure of the institutes that trained girls to become midwives and the cut in aid following Trump’s order has severely affected health service delivery. The Taliban have employed their relatives and other people they know. Most of the midwives in the hospital where I used to work are those acquainted with the Taliban. However, they haven’t yet graduated, nor completed their training and education as midwives. There’s been an increase not only in maternal mortality rate but also in children’s mortality rate because of the lack of qualified doctors, nurses and midwives over the past three to four years. 

Another midwife, this time from Jawzjan, who lost her job after the takeover, echoed these points. Her old colleagues had described to her a severe shortage of midwives and doctors, as well as of medicine and medical supplies in clinics. She said the difficulties in healthcare had reached a new high, and that all the problems were contributing to an increase in “the number of maternal deaths and the loss of infants and prematurely born babies.” She recounted a maternal death she had recently witnessed and explained the reasons behind such deaths:

Just a few days ago, I witnessed a death myself while I was in the hospital with a family member of mine who was giving birth. I saw a pregnant woman die during delivery. Also, another woman was in desperate need of a blood transfusion, and her family struggled in vain to find the right blood type for her. Without blood, she too was at risk of losing her life. … These deaths occur because mothers do not receive proper care during pregnancy. Many suffer from malnutrition, anaemia and weakness due to poverty and lack of resources. Without prenatal care, adequate nutrition and medical guidance, both mothers and their babies face risks. Even if the mother survives, newborns often do not. I’ve personally seen babies born prematurely at six months, and doctors explained this was due to the mother’s lack of prenatal care and the heavy physical labour they have to do in the villages. There are no instructions for these women in rural areas on prenatal care.

In Samangan province, a gynaecologist said that maternal and child healthcare in provincial centres had already begun to deteriorate after the fall of the Islamic Republic because many health workers left their posts, and the morale of those who remained plummeted because salaries were significantly lower than before the takeover. But now, she said, after the closure of midwifery schools and the end of USAID funding, “the health services women rely on are crumbling.” She pointed to cases of women dying of complications during delivery, including excessive bleeding. “Due to a shortage of staff and low salaries,” she said, “the quality of health services at provincial health centres just isn’t good.”

A graduate midwife from Balkh province said that women in her province, particularly pregnant women, must often travel long distances to the city for treatment because of the lack of services in remote areas. “Many women have lost their lives because of this,” she said. She believes the closure of midwifery programmes has directly contributed to an increase in the maternal mortality rate in the rural areas of Balkh.

A recent report on maternal mortality in Badakhshan province by the BBC’s Yogita Limaye heard multiple concerns at the provincial hospital there. The budget had been cut by almost two-thirds, 300 patients were being treated in a hospital with 120 beds, and maternal mortality had gone up: by August 2025, she reported, “there had been as many maternal deaths recorded [in the provincial hospital] as there were for the whole of last year.” At that rate, “maternal mortality could increase by as much as 50% [compared to] last year.” Deaths of newborn babies were also up by a third. The hospital’s head midwife, Razia Hanifi, was exhausted. “I have been working for the past 20 years,” she said, “This year is the toughest, because of the overcrowding, the shortage of resources and the shortage of trained staff.”

In Zabul, a local health official said maternal mortality had definitely increased in his province. He said they had only recently begun recording maternal mortality data, so could provide no statistics, but his strong sense was that considerably more women were now dying in pregnancy or childbirth. He gave some recent examples of deaths:

Two weeks ago, we received information about two maternal deaths in a remote village. Neither patient’s family had the money to take the pregnant woman to the hospital, nor was there an ambulance in the area. We also received news of another complicated case in the same district. In that case, we sought help from UNICEF; they arranged for an ambulance, but unfortunately, the area was very remote and, by the time the ambulance arrived, the mother had lost her life.

The problem with access to maternal health care in remote areas was also mentioned by an international health expert, Dr Kweku Ackom, who works with the UK’s foreign and development ministry, who said their implementing partners were relaying anecdotal accounts about women dying at home in hard-to-reach areas. However, as with the Afghan health officials we spoke to, he said there was no systematic data to give a clear idea of the extent of the problem.

A health official in Badghis also mentioned the lack of data. The situation in his province, he said, had anyway been dire. He was aware of the maternal deaths in areas where health facilities did exist, but also said there were large parts of Badghis with no health services at all. People living there were poor and unable to take their women to distant hospitals. “God knows how many pregnant women die there,” he said.

The issue of underreported maternal mortality was also raised by a health official in Paktika province, although for a different reason.

Maternal mortality is more than twice the reported figure. It has definitely increased significantly. The NGOs implementing health projects in my province are not providing accurate data because they attempt to portray their efforts and services as highly successful.

The head midwife from Takhar also said that in her hospital, maternal deaths were underreported to avoid raising questions:

Maternal mortality rates are extremely high; officially, [in my clinic] three out of every 100 patients die, but the real number is far higher. Many deaths are not reported at all; deaths at home or on the way are not reported at all. And even hospital deaths, the ones that are registered, are sometimes hidden or incorrectly recorded to avoid raising questions.

The response of the Islamic Emirate

Although the evidence of a rise in maternal mortality is anecdotal, it strongly suggests that all the reasons for pessimism are correct. The Afghan government, however, wants to tell a different story, shown in its response to comments made by UNFPA’s Deputy Executive Director, Andrew Saberton, who visited Afghanistan in May. He spoke about the funding cuts and the end of the ‘pipeline’ for new midwives, given the ban on midwifery training and on girls’ education beyond 6th grade. He also said that every two hours, an Afghan mother died “from preventable pregnancy and childbirth complications” (Tolo News).

That statistic, said spokesperson for the Ministry of Public Health Sharafat Zaman Amarkhel, was “unfair, unrealistic and incorrect.” He insisted that since regaining power, the Islamic Emirate of Afghanistan (IEA) had paid special attention tothe health of children and mothers. “Our request to all international organizations,” he said, “is that if they want to publish figures, they should do so in coordination with the Ministry of Public Health to prevent the spread of fear and misinformation among the public” (Tolo News).

Despite the government’s apparent attempt to control the narrative on maternal mortality, our interviews show why the rate is likely going up. In the following sections, we give a little more background on three of the causes mentioned: cuts in aid; scarcities of medicine and the end of midwifery training.

The reduction in aid and access to healthcare 

The difficulties facing pregnant women can be placed in the context of a wider problem with healthcare. At its peak in the late 2010s, Afghanistan’s health system consisted of more than 3,000 health facilities.[3] By 2024, this figure had been reduced by half, with just over 1,500 still operational. As a direct result of the end of US aid, said the WHO Health Cluster Bulletin, by July 2025, the number of health facilities had fallen even further, to 817. Only 297 of the approximately 400 districts in Afghanistan’s 34 provinces now have health facilities.

The funding situation is stark. The United States was the largest single donor to Afghanistan, providing 40 per cent of all aid in 2024. It cut all of it, suddenly and with no, or almost no, warning (for more detail on this, see AAN’s May 2025 report, The End of US Aid to Afghanistan: What will it mean for families, services and the economy?). Healthcare was particularly vulnerable, as it was very dependent on foreign financial support. This reliance was crucial during the Republic era, and nothing changed after the Emirate came to power. Although foreign aid to the health sector declined significantly, the new government allocated a minimal budget to it, prioritising other sectors, especially security.[4] Already, in relation to the much smaller decline in aid seen in 2024, ie before the US completely stopped aid, the World Bank had concluded, in its April 2025 Development Update, that the reduction in aid posed “a serious risk to the continuity of essential service delivery programs, particularly those implemented through the UN and funded via humanitarian channels.” It explained:

Key sectors such as healthcare, education, and social protection which have historically relied on international aid, may face severe disruptions, disproportionately affecting marginalized populations, including women, children, and displaced communities. The contraction in aid may also limit emergency response capabilities, further straining public services and slowing economic recovery efforts.

The decline in general healthcare provision is evident in the quantitative data. The March 2025 Humanitarian Needs Survey[5] assessed the ‘health needs conditions’ in Afghanistan’s 401 districts, and classified as conditions in 373 were severe (234 districts), extreme (134), or catastrophic (5). Just 28 districts in the whole of Afghanistan were classified as being in the ‘better’ categories, in a ‘stress phase’ or with ‘none to minimal health needs’. The assessment was based on: whether households had access to adequate healthcare; the availability of a health centre providing maternity services; and the average time it takes to reach the nearest functional health facility.

The Humanitarian Situation Monitoring, also published in March 2025 by the same group, which assessed 12,015 settlements across 401 districts and 34 provinces, found that residents in 10 per cent of them had no health facility at their disposal, 45 per cent reported that their medical facilities were not adequately staffed, 78 per cent said their medical facilities lacked medicine or equipment, while 28 per cent reported physical difficulties in accessing health services due to damaged roads, no transportation, flooding etc. On the national level, 13 per cent of respondents said the majority of households in their settlement currently had no access to adequate healthcare when they needed it. The worst-affected provinces were Ghor (where a majority of households in 52 per cent of settlements had no access to adequate healthcare), Takhar (37 per cent) and Kunduz (28 per cent). Additionally, the report found that 16 per cent of healthcare facilities were structurally damaged.

The Humanitarian Situation Monitoring also found that women and girls faced particular restrictions limiting their access to healthcare, with 49 per cent of their sample reporting that women were allowed access only when accompanied by a male relative,  or a female relative or friend. In December 2021, the Emirate forbade women from travelling long distances (72 kilometres) without a mahram (a close male relative). However, Emirate officials often interpret this as meaning that women need a mahram whenever they leave the house.[6]

Particularly important for expectant mothers have been the cuts to the UNFPA-run Family Health Houses (FHH),[7] which provide reproductive, maternal, neonatal, child and adolescent health services in the country’s remotest areas. In 2025, the UNFPA lost approximately USD 330 million in US funding worldwide, of which about a third, or USD 102 million, directly affected its work in Afghanistan (UN News). In 2024, UNFPA had supported 533 midwife-led Family Health Houses, serving about four million people, almost 80 per cent of them women, in the most remote areas of 26 provinces (UNFPA).[8] It was also running 263 mobile health teams and 28 clinics and health centres. The UNFPA said in a tweet on 21 May 2025 that, because of the funding cuts, more than six million people were losing access to “essential health care, most of them women and girls, including lifesaving maternal health services” and that “hundreds of health centres operating in remote areas and mobile clinics are being forced to close.” The number of midwives that UNFPA is able to support in 2025 has also almost halved. Instead of the 974 midwives that the agency planned to support this year, it will be able to pay for only 565 (UNFPA).

Some midwives and doctors, such as the gynaecologist from Samangan whom we interviewed, have agreed to continue working for free. She told us that after USAID pulled its funding, UNFPA asked if she would volunteer and work without pay for several months.

I work in Hazrat-e Sultan, a very poor area where people have nothing. How could we abandon them? So, we agreed. We also knew we weren’t the only ones; colleagues across Samangan’s remote districts made the same choice, working unpaid because the need was so urgent. 

The scarcity of medicine

Medication shortages have also gripped the current healthcare system in Afghanistan. With the decline of aid, medicines needed by health facilities in Afghanistan, including for women during childbirth, have also become scarcer, our interviewees reported. “The number of patients is overwhelming, yet resources and medicines are scarce,” the head midwife from Takhar province said:

Supplies intended to last three months often run out in just a month, leaving facilities empty-handed for the next two months. There has been a significant cut in funds and supplies are no longer as plentiful as before, which means a shortage of personnel, medicine and ambulances. Previously, I was part of a project that provided folic acid to pregnant women free of charge,[9] but that programme has now been stopped. Pregnant women must now buy everything themselves, but most can’t afford it. The majority of women don’t even have money for medicine or transport. Many walk six to seven hours just to reach a clinic.

The health official in Badghis said there was a critical need for medicines for their patients, including women in labour. He said: “We don’t have enough essential medicines, nor do we have medicines which are needed in an emergency for a mother during her delivery.” The health official in Zabul said they lacked medicines for mothers, both prenatal and postnatal, while a health official in Paktika also reported similar issues regarding medicines for childbirth: “I’m running a health project and I can say that we don’t have any medicines for those who give birth in our clinics.”

One high-ranking health official working in the Ministry of Public Health told AAN that the clinics have some emergency medicines available to provide to mothers before and after delivery. However, he mentioned that the stock of medicines had decreased since the collapse of the Republic. This medicine shortage was also one of the main findings of a qualitative study on the factors hindering access and utilisation of maternal healthcare in Afghanistan, published in the Healthcare journal in April 2025. The study found that:

Medication shortages have also gripped the current healthcare system, especially in the public health sector and rural areas. Public hospitals have also run out of medications quickly because they have more patients than private hospitals. In rural regions, distance and weather conditions hinder access to medication, leaving patients stranded and without essential medications. A provider noted that “In rural areas, when hospitals run out of medicine in the winter… They cannot travel to the city to get them because the snow blocks the road for 6 months or more.”

The end of midwifery training 

The latest trouble putting Afghanistan’s maternal health sector at risk is the IEA’s ban on all midwifery and nursing schools, effective from December 2024 (BBC, UNICEF).[10] This ban, along with the earlier general prohibition on girls’ education beyond the first six grades, and on higher education, including training to become a doctor, will have long-term consequences. This ban is even more serious than it would be in many other countries because of the cultural taboo and legal prohibition on male medical staff attending female patients. Already in 2024, the UNFPA had estimated that Afghanistan urgently needed at least 18,000 additional midwives to meet basic maternal care needs. Without a steady stream of new midwives, the need for medically trained women to help their compatriots in childbirth will never be met. Indeed, the existing shortage in midwives will only worsen. Earlier this year, in March 2025, UNICEF warned that, as a direct consequence of the education bans, the country would experience a shortage of qualified female health workers. “With fewer female doctors and midwives,” it said, “girls and women will not receive the medical treatment and support they need. We are estimating an additional 1,600 maternal deaths and over 3,500 infant deaths [no time span given].”

We interviewed a young woman from a family of midwives in Balkh province, who had just graduated from the midwifery programme when the ban was announced. However, she was unable to obtain her diploma or take the exit exam. This left her unemployable.

A former head of the Afghan Midwives Association, Sabera Turkmani, argued that the midwifery ban had to be lifted, in an opinion piece published in December 2024 in the British Medical Journal:

The health workforce is in a state of crisis, with most healthcare facilities lacking female health providers, leaving many women living in rural and remote areas without access to skilled maternity care. … I have witnessed substantial progress while working with Afghan communities. … Afghan midwives play a pivotal role in advancing primary healthcare and provide a wide range of essential reproductive, maternal, newborn, child, and adolescent health interventions. … Midwifery services are indispensable for saving lives as cultural and religious norms in Afghanistan prohibit male healthcare providers from attending to women. … Skilled midwives can have a central role in reducing maternal and neonatal mortality. Beyond clinical skills, the ripple effects of midwifery are profound. Empowering midwives is not merely a cost-effective health intervention; it is a pathway to economic growth, community resilience, and peacebuilding. 

The system, even as it is now, cannot provide quality healthcare services for mothers. But given that every year, female health professionals retire or leave the service for other reasons, without a steady stream of new female doctors, midwives and nurses, professional childbirth services in Afghanistan will likely not survive.

Looking ahead

It seems no exaggeration to say that Afghanistan’s maternal healthcare system is in crisis, under threat both from a dire shortage of funding and – especially with an eye to the future – the end of the education pipeline to ensure new female nurses, doctors and midwives are coming into the workforce to replace older women retiring or otherwise leaving their jobs. We may not have the exact numbers, but after two decades of fewer Afghan women dying in pregnancy and childbirth, the figures are surely now rising. Becoming a mother in Afghanistan, going through pregnancy and childbirth, was already riskier than in most other countries in the world, even during the relatively well-resourced Republic era. It has now become even more dangerous. As the midwife from Jawzjan put it: “Afghan women are among the most unfortunate in the world. … They lose their lives even while giving birth to new ones.”

Edited by Kate Clark

References

References
↑1 In the same period, the maternal mortality rate worldwide dropped by approximately 40 per cent (WHO).
↑2 Afghanistan’s economy shrank by a quarter after the takeover and while it has recovered somewhat, growth is not keeping pace with population growth. For more on this, see AAN’s The Afghan Economy Since the Taleban Took Power: A dossier of reports on economic calamity, state finances and consequences for households from 14 May 2023, and more recently, Survival and Stagnation: The State of the Afghan economy, 7 November 2023.
↑3 There are two types of health services within the government’s health system: the Basic Health Package of Services for Afghanistan (BPHS) and the Essential Package of Hospital Services (EPHS). The BPHS includes health centres such as District Hospitals (DH), Comprehensive Health Centres (CHCs), Basic Health Centres (BHCs), and Sub-Health Centres (SHCs). The BPHS delivers services in district centres and villages. Additionally, there are some Family Health Housings (FHHs) operating in villages.
↑4 In the World Bank’s October 2023 Development Update, it summarised the priorities of Emirate government expenditure as “utilizing available resources largely to pay for security, teachers’ salaries, and core civil and administrative functions while leaving donors to finance healthcare, food security, broader education needs, and the agri-food system.”

The figures are stark: in 2022, the Emirate spent 60 per cent of its operating expenditure (which takes up almost all of the budget) on the security services – army, police and intelligence – and only 1 per cent on health. See also Kate Clark, Survival and Stagnation: The State of the Afghan economy, AAN, 7 November 2023, for a later look at the Emirate’s spending choices, including on health.
↑5 The Needs Monitoring Framework was developed by a group of humanitarian actors in Afghanistan to assist humanitarian planning. It is designed for quarterly monitoring.
↑6 See Kate Clark, A year of Propagating Virtue and Preventing Vice: Enforcers and ‘enforced’ speak about the Emirate’s morality law, AAN, 21 August 2025.
↑7 The Family Health Houses were established as a cost-effective component of the basic health services package that has been incorporated into the Islamic Emirate’s National Health Policy 2025-2030. The national policy says this about the Family Health Houses/Primary Health Care Centres:

The centers that provide primary health care services are called family health houses will have the capacity to deliver preventive, promotional, treatment, and rehabilitation services based on a designated package of services.

The IEA’s National Health Policy 2025-2030 also says:

3.4. Human Resources:

In the year 2024, the number of doctors, nurses, and midwives per 10,000 people reached 10.3, which is below the proposed global standards for achieving sustainable development goals. The recommended number for international standards is 34.2 healthcare workers per 10,000 people. Additionally, the access to overall healthcare coverage is much lower than the suggested target of 44.5 healthcare workers per 10,000 people. Only 15% of nurses and 2% of doctors are women.

3.5. Health Financing:

In the year 2022, Afghanistan’s total healthcare expenditures amounted to 3.6 billion dollars, or approximately 102 dollars per person per year. Of this, 1% was covered by the government, 21% by foreign aid, and 78% privately spending from the people’s pockets. A significant portion of the people’s private expenditures is being spent on 540 private hospitals, 260 private OPD clinics, and through several private NGOs.

4.1. The Vision of Ministry of Public Health:

All residents of Afghanistan receive quality, affordable, accessible and sustainable health services according to the highest standards inside the country and have a healthy community.
↑8 Vaccination is also integrated into the FHH services to support the prevention of common childhood diseases and maternal infections.
↑9 Folic acid is prescribed for women who are pregnant or trying to conceive as it helps prevent birth defects known as neural tube defects, including spina bifida.
↑10 The last Republic-era acting Minister of Public Health, Wahid Majrooh, who carried on in his post through the takeover, wrote an article in the medical journal, The Lancet, in April 2025, calling for the immediate lifting of the midwifery ban:

The exclusion of Afghan women and girls from medical, midwifery, and nursing education will further limit women’s access to basic health services, erode their agency, deepen gender inequality, and worsen maternal and child health outcomes in Afghanistan. To avoid the reversal of the past two decades’ achievements and ensure the health of mothers and children in Afghanistan, the ban on women and girls’ education, especially in medicine, midwifery, and nursing, must be lifted now.

 

Is maternal mortality on the rise in Afghanistan? No official data, but much cause for concern
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The terrifying spectre of an internet shutdown in Afghanistan

September 22, 2025

By Hujjatullah Zia

A Kabul-based journalist.

Al Jazeera

22 Sep 2025
A partial shutdown of fibre-optic internet has spread fear. Afghans do not want to be cut off from the world.

When I was a child, Afghans had to travel to Pakistan whenever they needed to make a phone call to their relatives outside the country. Today, we face the real possibility that we may also be forced to travel to a neighbouring country just to use the internet.

Last week, fibre-optic internet services were stopped in several provinces, including Kandahar, Helmand and Balkh – a move that may extend to the entire country. Afghanistan may be cut off from the rest of the world if the Taliban leadership does not reconsider its policy.Soon, you may no longer read my stories and those of millions of Afghans because we may not be able to connect to the internet. A total silence would prevail in the country.

After the shutdown of fibre-optic internet in Balkh province, Haji Zaid, a spokesperson for the Balkh provincial government, said on X that the ban was a direct order from Taliban leader Haibatullah Akhunzada to prevent “vice”.

However, many reacted negatively to his post, arguing that a proper alternative had to be introduced before the implementation of this policy.

A nationwide cutoff of internet access would affect Afghan citizens in many ways. Business activities and banking systems would be immediately disrupted. The opportunities for online learning and scholarships would be lost. Many national and international organisations, NGOs and e-government services would encounter serious challenges, and online workers would lose their jobs. Communications with the world would be cut off.

My family would also suffer. As someone who has struggled with unemployment for a few years now, I have found on the internet various opportunities to earn some kind of income, including launching a YouTube channel to showcase beautiful parts of my country. More importantly, if it was not for a good internet connection, we would struggle to keep in touch with family who now live abroad and who we are unlikely to see for years.

Shutting down the internet would marginalise Afghanistan at the global level. It would be like implementing a self-imposed embargo on the country, which would have an adverse effect on many public spheres in Afghanistan, especially the already struggling economy.

Instead of going to this extreme, Afghanistan should heed the example of China. It should be noted that China, as the world’s second largest economy, owes its economic development to reform and a policy of opening-up, adopted by Deng Xiaoping in 1978. This agenda transformed China from a poor country into a manufacturing giant.

When internet use spread across the country in the 2000s, the authorities in Beijing saw some risks. But instead of cutting off their country from being connected to the rest of the world and reversing the policy of openness, they instead invested in building home-grown internet infrastructure and filters. Thus, internet content that is considered risky is filtered out without the need to largely shut off 1.4 billion Chinese citizens from the rest of the world.

In Afghanistan, videos considered immoral are already censored, preventing citizens from accessing such content. If the government is concerned that these filters are failing, there is certainly a technological solution to make them more effective. It should also be recognised that shutting down the internet for everyone will not prevent “immorality” in real life.

If the aim of the policy is to pressure the international community for formal recognition, this will not work either. It would simply harm the Afghan people rather than effectively move other countries to change their policy on Afghanistan.

The internet is now an essential part of daily life, comparable to fundamental needs such as food and water. After two decades of being a netizen, living the life of my forefathers – being cut off from the rest of the world in the era of technological innovations and AI – seems scary to me.

While writing this piece, I have had to check my internet connection every few minutes, worried that I would lose access before I could send it. I am terrified to imagine living like in the old days when listening to the radio was the only way to get information about what was going on in Afghanistan and the rest of the world.

Our stories matter, and we want the world to listen to us and to support us in times of hardship. A marginalised, disconnected and poverty-stricken Afghanistan is in the interests of no one. Afghans want to remain part of the global community and interact with the rest of the world, not be forced into full isolation.

Hujjatullah Zia is a journalist and senior writer in Daily Outlook Afghanistan Newspaper

The terrifying spectre of an internet shutdown in Afghanistan
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A U.S. return to Bagram isn’t a bad idea

September 21, 2025

Editorial

The Washington Post

September 21, 2025

The abandoned airfield in Afghanistan was once a symbol of American power. Trump wants it back.

For nearly 20 years, the Bagram air base stood as the sprawling symbol of American power in Afghanistan and as the heart of the long U.S. military intervention there. The Biden administration secretly evacuated the base on July 1, 2021, a few weeks ahead of its chaotic withdrawal from Afghanistan. The Afghan army left in control of the base surrendered to the Taliban.

Now, President Donald Trump says he wants Bagram back. “We gave it to them for nothing,” he said in in London on Thursday. “We’re trying to get it back, by the way. … We’re trying to get it back because they need things from us.” Good. Bagram is worth pursuing, though not at any cost.

Bagram is strategically important because of its proximity to the border with China and to a nuclear testing range at Lop Nur in a remote part of Xinjiang province. The testing range was long believed abandoned, but there have been reports of increased Chinese military construction activities in the area.

An American military presence at Bagram would also allow the U.S. to conduct counterterrorism operations in a volatile region against the Islamic State-Khorasan terrorist group, which is also at war with the Taliban and has also spread its tentacles into Europe.

What the Taliban wants most from the U.S. is recognition. The country’s seat at the United Nations is still held by the former government. The Taliban would also like to access $7 billion in assets frozen in the U.S. to boost its flagging economy.

Taliban officials don’t sound eager for American troops to return to Bagram. “Afghans have never accepted foreign military presence in their land throughout history,” a senior foreign ministry official, Zakir Jalaly, said. But there’s room to negotiate. As Jalaly pointedly added: “Afghanistan and America need engagement on economic and political relations based on bilateral respect and common interests.”

Trump has leverage. This month, the Taliban’s foreign minister, Amir Khan Muttaqi, and Trump’s special envoy for hostages, Adam Boehler, said they had reached a deal on a prisoner exchange. The Wall Street Journal reported that talks about a small American contingent basing out of Bagram were in the early stages.

But there’s little reason to believe that the U.S. diplomatic boycott of Afghanistan, more than four years after the Taliban took over, is exerting meaningful pressure that will make the government crack. Other actors are filling the void. Better for Washington to have more influence in Kabul than less.

The return of a small American military contingent to Bagram would be a far cry from the commanding presence that existed before. But it would give the U.S. a toehold in a strategically vital region as competition with China continues.

A U.S. return to Bagram isn’t a bad idea
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Afghanistan’s Urban Water Dilemma: Why are Afghan cities running out of water?

September 17, 2025

Mhd Assem Mayar 

Afghanistan Analysts Network

 

Water scarcity, once thought to be a problem only for Afghanistan’s driest provinces like Farah and Nimruz, is now gripping Afghan cities. Predictions that Kabul’s groundwater will be exhausted by 2030 have already made international headlines, but Kabul is not alone. In cities across the country, taps are running dry, wells are having to be deepened and government systems are collapsing under the weight of rising demand and institutional paralysis. Urban water supply has long sat on the margins of Afghanistan’s development agenda – underfunded, uncoordinated and poorly understood. With climate change accelerating and urban populations swelling, that neglect is becoming catastrophic. A crisis, decades in the making, is now unfolding in real time. Guest author Mohammad Assem Mayar* discusses a key question in this, his latest report for AAN: Why are Afghan cities running dry and what can be done about it – before it is too late?

You can preview the report online and download it by clicking here or the download button below

Once an oasis of underground reserves and natural springs, Kabul is now facing a steady and alarming decline in its groundwater. Yet the water crisis in Afghan cities is neither new nor limited to the capital. Urban water shortages have developed for multiple reasons. Climate change has altered the seasonal rhythms that once recharged aquifers, while rapidly growing urban populations have increased demand for water, outpacing the expansion of infrastructure. Most consequentially, the systematic mismanagement of the country’s water resources – including fragmented institutions, weak regulation and chronic underinvestment – has left cities without the necessary infrastructure to deliver safe and reliable water. Urbanisation has continued apace also without regard for safe sewage disposal, leading to the contamination of groundwater.

There is also a glaring disparity in the ability of Afghans to access water. While the urban poor have to buy their water from tankers – spending up to 30 per cent of their household income – the rich can continue to squander water without personal consequences. Ironically, it is those with the power to change policy who are least motivated, personally, to do so. For them, water is free and, if the water table falls, they can always ‘buy’ their way out of any shortage by digging their own private wells deeper.

Each of these stressors – climate change, urbanisation, mismanagement and the political economy of water – magnifies the others. The result is a emerging urban water crisis, one that is no longer limited to low-income neighbourhoods or informal settlements.

There are potential solutions and the report considers these – from managed aquifer recharge to institutional reform. As of now, however, with snowmelt dwindling and rainfall erratic, city populations still growing and institutions remaining fractured, access to safe water is slipping out of reach for many urban residents. The question is no longer whether Afghan cities are facing a water crisis, but can Afghanistan still avert a collapse of its urban water systems.

Edited by Kate Clark 

* Mohammad Assem Mayar is a water resources management and climate change expert with a PhD in water resources management and environmental engineering from the University of Stuttgart in Germany. He is a former lecturer at Kabul Polytechnic University in Afghanistan and currently, an independent researcher based in Germany. He posts on X as @assemmayar1.

 

You can preview the report online and download it by clicking here or the download button below

 

20250918 Urban Water FINALDownload

Revisions:

This article was last updated on 17 Sep 2025

Mhd Assem Mayar

Afghanistan’s Urban Water Dilemma: Why are Afghan cities running out of water?
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How the United Nations Can Turn Afghanistan’s Seat Into a Path Forward

September 17, 2025
PeaceRep
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Dostyar, A. (2025). How the United Nations Can Turn Afghanistan’s Seat Into a Path Forward (Afghanistan Research Network Reflection). PeaceRep: The Peace and Conflict Resolution Evidence Platform, University of Edinburgh

http://dx.doi.org/10.7488/era/6483

How the United Nations Can Turn Afghanistan’s Seat Into a Path Forward

Author: Aref Dostyar

This paper examines Afghanistan’s seat at the United Nations, which reflects the country’s broader political reality of uncertainty and inertia. Four years after the collapse of the Islamic Republic, the question of who should represent Afghanistan at the UN remains in limbo. The Taliban claim the seat, the remnants of the former government hold it without voting rights, and the UN defers decision. This paper proposes to the UN Secretary-General, the UN General Assembly, and Afghanistan’s movements, to treat the status of the seat as an opportunity for constructive diplomacy, analysing different possible scenarios and arguing in favour of a joint nomination as the most strategic option for Afghanistan.

This publication is part of a series highlighting the work and analysis of the Afghanistan Research Network (ARN), a project convened by LSE / PeaceRep, and the Civic Engagement Project (CEP). The network brings together over 20 Afghan researchers (and several non-Afghans) with diverse expertise and backgrounds investigating a range of issues. This project aims to support Afghan researchers who were recently forced to leave Afghanistan; to ensure expert and analytical provision; inform contextually-appropriate international policies and practices on Afghanistan; and to deepen understanding of evolving political, security, and economic dynamics.

Learn more about the Afghanistan Research Network

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How the United Nations Can Turn Afghanistan’s Seat Into a Path Forward
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The Daily Hustle: How one mother cares for her family through sickness, hunger and debt

September 8, 2025

Rama Mirzada • Roxanna Shapour

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In Afghanistan, years of conflict, economic collapse, and rising poverty have left hundreds of thousands of families struggling to survive. For those already on the brink, a single illness can be life-altering, pushing the household into crisis and making even the most basic necessities, such as bread, cooking oil, or school uniforms, unaffordable. In this instalment of The Daily Hustle, Rama Mirzada hears from a mother of four who has spent the past three years caring for her bedridden husband while trying to keep her family afloat. Her story tells of the struggles of many Afghan families who, like her, face hunger, debt and illness, but continue to hold out hope that, with education, their children will find a way out of poverty and have better futures.
A woman knits at a small tailoring business supported by UNDP in western Afghanistan. Photo: UNDP, 18 April 2023

I was born during the civil war in Afghanistan, but I don’t know my exact age because my parents were unable to register my birth. Based on what they and other family members have told me, I think I am in my mid-thirties. Three years ago, my family’s life was turned upside down when my husband fell ill. At first, things weren’t so bad and he mostly managed, but over time, he got worse. Now he is bedridden and feels a burning sensation all over his body. It is heartbreaking to see my husband, who used to be strong and energetic, suffer in pain. All I can do is hold his hand and use cold compresses to make him more comfortable.
We rent an old, dilapidated house in Kabul for 3,000 Afs (about USD 40) per month. The municipality has marked the house for demolition because it wants to widen the road. I don’t know where we’ll go when we finally have to move. House rents are increasing with each passing day, and I don’t think we’ll be able to find another we can afford. Even now, there are times when I don’t have enough money to pay the rent, and I must beg the landlord for more time. He is kind and doesn’t pressure me, perhaps because he knows he won’t be able to rent a house marked for demolition to anyone else.

Afraid to step outside alone

As if trying to keep my family afloat and caring for a bedridden husband weren’t enough, I also struggle with an illness. I suffer from seizures, which began when I was still a girl. Back then, my husband and I were secretly courting. One day, my brother caught us and threatened to tell my father. The fear and trauma triggered my first seizure, and I’ve suffered from them ever since. I need daily medication to manage them. I can’t go out alone, because I’m too scared that I’ll collapse in the street.

Here in Afghanistan, seizures are misunderstood. People mistakenly believe they are a sign of possession, and some even attempt to “exorcise” the person who is having a seizure. Others take advantage and seize the moment to rob them. Because of this, I hardly ever leave the house by myself and must depend on others for even the simplest tasks.

The weight of family ties

On top of my illness and my husband’s, we face pressure from relatives. My husband’s four brothers take him to doctors and pay his medical costs, but only because my mother-in-law insists. They lend us the money for treatment, but don’t help with daily expenses. Now we’re buried in debt to them – some 300,000 Afs (about USD 4,000) – that we are expected to repay one day.

Even so, they don’t believe my husband is truly ill. They often accuse us of pretending and rarely visit. This hurts my husband deeply. Everyone knows that my husband is a proud, hardworking man who has never missed a day of work before he fell ill. Sometimes he cries and says, “No one comes anymore because I have nothing to offer.” All I can do is hold his hand and tell him it isn’t true. I try to console him by saying everyone is struggling and anyone can fall sick, but in my heart, I know he feels his dignity has been damaged and that he misses his family.

Living on bread and the kindness of others 

Still, I try my best to find ways to make ends meet. To earn a little, I embroider khamak (an intricate form of embroidery using white silk thread). In a good month, I can earn 1,000 Afs (around USD 14) and I use the money to buy flour, oil and other groceries. Doctors say my husband needs meat, fruit, broth and vegetables, but we cannot afford to buy them. Most days, we eat bread for breakfast and lunch. For dinner, we eat potatoes. I buy the smallest potatoes because they’re cheaper. My husband eats what we eat.

My own family isn’t doing well either. Only my younger sister visits and helps when she can. She sometimes brings clothes for my children or a little food, but she cannot do much more. Once, we didn’t have money for gas to cook dinner. I couldn’t bear to tell the children we had nothing, so I took them to my sister’s house, saying they missed their cousins. We ate dinner there.

My eldest son, now 18, went to Iran for work when he was 14 but was deported this past spring. He had just finished eighth grade when he left. At first, he got a job in a tailor’s shop and later he worked in a plastic factory. He used to send us 5,000 Afs (about USD 66) each month, and after my husband fell ill, we relied on that money to pay the rent and other expenses. He started looking for a job as soon as he got back to Kabul, but he hasn’t managed to find one yet. We also tried to put him back in school, but the school would not accept him because he needs a new electronic tazkira (ID card). He has to go to our village to get one, but we don’t have the money to send him there.

My middle son is 13 and in grade nine. He works after school in a tailor’s shop. My daughter is 10 and in the third grade. My youngest son is seven and has just started school. This year, the government changed the uniform of schoolchildren from the Western-style ones introduced during the Islamic Republic to traditional clothing. My second son bought his own uniform with the little he earns at the tailor’s – 200 Afs a week. My sister paid for a uniform for my youngest. My daughter wears one of her cousin’s old clothes because I couldn’t afford one for her.

There are days when one of my children comes home from school in tears, because their classmates bring food and snacks to school, but they sit with nothing to eat. Sometimes I give them bread, so at least they have something in class.

Sometimes a relative brings us flour, oil or meat and a family we know regularly helps with food. Last Ramadan, the family said they would give us oil. On the way to their house, I met a man distributing aid. I begged him to see my home. He did, and when he saw how we lived, he gave us flour, rice, beans, oil and even some meat. But he never came back, and we haven’t received any other assistance.

Some people have told me to go to the office of Ayatullah Fayaz in Kabul,[1] because they may be able to help, but I can’t go there alone without a mahram. The office is only open while my children are in school and I can’t risk being out by myself and having a seizure in the street. Once, I took my husband’s health documents to our mosque’s mullah and the street representative, begging for aid. They looked but did nothing.

Holding on to hope for my children

Some nights I feel overwhelmed by how hard life can be. I stay up thinking about how we will make it through the next day, how I will repay all our debts and how I can keep going. I cry quietly when the children are asleep, wondering how much longer we can survive like this and if my husband will ever recover.

My children are the only thing that keeps me going. I look at them and dream of a day when they will finish school, find good jobs and make better futures for themselves and our family. I tell them to study hard every day, to become doctors, engineers and teachers, and to build lives better than the one we are living now. That is what keeps me going. Hope—for them and for their future.

Edited by Roxanna Shapour 

 

References

References
↑1  Grand Ayatollah Mohammad Ishaq Fayaz is one of most senior Shia marja (sources of emulation). He was born in Jaqhori, Ghazni province, in 1936.

 

The Daily Hustle: How one mother cares for her family through sickness, hunger and debt
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