Defence`s Feeds

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The European Defence Agency’s (EDA) ministerial Steering Board met this Tuesday afternoon under the chairmanship of the Head of the Agency, Federica Mogherini. Defence ministers discussed the Head of Agency’s report on the implementation of EDA’s long-term review and of the statute of the Agency agreed in 2015. They also tasked EDA to pursue its work in key research and capability development domains. In the margins of the meeting, a new military mobility programme on cross-border movement permissions was signed. 
 

Implementation of EDA’s long-term review and the 2015 Council decision  

Ministers welcomed the presentation by the Head of Agency of the report on the implementation of the conclusions and recommendations of EDA’s long term review (LTR, endorsed in May 2017) which reinforced EDA’s mission on three aspects: as the main intergovernmental prioritisation instrument at EU level in support of capability development; as the preferred cooperation forum and management support structure at EU level to engage in technology and capability development activities; and as a central operator with regard to EU funded defence-related activities and military voice in wider EU polices. In parallel to the implementation of the Council decision of 2015, the LTR adjustments allowed EDA to adapt to the fast-changing European defence landscape and the new requirements stemming from the EU defence initiatives that followed the 2016 EU Global Strategy: CARD, PESCO, European Defence Fund.   

Reflecting the Head of Agency’s report, Ministers acknowledged the important support role EDA plays in the implementation of these initiatives as well as in ensuring coherence among them. They tasked the Agency to continue its coordination with the European External Action Services (EEAS including EU Military Staff), the EU Military Committee and the European Commission in their respective areas of responsibility, and to pursue coherence of output and avoidance of unnecessary duplication with NATO. 
The Steering Board agreed to revert to the review of the 2015 Council decision on EDA’s statute, seat and operational rules in 2020.
 

Implementation of EDA’s key taskings and next steps

Ministers were also provided with a comprehensive update on the progress made in the numerous technology and capability development activities currently underway in the Agency. It shows that EDA manages a constantly growing number of projects and programmes which is set to even further increase in the future, also as a result of Member States’ request for support on PESCO projects. 

Among the many research and technology domains in which EDA is active, a particular emphasis was put on Artificial intelligence (AI). In order to better understand the potential future military applications of AI, Ministers agreed on a two-step approach. The first phase will see the creation of a specific EDA cross-Directorate ad-hoc team which will develop a “AI Definition, Taxonomy and Glossary Document”, as well as increased collaboration with EU stakeholders (especially the Commission) and the launch of an Innovation Prize in the area of AI. The second step, later this year, will consist of in-depth analyses of concrete AI defence applications in areas where capability gaps exist.
Ministers also welcomed the Agency’s contribution to the identification of initial lessons related to the 2018 revision of the Capability Development Plan (CDP), the CARD Trial Run, the first PESCO projects and the Preparatory Action on Defence Research. These lessons identified should be reflected and taken into account, as appropriate, in the further development of the defence initiatives, it was stressed. 

The Steering Board also asked the Agency to pursue the implementation of the 2018 EU Capability Development Priorities through robust and output-driven Strategic Context Cases (SCCs). EDA was asked to present to Capability Directors in June 2019 for endorsement the landscaping part of the SCCs, including their avenues of approach to tackle the capability shortfalls and lack of coherence in the European defence landscape, in order to inform the further implementation of the EU defence initiatives. The Agency was also invited to present to the Steering Board in February 2020 detailed roadmaps with objectives and milestones for those activities that, subject to the necessary ad-hoc decisions by Member States, could be taken forward in the Agency framework. 
 

Military Mobility

In the margins of the Steering Board, ministers also signed the new EDA programme on “Optimising cross border movement permission in Europe” (see related news here). The programme aims at decreasing the administrative burden for military movement in the framework of the Agency’s work on military mobility.

 

EDA press contacts:

Elisabeth SCHOEFFMANN
Head of Media & Communication
elisabeth.schoeffmann@eda.europa.eu
T+32 470 87 01 65

Helmut BRULS
Media & Communications Officer
helmut.bruls@eda.europa.eu
T+32 2 504 28 10

 

 

 

 

 

 

 

In the margins of today’s EDA Steering Board, 23 Member States (Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Estonia, France, Germany, Greece, Hungary, Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Poland, Portugal, Romania, Slovakia, Spain, Sweden) and EDA signed a new programme that will facilitate the granting of cross-border surface and air movement permissions. The programme is developed in the framework of EDA’s work on military mobility. It implements an important part of the ‘Action Plan on Military Mobility’ which was presented by the High Representative of the Union for Foreign Affairs and Security Policy (HR) and the Commission to the European Parliament and the Council in March 2018. Military mobility is also highlighted in the EU-NATO Joint Declaration signed in Warsaw in 2016.

The purpose of the programme signed today is to harmonise different national regulations of the participating Member States. It should allow Member States to reduce the administrative burden associated with different permission procedures and thus significantly shorten the timelines for granting surface and air cross border movement permissions. The programme provides the basis for important activities at technical and procedural level to develop the necessary arrangements for cross border movement per transport mode during crises, preparations for crises, training and day-to-day business. The arrangements cover surface (road, rail and inland waterways) and air movements (Remotely Piloted Aircraft Systems, fighter aircraft or helicopters). They are expected to be finalised in 2020. 

“Military mobility is about improving the movement of military personnel and assets across and beyond the EU. The high number of Member States participating in this new programme on cross-border movement permissions shows the need to alleviate the administrative burden while fully respecting the sovereignty of Member States”, said Jorge Domecq, EDA’s Chief Executive.
 

Military mobility

Military mobility covers the movement of military personnel and assets from one place to another, including crossing borders by using different modes of transport. The latter is of utmost importance for multinational operations. The capacity to ensure a smooth, efficient and effective movement of military personnel and assets across and beyond the European Union (EU) will enhance the EU’s preparedness and response to crises. It will enable EU Member States to act faster, in line with their defence needs and responsibilities, both in the context of Common Security and Defence Policy missions and operations, and in the framework of national and multinational activities.  
 

EDA’s role in the implementation of the Action Plan

EDA is committed to supporting its Member States. The ‘Action Plan on Military Mobility’ builds upon the ‘Roadmap on Military Mobility’ developed by an EDA expert working group which was set up on request of the EDA Member States in September 2017. In addition to the programme on cross border movement permission, the Agency support to Member States comprises another programme on harmonising of military requirements in the customs domain as well as surveys on transportation of dangerous goods and other legal aspects.
 

Further information:

• Factsheet on Military Mobility

 

EDA press contacts: 

Elisabeth SCHOEFFMANN
Head of Media & Communication
elisabeth.schoeffmann@eda.europa.eu
T+32 470 87 01 65

Helmut BRULS
Media & Communications Officer
helmut.bruls@eda.europa.eu
T+32 2 504 28 10

 

 

 

 

 

 

B-52s as well as F-15Cs and F-35As have conducted “deterrence missions” in the CENTCOM AOR recently. As already reported, four B-52 bombers deployed from Barksdale AFB, Lousiana, to Al Udeid, Qatar, as part of a [...]

Five EDA Member States operating C-27J Spartan military aircraft (Bulgaria, Italy, Lithuania, Slovakia and Romania) participate in the 4th edition of the European Spartan exercise which started today (13 May) at Otopeni airbase in Romania. Observers from other C-27J user countries, such as Greece and even the United States and Australia, also attend the event which runs until 24 May. The aim of the exercise is to increase interoperability among European C27J Spartan operators. It is one of the outcomes of the European Air Transport Fleet (EATF) partnership signed in 2011 by 20 EDA Member States.

Designed by EDA and hosted by the Romanian Air Force, the event aims at promoting aircraft user type approaches to harmonise tactics, techniques and procedures as well as to develop more cost-effective solutions to operate and sustain the C27J. The objective is to provide air crews with both academic and flight training as well as to have ground crews developing harmonised procedures to eventually allowing them to perform cross maintenance on each other’s aircraft.  The C-27J Spartan aircraft can perform tactical missions in peacekeeping and humanitarian operations, providing direct air transport to the theatre, day and night.

This flying event was developed in the framework of the C27J cooperation concept launched in 2015 by EDA. This concept is looking at developing a far-reaching level of interoperability amongst European C27J operators through a variety of projects in the areas of operations & training, logistics, airworthiness, common procurement and SESAR. The main advantages of EDA’s user groups – that are working in full transparency and cooperate with all other existing user groups led by other organisations, industry and/or service providers – is to group medium and small national fleets to take advantage of economies of scale, to exchange best practices and to be more cost-efficient in operating and sustaining the aircraft.
 

Media & VIP Days

On 22 May, a dedicated Media Day will take place offering journalists the possibility to attend a flying exercise at Boboc Airbase will include the landing of C-27J Spartan aircraft on soil and short-distance tracks, parachuting personnel and materials, cooperation with combat aircraft, airline coordination with land forces and medical evacuation. Media representatives who want to participate are requested to send their personal data (name, surname, ID number, name/address of media they represent) to proff@roaf.ro (deadline: Friday 17 May, 2pm).

The following day, on 23 May, there will also be a Distinguished Visitors’ Day attended by Romanian Defence Minister Gabriel-Beniamin Leş and EDA Deputy Chief Executive Olli Ruutu. Media representatives who want to attend the Distinguished Visitors’ Day are requested to send their personal data (name, surname, ID number, name/address of media they represent) to proff@roaf.ro (deadline: Wednesday 22 May, 2pm).
 

Background information

The European Air Transport Fleet (EATF) partnership, launched in 2011 and now gathering 20 Member States (AT, BE, BG, CZ, DE, EL, ES, FI, FR, IT, LT, LU, NL, PL, PT, RO, SK, SE, NO and HU), aims at increasing the airlift provision in the EU, developing concrete solutions to increase the efficiency of existing and future fleets and to optimise the use of air transport organisations and structures. Other activities undertaken as part of EATF include the C-27 J Spartan Cooperation CAT B Programme, the Transport Plot Training Capacity AHWG, the Diplomatic Clearance Ad Hoc Working Group (AHWG) and the Operations and Training AHWG.
 

European 2019 Spartan: List of participating air forces and aircraft

• Romania:  1 C-27 J, (plus 1 C130, 1 Helicopter, 1 C 27 J for logistic support)
• Bulgaria: 1 C-27 J
• Italy: 1 C-27 J
• Lithuania: 1 C-27 J
• Slovakia: Maintenance personnel only
• Observer nations: Greece, United States, Australia
   

Background

Beside  the Spartan Exercise, the C27-J Spartan Cooperation is developing a common type training for aircrews, using the already existing facilities placed in Romania and Italy; a common training for maintenance under the new European standards, a common logistic support and a common avionics upgrade programme to benefit of economies of scale.
 

More information:

• EDA factsheet European Spartan 2019

 

Last April, the OMBT-Leo 2 programme entered a new phase with the publication of a call to European industry to participate in a Preliminary Market Consultation (PMC). Industry is invited to respond to the PMC not later than 18 July 2019.

On this matter, EDA encourages EU defence industry to establish European multinational cross-border industrial partnerships as the preferred mechanism to exploit this opportunity. Additionally, EDA considers the OMBT-Leo2 programme as a suitable vehicle for enhanced access for sid-caps/small and medium enterprises (SMEs) to the European cross-border supply chains.

In order to support the PMC, EDA organised today (13 May) a business-to-business (B2B) workshop to encourage industry to consider the establishment of business relationships between potential future prime contractors and sub-contractors and / or the formation of related consortia (national or multinational) that will provide the basis for the delivery of a full capability for the OMBT-Leo2 Programme, covering MBT, derivatives, as well as the rest of the Programme aspects (e.g. Integrated Logistics Support, simulation, training, …).

EDA’s B2B workshop attracted wide participation: a substantial number of industrial entities (31 in total) covering a wide size range, from major industries down to SMEs, and Leo2 MBT capacities at system and sub-system level, attended the workshop. The B2B workshop proceedings provided a solid opportunity for industries to meet, get known to each other, present their requirements/capabilities, identify potential business opportunities and find the right partners, in view of best preparing for the future implementation of the OMBT-Leo2 Programme.

In conclusion, EDA’s B2B workshop successfully fulfilled its mission to promote industrial cross-border cooperation within the EU, especially in view of future enhanced Mid-caps/SMEs’ access to defence contracts and to supply chains of the industrial entities that may be awarded in the future contracts for the implementation of the OMBT-Leo2 Programme.
 

Background

• EDA seeks European defence industry’s input on Main Battle Tank optimization – 22 September 2017
• Wanted: Industry solutions for optimisation of MBT capabilities – 2 April 2019

DARK BLADE 2019, the 13th helicopter exercise organised under the umbrella of the European Defence Agency’s Helicopter Exercise Programme (HEP), takes place as of today (13 May) at Náměšť airbase in Czech Republic, until 1 June 2019.

A total of 29 air assets (25 helicopters + 4 fixed wing) and some 600 military personnel from six countries - Belgium, Czech Republic, Germany, Hungary, Poland and Slovenia, - will participate in this exercise hosted by the Czech Air Force. DARK BLADE 2019 will allow crews to practice operations in various environment replicating the challenging conditions that participant forces are expected to encounter when deploying to a theatre of operation.

The exercise’s main focus will be on enhancing interoperability at the tactical level between helicopter units by using the Composite Air Operations (COMAO) concept in a combined, joint, realistic and challenging environment.

Its main objectives are to:

• enhance tactical interoperability between helicopter units from the participating countries by using the COMAO concept in a combined, joint, realistic and challenging environment and to operate using standard helicopter Tactics, Techniques and Procedures (TTPs). The focus will be on Composite Air Operations (COMAO) with live firing and trooping;
• train and practise TTPs with/against fighter jets and electronic warfare means on the ground;
• improve interoperability in training and operational tasks with Ground Forces involvement (NVG operations, low level flying, formation flights, FARP training, gunnery, etc.) in a full spectrum environment.
   

Programme

Participating crews will fly diverse day and night COMAO missions and execute Air Assault (AA), Air Interdiction (AI), Air Transport (AT), Close Air Support (CAS), Personnel Recovery (PR) missions, night flights (with/without NVG) and other missions at tactical level.

They will also train special procedures like marshalling, fast rope and abseiling techniques, Special Patrol Insertion/Extraction (SPIE), pick-up and drop off procedures, air-to-surface live firing (helicopter door gunnery and sniper training).

In addition, DARK BLADE 2019 will provide multiple opportunities to practice multinational training with the Special Operation Forces (e.g. infiltration and exfiltration) and will enhance crews’ skills in using the HEP Standard Operating Procedures (SOP) and COMAO planning procedures in the conduct of tactical missions.

Six instructors from Austria, Sweden and the United Kingdom trained in EDA’s Helicopter Tactics Instructors Course (HTIC) accompanied with some Instructors from the Netherlands trained on the Dutch Helicopter Weapon Instructor (HWI) course will jointly form the DARK BLADE 2019 Mentor Team, ready to support the multinational crews during the preparation and execution of the COMAO missions. The EDA’s Chief Instructor (CI) Team will manage and supervise the Mentor Team to ensure consistency and the best possible uptake of lessons learned coming from EDA helicopter activities (HTC, HTIC, COMAO planning and the EW Course) and operational experience.
 

Distinguished Visitors Day

A Distinguished Visitors Day (DVD) is planned for 28 May 2019 when representatives from all EDA Member States and representatives of Switzerland, Norway and the Republic of Serbia will have the opportunity to attend and observe various live training sessions.
 

Background

The annual Blade exercise is part of EDA’s wider Helicopter Portfolio aimed at providing Member States with a joint European framework to develop, consolidate and share best practices in order to meet the challenges of flying helicopters in a modern operational environment. Other components of this Portfolio are the annual HEP Symposium, the Helicopter Tactics Courses (HTC), the Helicopter Tactics Instructor Courses (HTIC), and the COMAO Planning and Electronic Warfare (EW) Courses.
 

More information:

• DARK BLADE factsheet
• Helicopter Initiatives (EDA project page)
• HOT BLADE 2018 improved joint and combined helicopter training (EDA news)

 

 

Take a look at how the Super Hornet’s flight control surfaces move during approach. Earlier this month, our friend Ben Ramsay (UK Aviation Movies) visited Meiringen Air Base, in Switzerland, during the Super Hornet demonstration [...]

Weddings in Afghanistan are often an expensive and ‘back-breaking’ affair. A government law to change the expensive wedding culture remains largely unimplemented and there seems to be little will to enforce it. The Taleban have also imposed an assortment of rules for controlling wedding costs in areas under their command, which vary depending on the area and commander. In practice, their edicts have had limited impact. This is particularly the case in the Turkic dominated provinces of the northwest, where bride prices and wedding ceremony costs are often driven up by a bride’s carpet-weaving skills. In this dispatch, AAN’s Obaid Ali looks at the social culture of weddings among the Turkic community and finds that in spite of government laws, Taleban pressure and local initiatives, the culture of holding expensive weddings remains firmly in place.

A wedding in Afghanistan tends to be an expensive affair. There have been several attempts by the Afghan government, social activists and community elders, as well as by the Taleban, to change this culture. While their attempts have had some impact in certain local communities, they have not led to a larger cultural shift.

Practices with regard to bride price and wedding expenses are different for different ethnic groups, communities, and regions (see also AAN’s previous report here). The ‘bride price’ in the northwest, for instance, is not a mahr (dowry), a sum of cash that should be given to a bride by her groom as a financial pledge and which remains the property of the bride. Rather, in Turkic communities where women are often employed as professional rug makers, the bride price is known as qaleen.

Bride prices and wedding expenses in northwestern Turkic communities (including provinces like Faryab, Jawzjan, Sar-e Pul, and Balkh) tend to be high, largely due to the fact that a woman’s skill makes her a high earner. Moreover, in the Turkic community (e.g. among Uzbeks and Turkmen), an expensive wedding party is considered an honour for both the groom and bride’s families.

Weddings in Turkic communities

The qaleen for a rug-weaving bride in the provinces of Faryab, Jawzjan, and Balkh tends to range from 15,000 USD to 25,000 USD. The price variation is often affected by the reputation of the family and the skills of the woman. Skilled women weavers from these provinces are famous for their ability to produce some of the most sought-after and hard to find rugs in the country (listen, for instance, to this famous Afghan song about rug weaving in Jawzjan province). The skill involved in producing such rugs means that they are often sold even before they are completed or on the market. The high prices of such carpets means that a prospective groom can expect a relatively prosperous life. Therefore, the bride price a groom has to pay is considered to be not only for the girl herself but also for the income her unique skill will provide for the rest of their lives as husband and wife. Because of the extra high costs of the qaleen and wedding party for skilled brides, it is actually very difficult to find a rug-weaving woman to marry.

When a groom’s family initiates a marriage proposal for a rug-weaving woman they face huge expenses. Although the high asking price is often an indirect way for the bride’s family to deter unsuitable marriage proposals, in many cases this does not prevent the groom’s family from persisting. The groom’s side will often try to negotiate the cost down to a manageable amount. However, high interest in a particular bride and her skills means that her family can insist on the price and even add additional wedding costs. These include the costs of the marriage and wedding parties, as well as items that the groom’s family must provide.

A list of items

In many northern provinces, the bride’s family submits a long list of items that the groom must purchase. The list often includes jewellery for the bride, clothes and gifts for the bride and her close relatives, food for the guests, other expenses of the bride until she leaves her parent’s home and a guarantee that the groom will provide two fully-furnished rooms for his bride. The groom’s family is then left with two options: to accept the conditions or to step away from the negotiations.

Haji Khalilullah Azizi, a former speaker for Sar-e Pul’s provincial council, described weddings among the Turkic community as kamarshekan (‘back-breaking’). He told AAN that an ordinary wedding for a woman without carpet weaving skills, including the qaleen price, averages a total of at least 1,500,000 Afs (19,000 USD).Qubuddin Kohe, a local journalist and a civil society activist from Faryab province, said that the qaleen in Maimana city, Faryab’s provincial centre, normally exceeds 800,000 Afs (nearly 10,000 USD). He added that the groom must submit the money in a number of instalments before he gets married. He told AAN that there had been several attempts by social workers, the educated generation, and community elders – both at the local and national levels – to advocate for reduced wedding expenses. Their efforts, however, had only had a limited impact.

Durtaj, the district governor for Khan Charbagh district in Faryab, said the high qaleen prices have compelled some girls to flee. Speaking to AAN, she said that since her appointment in mid-2017 more than ten cases of girls who had fled their home “largely due to their parents’ unwillingness to marry them for a lower qaleen” had been registered. She told AAN that most of these girls ran away with their partners of choice to a hiding place. Community elders then had to mediate between both families, often convincing the girl’s family to allow her to marry the boy after all. In other cases, girls fled to local government-run women’s shelters, refusing to return to their families unless their parents guaranteed their safety and security. In the worst case, she said the girls could face death if captured by their parents, because of harsh traditions and the perceived damage to their family’s reputation.

If a groom’s family cannot provide enough cash for a qaleen, they can offer livestock and other goods during the engagement period instead, particularly in rural areas where goods are acceptable currency in the marriage market. The rest of the wedding expenses, such as jewellery for the bride, clothes for her and her close relatives, as well as food for guests should still be paid for and prepared by the groom’s family.

According to Haji Khodai Dad, a local elder from Faryab who has mediated several negotiations between brides and grooms’ families, as soon as the bride’s family accepts a groom’s family proposal and has fixed the price of the qaleen, any goods the groom sends to the bride’s family counts as cash. The price for these items is calculated based on their local market value. This is not, however, without occasional trouble. Haji Khodai Dad said that a quarrel erupted recently between two families over a dairy cow that was sent to the bride’s family, which stopped producing milk after a couple of weeks. The issue was taken to village elders for a resolution. They decided that the cow should be sold and the groom’s family should add money so that the bride’s family could buy another cow that could produce milk.

In most of the Turkic-dominated provinces of the northwest, the bride’s family agrees to arrange the nikah (a legal contract between man and woman to marry) during the engagement party. After the nikah, the groom becomes a mahram (the male companion for his bride) and he can meet and sometimes stay at his bride’s home. According to Durtaj, during the engagement period, which can last several years, the bride may already become a mother of two or three children. This pushes the groom to work even harder, as he now not only has to earn the qaleen, but also has to provide food and clothes for both his wife and children while they are still in his father-in-law’s home. Some of the grooms who take a long time to submit the qaleen not only bring a bride back to their family’s home, but also an already established family.

There seems to be a general reluctance to give up on expensive wedding parties. For the Turkic community, expensive weddings are not only a social demand but also an opportunity: for the groom to make a name within the community by holding a remarkable wedding, and for the bride’s family to increase their reputation by having secured an expensive wedding for their daughter. This has spread an ideology among villagers that, for the last few decades, has compelled them to invest in enormous weddings and high qaleen prices. But these expensive weddings also mean that grooms have to start a long and difficult journey to earn money. They often leave the country for Iran or Turkey, where they spend years working to save money, which can delay a wedding ceremony for years.

The government law on wedding ceremonies  

The Afghan government published a wedding ceremony law in the official state gazette in December 2017. The law includes clauses on the bride price and ceremony expenses. According to article six, the bride’s family and relatives cannot force the groom to pay a bride price as a condition for getting married. The law also limits the number of guests at a wedding party: article ten says the groom and bride’s families may hold the wedding party in a wedding hall or a restaurant, but should not invite more than 500 people (full text in Dari and Pashtu here).

According to Azizi, Sar-e Pul’s former provincial council speaker, the local government is not seriously committed to enforcing this law in the Uzbek dominated provinces of the northwest. He told AAN there were no outreach teams or public awareness programmes to inform people about the new rules. To enforce this wedding law, the Afghan government would probably face serious problems as it would see itself confronted with the expectations of guests and the interests of the prosperous wedding hall industry. (1)

There have been some local initiatives in Faryab, Sar-e Pul and Jawzjan provinces to reform the costly wedding culture, which have seen limited results. In some parts of Faryab’s provincial centre, Maimana, local elders say they have achieved a minor shift in that the qaleen. Here, wedding expenses are said to have been reduced from an average of 800,000 Afs (nearly 10,000 USD) to around 400,000 Afs (around 5,000 USD). Similar efforts have taken place in some parts of Jawzjan and Sar-e Pul provinces. According to Durtaj, the local government has held several gatherings and carried out campaigns to reduce wedding expenses in local districts. She told AAN, however, that because of the insecurity, these efforts had only affected district centres and nearby villages. (2)

 Taleban restrictions and rules on wedding ceremonies

In some areas, according to local sources, Taleban rules and restrictions were being enforced instead of the government’s law. These Taleban rules on wedding ceremonies are largely enforced by their local vice and virtue committee, known as the religious police, tasked with enforcing Sharia law. The rules themselves seem to vary in different parts of the country, as does their enforcement. There seems to be no general or national Taleban regulation with regard to wedding ceremonies.

When it comes to public awareness of these disparate rules on weddings, the Taleban use local mosques and public gatherings to inform people and announce new restrictions, as well as the consequences for those who violate them. Taleban regulations that have been announced in parts of Faryab, Jawzjan, and Sar-e Pul provinces include that:

• The bride price should not be more than 200,000 Afs (2,650 USD);
• Men and women should be segregated and/or attend wedding parties at different times;
• Playing music and recording videos is prohibited;
• The bride and groom should receive only three suits of clothes each (normally the bride’s family asks for up to 20 suits of clothes for the bride and, in return, prepares five to ten suits of clothes for the groom).
• The wedding ceremony should take place in the groom or bride’s family home;
• The number of guests should be low (there is, however, no requirement to actively reduce the number of invitees, since it is understood that villagers will often attend the party without official invitation);
• The food for guests should be simple food, common among villagers: palao (rice with meat).

In practice, in the Taleban-controlled areas of Faryab, Jawzjan and Sar-e Pul provinces, locals often obey the Taleban’s rules in public but ignore them in private. For example, in Taleban-controlled areas, though the qaleen is presented as low in public, both families will often negotiate a confidential deal with a higher qaleen.

Even in the government controlled areas of Faryab and Sar-e Pul the local Taleban has tried to prevent people from holding parties in wedding halls. In July 2017, for instance, the Taleban issued warnings against wedding halls in the provincial centres of Sar-e Pul and Faryab. Speaking to AAN, Mahsuma Ramazan, a female provincial council member for Sar-e Pul, said that because of these warnings, the wedding halls in her province remained closed for a couple of months (see this media article). She said it was a clear indication of the Taleban’s influence on people’s social lives even in government-controlled areas. Eventually, the wedding halls reopened. It was unclear whether this was due to a deal between the Taleban and owners of the wedding halls, or whether pressure had simply subsided. (3)

Given that in Turkic communities wedding ceremonies usually take place in the bride and groom’s houses anyway, without much pressure to hold the party in a wedding hall, the impact of this specific restriction is limited. But other aspects of the wedding ceremony that the Taleban try to regulate are a common practice among locals, including the qaleen negotiation and payment, live music during the party, and the video recording of the wedding ceremony. The Taleban rules, if enforced, would thus surely impact the ways the Turkic communities marry in the northwest.

According to Sayed Fazel Agha, a former member of the Sar-e Pul provincial high peace council, neither the government law on wedding ceremonies nor the Taleban’s regulations were being obeyed by the population, at least not in his province. Wedding expenses, he said, thus remained a serious issue within the local community.

Conclusion: The cost of high expenses

Despite the government law on weddings, Taleban pressure and local initiatives to change the expensive wedding culture, the phenomenon of expensive parties and high qaleen prices remains firmly entrenched within the Turkic community. This comes at a high cost, in particular for the next generation. The need to meet qaleen prices has prevented many young men from studying, as they need to work and save money to get married. The high qaleen expenses also narrow the bride’s options for what she can do with her life, as she is under pressure to continue rug making instead of pursuing other possible futures. Even though she may have entered into marriage with seemingly high status, in reality, her marriage merely moves her as a worker from one rug making factory to another for the remainder of her life. So far, neither the government law on weddings nor the Taleban rules have solved this problem. Both laws and regulations are largely ignored: at best observed in public and ignored behind closed doors; at worst, openly flouted.

 

(1) The wedding halls in Kabul, for instance, located only a few kilometres away from the Ministry of Justice, host thousands of people every night in luxury wedding parties with expensive food. According to a wedding hall manager from Kabul, the prices for the wedding party’s menus ranged from 400 Afs (5 USD) to 1200 Afs (16 USD) per head. He said they would not host parties with fewer than 500 guests, since preparing food for fewer people wouldn’t allow them to make a profit (see for instance these pages for wedding halls in Kabul here and here which show a clear lack of awareness of, or refusal, to obey articles 17 and 18 of the law that limit the wedding menu price to 300 Afs (4 USD) and the number of guests to 500).

(2) At the national level there are ongoing efforts to reduce wedding expenses by holding mass wedding ceremonies, for instance in Kabul, Herat, Balk and Bamyan provinces. These ceremonies, organised by charity foundations and local businessmen, are aimed at shifting away from the expensive wedding culture (see a media report here, here, here, here and here. But there is little sign of such initiatives in the Turkic communities of the northwest.

(3) During the Taleban regime (1994-2001), holding a wedding party in a hall was prohibited. Wedding ceremonies in wedding halls, however, have a long history in Kabul and other big cities. After the Taleban’s government collapsed, weddings were again held in halls, and the number of wedding venues in Kabul alone now stands at over 200.

 

The unit, inactivated in September 2014 due to budget constraints imposed by sequestration, is going to “resurrect” and fly the 5th generation aircraft. On May 9, the U.S. Air Force announced the plan to reactivate [...]

The U.S. Air Force is positioning four B-52s to Qatar. And, for the very first time, at least one of the Stratofortress bombers could be tracked online as it deployed from Barksdale Air Force Base [...]

EDA has issued a call for applications from parties interested in participating in the third edition of the ‘EDA Defence Innovation Prize’ contest rewarding companies and research entities who come up with innovative and ground-breaking technologies, products, processes or services applicable in the defence domain.

The area that has been selected for this year innovation prize is “AI applications for defence” and will include:

• Supporting decision-making tools in command and control
• Improve intelligence gathering and processing of information to improve the common operational picture
• Supporting the autonomy of unmanned systems
• Demonstrating the efficient use of AI in combination with 5G and Internet of Things

 
The winning idea/concept will be worth 30,000€

Artificial Intelligence (AI) is recognised as a disruptive technology with potentially revolutionary effects already in the short term. 

Even though civil applications and commercial producers are the main drivers behind the Artificial Intelligence evolution, Ministries of Defence and armed forces do not ignore the potential benefits of using these technologies to improve European defence capabilities.

Against this backdrop, contesters for this EDA Defence Innovation Prize are expected to propose ideas or concepts which, if implemented between now and 2035, would help improve and enhance specific EU defence capabilities.

No specific defence background is required to participate in the contest which is open to innovators from ALL types of industries and research institutions in Europe: defence & civil/commercial producers, large companies & SMEs, defence-related & civil research communities. Applications from dual-use and civil/commercial innovators and researchers are even particularly encouraged.

The rules of the contest and the criteria for participation are available here. 

Deadline for submissions: 30 August 2019 (5pm Brussels time).

Information on how to apply can be found in the contest documentation under the link above.

The prize winners will be notified not later than October 2019. An EDA Defence Innovation Prize award ceremony is scheduled to take place at the 2019 EDA Annual Conference in Brussels.

 

Status of the 2nd edition of the EDA innovation

The selection committee of the 2nd EDA Innovation prize, after a thorough evaluation of the submitted project ideas, decided not to award the prize to any of the participating project ideas. The reasoning behind this decision of the selection committee wasn’t because of the quality or merit of the submitted ideas but due to the fact that none of them could demonstrate a clear contribution of the project idea to a defence problem.
 

More information:

• Call for applications
• EDA Defence Innovation Prize webpage

 

The 19th edition of the Joint Personnel Recovery Staff Course, which ended today in Veszprem (Hungary), was also the last one of its kind: after six years, EDA’s Personnel Recovery Controller and Planner Course (PRCPC) project came to a successful conclusion. The last JPRSC was organized by the Hungarian Defence Forces’ Air Command and Control Centre with the support of the European Personnel Recovery Centre (EPRC), a close partner of EDA. 

Launched in May 2013 as an EDA ‘Cat B’ project initially supported by Sweden (lead), Austria, Germany and The Netherlands, the PRCPC grew over time to count today eight participating Member States (Belgium, Cyprus, Hungary and Italy joined later). During the six years, the project allowed participating Member States to train more than 500 staff who are now able to perform specific Personnel Recovery Planning tasks during military operations.
 

Follow-up project underway

Based on the project’s success, a follow-up collaborative initiative is already under preparation within the Agency, as a ‘Cat B’ project called ‘Joint Personnel Recovery Education and Training Courses’. Its objective will be to organise multinational Joint Personnel Recovery (JPR) training events under EDA’s umbrella.  Moreover, new courses will be developed and organised such as specific ‘JPR Leadership Courses’ and ‘JPR operational Planner Courses’.
 

Background

In 2011, EDA’s Project Team Personnel Recovery identified the lack of well-trained PR staff in military operations as an important operational shortfall, as well as a training gap. Accordingly, it initiated a series of four pilot courses for PR controller and planners to assess the need for conducting multinational PR courses at EU level. The four pilots were hosted by Sweden (March 2011), the Netherlands (November 2011) and Germany (March & November 2012).  Based on their success, four PT PR participating Member States (AT, DE, NL, SE) decided to join their forces under EDA’s umbrella for organizing multinational PRCPC events. The Cat B project PRCPC was established, initially for just two years but later extended twice for two years respectively, until 30 May 2019. In the meantime, four additional Member States (BE, CY, HU, IT) had joined.

In November 2018, the PRCPC contributing Member States decided to make the course documentation available to all EDA Member States, at no cost, in order to support them overcome the existent shortfall on well-trained PR staff. For this purpose, a dedicated workspace will be created under EDA’s Collaboration Platform.
 

More information

For more details regarding PRCPC/JPRSC documentation and related PR training tools (SERE e-learning and PR FAS ATD) please contact EDA at CAP@eda.europa.eu.

While researching the delivery of health, education and other services in districts affected by the insurgency, we found that three of our featured districts, in Helmand, Nangrahar and Kunduz provinces, had seen cases of polio leading to paralysis in the last five years. There is no cure for polio, but there is an effective vaccination, so why, more than forty years since polio vaccination began in Afghanistan, are some children still not being protected? AAN’s Jelena Bjelica (with input from the AAN team*) finds some answers in the impact of the conflict, a mobile population, patchy and scarce health care, women being unable to take decisions on health care, and vaccination strategies that might need to be re-thought.

Service Delivery in Insurgent-Affected Areas is a joint research project by the Afghanistan Analysts Network (AAN) and the United States Institute of Peace (USIP).

Previous publications in the series include an introduction, with literature review and methodology, “One Land, Two Rules (1): Service delivery in insurgent-affected areas, an introduction” by Jelena Bjelica and Kate Clark; and three case studies: on Obeh district of Herat province by Said Reza Kazemi; Dasht-e Archi district in Kunduz province by Obaid Ali; and Achin district in Nangrahar province by Said Reza Kazemi and Rohullah Sorush.

In this dispatch, the author first looks at what polio is and how efforts to eradicate it began, in the United States in the 1950s and globally, including Afghanistan in the late 1970s. She plots how polio has declined since then, before looking at why it continues to circulate here. She assesses current strategies for reaching newborns and under-fives. She then looks at three case studies, districts where polio has resulted in paralysis in recent years: Achin district in Nangrahar province, Nad-e Ali in Helmand province and Dasht-e Archi in Kunduz province.

What is polio?

Polio, short for poliomyelitis, is an infectious disease that is caused and transmitted by the poliovirus. The name ‘poliomyelitis’ is derived from the Greek for grey (polios) marrow (myelon) and refers to the tissue inside the spinal cord.

There are three types of poliovirus, all members of the enterovirus genus. (1) Poliovirus only infects humans. It is very contagious and spreads through person-to-person contact. The virus is most often spread by the faecal-oral route, ie it enters through the mouth and multiplies in the intestine. Infected individuals shed poliovirus into the environment for several weeks, where it can spread rapidly through a community, especially in areas of poor sanitation.

One of the severe symptoms of polio in childhood is paralysis, and the disease is therefore also known as ‘infantile paralysis’. Polio can interact with its host in two ways: as an infection that does not affect the central nervous system and only causes a minor illness with mild symptoms; or, as an infection affecting the central nervous system when it may cause paralysis and in some cases even result in death. In about 98 per cent of cases, polio is a mild illness, with no or only flu-like symptoms. In paralytic polio, the virus leaves the digestive tract, enters the bloodstream, and then attacks nerve cells. Fewer than two per cent of people who contract polio become paralysed, but they are disabled for life.

Global eradication

In the early 20th century, polio was one of the most feared diseases. In 1916, for example, New York experienced its first large epidemic, with more than 9,000 cases and 2,343 deaths. Nationwide in 1917 in America, there were 27,000 cases and 6,000 deaths. Polio struck in the warm summer months, sweeping through towns in successive epidemics every few years.

It was only in the mid-1950s that a preventive vaccine was found and tested. In 1952, Dr Jonas Salk began to develop the first effective vaccine against polio. Mass public vaccination programmes followed and had an immediate effect; in the US, cases fell from 35,000 in 1953 to 5,300 in 1957. In 1961, Albert Sabin pioneered the more easily administered oral polio vaccine (OPV). (See this BBC timeline on the history of polio and this timeline on the history of polio vaccine).

It took somewhat longer for polio to be dealt with as a major problem in developing countries. It was only in the 1970s that routine immunisation was introduced worldwide as part of national programmes. By 1988, polio had been eliminated from the US, UK, Australia and much of Europe, but remained prevalent in more than 125 countries. The same year, the World Health Organisation adopted a resolution to eradicate the disease completely by the year 2000. Since then, through the Global Polio Eradication Initiative, more than 2.5 billion children have been immunised against polio.

The World Health Organisation (WHO) certified the Americas as a polio-free region in 1994 and the European region in 2002. India reported the last positive case in January 2011 and was certified polio-free in 2014; China was certified polio-free in 2013. Since 2012, polio has remained officially endemic in only three countries – Afghanistan, Pakistan and Nigeria.

Although the global incidence of polio has decreased by 99 per cent since the start of the global vaccination campaign, tackling the last one per cent of polio cases has proved difficult, as the Global Polio Eradication Initiative reported on its website:

Conflict, political instability, hard-to-reach populations, and poor infrastructure continue to pose challenges to eradicating the disease. Each country offers a unique set of challenges which require local solutions.

In Afghanistan, between January 2001 and March 2019, there were 414 cases of individuals contracting polio and becoming paralysed.

Positive polio cases in Afghanistan: 1980 to 2018   

Despite the ongoing conflict, the number of paralytic polio cases in Afghanistan has decreased over the last 40 years. The publicly available historical data on positive paralytic polio cases in Afghanistan that can be found on the website ‘Our World in Data’ by Oxford University, shows that the number of positive polio cases dropped from almost 2,000 in the mid-1980s to four in the early 2000s. (See graph 1 below for an overview of positive cases between 1980 and 1990 and graph 2 for 2001 to 2018). Although the numbers fluctuate, positive polio cases in Afghanistan in the 2000s and 2010s have been as low, annually, as in the dozens and even fewer than ten. This compares positively to the number of cases in the 1980s, which ranged from several hundred to often more than a thousand, indicating a relatively effective immunisation campaign (more on this below).

Graph 1: Positive polio cases in Afghanistan in the period 1980 – 1990. WHO data cited on the Oxford University’s website, ‘Our World in Data’. Graph by AAN, 2019.

Graph 2: Positive polio cases in Afghanistan in the period 2001 – 2018. WHO dataset of positive polio cases in Afghanistan, which AAN received from the organisation, segregated by province, district and date. Graph by AAN, 2019.

Data on positive polio cases in Afghanistan for the first half of the 1990s is almost non-existent. There is only a figure for 1991 when two cases were documented. It is nevertheless interesting to note that an almost complete dataset exists for the period of Taleban rule. According to the WHO, 19 cases were documented in 1997; 59 in 1998; 150 in 1999, and 120 in 2000. The data for 1996 is missing; that year saw the increased conflict as the Taleban moved to consolidate their power. How reliable these datasets are, given the WHO’s limited access during the civil war and subsequent Taleban rule is another question. The presumption that the Soviet-backed regime in Afghanistan during the 1980s had accurately reported the health situation in the country is also suspect. As usual, caution is needed when using historical datasets for Afghanistan.

An analysis of the WHO dataset of positive polio cases in Afghanistan between 2001 and 2018 segregated by province, district and date, which AAN received from the organisation, shows that the poliovirus has most often been detected in the eastern and especially the southern regions in Afghanistan. (See graph 2 for an overall number of positive polio cases between 2001 and 2018.)  In the south, they were mainly in Kandahar province, with spill-over transmission observed into other southern provinces, mainly Helmand and Uruzgan. In the eastern region, the epidemic is part of what is called the northern corridor transmission zone extending from Nangrahar, Kunar and Nuristan into Khyber Pakhtunkhwa and the Federally Administrated Tribal Areas in Pakistan. There was also a smaller number of positive polio cases during this period further north, for example, in Kunduz and Balkh, as well as one case in Kapisa, the easternmost province of the central region. Herat province in the west of the country also had positive polio cases, as did Farah, which neighbours both Herat and Helmand.

Taking 2018 as an example, 21 children were paralysed by the poliovirus in Afghanistan. Despite this high number of cases, the transmission was geographically limited to the southern and eastern regions and reported from only six of Afghanistan’s 34 provinces. 15 of the cases were in the southern region – nine in Kandahar province and with spill-over transmission to Helmand and Uruzgan. In the southern region, a major issue is lack of access: more than 840,000 children have missed out on the vaccination since May 2018. Inaccessibility coupled with some communities refusing to allow vaccination (more on this below), particularly in and around Kandahar, is a major obstacle for polio eradication in the country. It also makes responding to detected polio transmission difficult. The six cases in the eastern region are in the northern corridor transmission zone.

What causes the poliovirus to spread?

The vital question for those trying to protect children against the poliovirus is what drives it to spread in Afghanistan? According to experts, it boils down to two factors: lack of access for vaccinators and a highly mobile population. The 2017 report of the Afghanistan Technical Advisory Group (TAG) on polio eradication, looking at the epidemiological evidence, said it showed that “the vulnerability of pockets of unreached children” and “the role of population movement” are the key factors for poliovirus transmission across Afghanistan. The number of positive polio cases in Pakistan plays an important role in the virus spread through population movement across the border. In 2017, this number declined to only eight, from 306 cases registered during 2014, 54 in 2015 and 20 in 2016.

Afghanistan and Pakistan’s eradication efforts are interlinked and the two countries are dependent on each other’s success in eliminating polio – or held back by the other’s failings. This is why the two countries established a daily communication channel on polio in 2016 (see here) and why Afghanistan established compulsory vaccination at border crossings with Pakistan for children under five years of age. However, poor access to health services at the sub-national level, a lack of professional health staff and in particular limited access for women to health services play an equally important role in the spread of the virus in Afghanistan.

Immunisation in Afghanistan

Routine immunisation against polio, launched under the name of ‘Mass Immunisation Programme through the Ministry of Public Health (MoPH), has been mandatory since 1978 in Afghanistan. This followed the global trend of mandatory immunisation against polio introduced in the 1970s. This so-called ‘routine immunisation’ against polio means that every newborn child should be given his or her first oral polio vaccine within their first 14 days of life, with four more vaccines to follow in the sixth, tenth and fourteenth weeks and a final one at nine months. However, the reach of mandatory routine immunisation, despite improvement over the years, has remained limited – because of the conflict and lack of access to health services.

According to publicly available WHO data, immunisation coverage among Afghan one-year-olds rose from three per cent in 1981 to 33 per cent in 1989. (A word of caution here: all percentages are estimates rather than hard statistics.) During the 1990s, it dropped back to an annual average of 25 per cent. The first supplemental immunisation activity, ie national immunisation days or polio vaccination campaigns aimed at children under the age of five, was launched in 1997. These campaigns, that usually last several days, have been conducted on a yearly basis since 1999. Their aim is to reach as large a population as possible and create an immunological barrier against the spread of wild poliovirus and risk of outbreaks. During these designated days, tens of thousands of polio workers go from door to door, making sure that every child under five, “including new-borns, sleeping, sick, and visiting children,” receives the polio vaccine. However, this approach has often been met with resistance and scepticism by local communities, especially since 2001, as will be explained in more detail in the following sections.

Nevertheless, the coverage of immunised children has increased over the years, from 24 per cent of one-year-olds in 2000 to 66 per cent in 2010. It rose further in 2011 and 2012, reaching 68 and 67 per cent, respectively. Progress was halted in 2014, the year when most foreign troops left Afghanistan and a presidential election was held, both events which lead to a general deterioration of security and consequently less access for vaccinators. The number of children immunised dropped to 50 per cent in 2014. In 2015, it increased again, to 60 per cent, and remained stable during both 2016 and 2017 (the latest available figures). This, however, is still too low: Afghanistan’s aim is to reach and immunise up to 80 per cent of newborns every year; this is the universally-accepted threshold for full immunisation.

Health sector shortfalls and some cultural considerations

Low routine immunisation coverage is one of the reasons the poliovirus continues to circulate in the country, said a 2011 UNAMA report. Even so, routine immunisation of all newborns, infants and pregnant mothers is only one of the strategies for polio eradication. Other strategies include: supplementary immunisation activities, surveillance, ‘mop-up’ campaigns, ie door-to-door immunisations that are carried out in specific areas where the virus is known or suspected to still be circulating and care for post-polio paralysis – part of the strategy because an infected person can spread the virus. Afghanistan’s health sector, however, is still not at the required level to systematically deliver basic routine immunisation.

Health expenditure in Afghanistan, although pretty high – 9.5 per cent of GDP according to the country’s Central Statistics Office (2) – is heavily dependent on donors, with around 75 per cent financed by foreign aid (see page 10 of this report). It is thus mainly driven by donors’ policies. For example, programmatic decisions as for major on-budget aid investment, such as the Afghan Reconstruction Trust Fund (ARTF,  through which the Basic Package of Health Services (BPHS) (see also endnote 7) is entirely funded, although it is a fully ‘on-budget’ programme,  are still made by the World Bank (see this AAN analysis on aid and poverty in Afghanistan).

The number of health workers is also too low. Nationwide, there are 2.3 physicians and five nurses and midwives per 10,000 people, 2011 WHO study found. The global average is 13 physicians and more than 20 nurses and midwives per 10,000 people. (3)

A minimum of 23 health workers per 10,000 people, according to 2006 WHO report, is required to achieve “80 per cent skilled coverage of births, one of the interventions considered by the Millennium Development Goals (MDG).” In Afghanistan, only 50.5 per cent of births are attended by a skilled health worker, as the latest available WHO estimate for 2015 shows. This is important for two reasons: it is one factor behind the still-high maternal mortality rate, which was at 396 deaths per 100,000 live births in 2015, (4) and the high mortality rate of children under 5 years of age, which was 91 per 1000 live births in 2017 and; secondly, the presence of skilled personnel at birth means mothers can be informed in a timely manner about vaccination. The first polio vaccine can also be administered by health personnel. This may be why only 15 per cent of surveyed mothers that had newborns in 2015, a year when the first ever Afghanistan Demographic and Health Survey was carried out, reported that their children had been vaccinated against polio at birth. (5)

A journal article on routine immunisation coverage in Afghanistan, published in 2017 in BMC Public Health, an open access, peer-reviewed journal that focusses on the epidemiology of disease and the understanding of all aspects of public health found that, nationally, only 51 per cent of children participating in the survey had received all the vaccines included in Afghanistan’s routine immunisation schedule. (6) The survey found that 31 per cent of surveyed children had only been partially vaccinated and for the following reasons: the place to vaccinate child was too far (23 per cent), mother was not aware of the need to vaccinate (17 per cent), mother had no faith in vaccination (16 per cent), mother was too busy (15 per cent) and had fear of side effects (11 per cent). The remaining 18 per cent of mothers in the survey sample had never had their children vaccinated, mainly for the following reasons: place for vaccination being too far (40 per cent), no faith in immunisation (34 per cent), unaware of the need for vaccination (33 per cent), concerns about conflict-related security (21 per cent) and not being allowed to go to a clinic without a male family member (or mahrahm) (21 per cent).

Women’s lack of access and lack of power to make health-related decisions are detrimental to their own health and make significant obstacles for them to get their children vaccinated. 2013 WHO study on gender-sensitive health service delivery said that:

For health-related decision-making, the findings were unanimous that women cannot take independent decisions on their own health and often need accompaniment for seeking health services. The heads of households (i.e. husband, father or brothers) are the ones who make those decisions for the women and this inhibits their timely access to health care services.

It is not only cultural norms that prevent women from accessing health services. The way health services are provided in the health sub-centres in villages is equally limiting. A 2017 study published in The Journal of Infectious Diseases found that, although the average availability of essential vaccines, such as OPV (Oral polio vaccine), BCG (Bacillus Calmette–Guérin, against tuberculosis) and measles vaccines were generally high (above 90 per cent) at the various types of health facilities, in the health sub-centres (HSCs), it was typically below 80 per cent. (7) The study said:

Compared with other facility types, HSCs were less likely to have adequate stock of vaccines, essential cold-chain equipment, or proper documentation of vaccination activities […] Staffing inadequacies at the HSC level, which averaged 1 vaccinator compared with 2 for other types of facilities, may hamper the ability to deliver RI [routine immunization] services. Furthermore, unlike other facility types which had an average of 1 trained female vaccinator, most HSCs had none. This could hinder compliance with immunization, especially among women of childbearing age, given cultural sensitivities.

In 2018, as a result of all of these factors, according to UNICEF, only one in three children less than a year old received a vaccine through routine immunisation.

Door-to-door campaigns

Supplementary immunisation activities, commonly known as ‘door-to-door campaigns’ have intensified over the years in the form of national and subnational immunisation days, ie short and intensive campaigns. Usually, there is more than one campaign a year (see, for example, details about the national immunisation campaign from July 2018 here; from August 2018 here: and from November 2018 here). These campaigns are intensive, massive and sometimes geographically defined, ie vaccinations are targeted at particular provinces or districts. They also come with pre-defined targets. In July 2018, for example, the target was 6.4 million children under five; in August 2018 it was 9.9 million and; in November 2018, 5.3 million.

An Afghan health worker administers the polio vaccine to a child during a vaccination campaign on the outskirts of Jalalabad in November 2018. Supplementary immunisation activities, commonly known as door-to-door campaigns have intensified since 2001 in the form of national and subnational immunisation days. Photo: NOORULLAH SHIRZADA/AFP

However, this ‘targeted outcome’ approach also has a downside. In the past, it repeatedly resulted in dishonest services, as AAN heard from two different sources in international organisations involved in the vaccination campaign. In some instances, the vaccinators simply dumped vaccines in the garbage, but counted them as administered, in order to reach their quota. In another case, according to the sources, the vaccinators took responsibility for areas they felt were too dangerous to work in, but did not report this lack of coverage back. This was also possible because there were no means to verify the number of vaccinated children. According to the director of the National Emergency Operation Center, Dr Maiwand Ahmadzai, they managed to overcome these limitations on monitoring in 2016. Through a presidential decree, a call centre was established which used GPS tracking of phone calls. Through this call centre, Dr Ahmadzai said, almost 95 per cent of physically-inaccessible areas could be communicated with and monitored. This, however, happened without sufficient consideration that the tracking method might amount to a violation of privacy or safeguards for the data collected not being used for other purposes.

The campaigns also often cause political tensions. Although organisers regularly highlight their neutrality, see for example in the 2019 National Emergency Action Plan for Polio Eradication, which says that the goal is to “maintain dialogue with AGEs [anti-government elements, ie the insurgents] at local, provincial and higher level on programme neutrality for polio and supporting activities” (see here), this is often disputed by the Taleban. Their spokesman, Zabihullah Mujahed, told AAN via WhatsApp that the polio vaccination had most recently been misused in Helmand, Kandahar, Ghazni, Uruzgan and all other areas where fighting was intense. “The enemy was misusing vaccinators for collecting intelligence data,” he said, adding that:

Several people were arrested, who had entered Taleban-controlled areas, calling themselves vaccinators, but actually collecting intelligence data.  Such had been appointed to identify the houses [and] residential areas of Taleban commanders and leaders. The vaccinators would leave chips [GPS tracking devices] in houses, so that the government would identify that house and locate it for targeting. This clearly shows that the enemy was seriously misusing the polio vaccination drive.

The director of the National Emergency Operation Center, Dr Maiwand Ahmadzai, said it was not easy for them to deal with these issues:

I have only a few people that I can send to these [contested or controlled] areas and who are technically able and trustworthy to us and to the Taleban […] and there are more than 50 districts that are in need of these kinds of people.

Mistrust has led to low levels of immunisation acceptance in some communities, (8) although acceptance has improved over time. The government’s National Emergency Action Plan 2019, for example, foresees a publication of the qualitative analysis aimed at understanding why people might refuse the vaccine. The government also plans to engage with media and social media to address rumours undermining the drive to vaccinate.

Nevertheless, the political tensions surrounding vaccinations still most often result in bans, which can be imposed by a local insurgency commander or at the regional level, as was the case in 2018 in Helmand, Kandahar, Ghazni and Uruzgan provinces (more on this below).

Three district case studies

1. Achin, Nangrahar province

Achin is a long-embattled district with complicated conflicts (see this AAN report). As of early 2019, most of the district was under government control. But, before that, in the 2015-18 period, the Islamic State Khorasan Province (ISKP), the Islamic State’s Afghan-Pakistani franchise, also known as Daesh – controlled most of it. The ISKP still continues to operate from mountain strongholds in the southern parts of the district. Before ISKP, between 2009 and 2015, the Taleban were in control of much of Achin. These power shifts, messy and often brutal, have resulted in the frequent internal displacement of people (see here and here) and a lack of access to health providers. Additionally, most health facilities have been damaged in the fighting. Even though, as of early 2019, health service delivery had only been hindered in ISKP-ruled areas, there are more general problems. For example, there are no female doctors in the district.

According to the WHO database on polio cases in Afghanistan, six positive polio cases were recorded in Achin between January 2001 and March 2019: one in 2012, one in 2014 and four in 2015, ie two were during Taleban rule and four during the shift in power in 2015 when ISKP captured Achin and turned the Mamand Valley into their local headquarters. It was also in 2015 that the Taleban banned vaccinations in areas still under their control in Nangrahar province. That ban included Achin, Dehbala and Rodat districts (see here). Both of these security-related factors were probably behind difficulties in vaccinating and the four positive polio cases, as this report) also found. Dr Sebghatullah, in charge of polio vaccination in Achin at the time, told AAN that he remembers that two of four children infected in 2015 were from Taleban families.

It is interesting, however, that there were no positive polio cases in Achin during most of the ISKP rule over the district, despite their strict ban on the government provided public health services. AAN research on service delivery in Achin found that the ISKP opposes both the running of health services, as well as the administration of any vaccination campaign in areas under its rule. The significant factor here may be something different, however, a doctor from Achin, Ezzat Shah Samim, told AAN that between 2016 and 2018, there had not been any positive polio cases in Achin because most of the people had fled areas under ISKP rule.

The history of positive polio cases in Achin shows the impact that lack of access for vaccinators, either because of bans or insecurity, can have on community health.

2. Nad-e Ali, Helmand province

The ethnographic make-up of Nad-e Ali district is somewhat different from Achin’s, although the communities in both districts are largely monoethnic, predominantly Pashtun. Achin is traditionally inhabited by members of the Shinwari tribe and as such is a homogenous community, albeit with significant sub-tribal conflict (see this AAN report). Nad-e Ali has a diffuse tribal structure as a result of large-scale government-led irrigation and settlement schemes that began in the 1950s. According to David Mansfield in his 2016 book A State Built on Sand (p 247), the mixing of new settlers with the original population resulted in a rural élite that is “fragmented, competitive and limited in its geographic sphere of influence.”

Nad-e-Ali communities are extremely dependent on opium cultivation. The district frequently featured as either the top or second place opium poppy-cultivating district during the mid and late 1990s. During the 2000s, opium poppy cultivation decreased, and the Helmand Food Zone project that began in 2008 aimed to replace illicit crop with licit ones. This led to the loss of income for many farming families and lowered health expenditure. By, 2018 Nad-e Ali was yet again the top opium cultivator in the county with 21,396 of a total countrywide estimated 263,000 hectares.

According to the data received from WHO, the district has had at least one positive polio case on an almost annual basis during the past 14 years, apart from a four-year break between 2014 and 2017. The number of cases was respectively: one in 2005; three in 2006; two in 2007 and 2008; four in 2009; three in 2010; up to a maximum of eight in 2011; and down again to two in 2012 and one in 2013, followed by four years without any recorded cases. A new case was registered in 2018. The increase in positive polio cases between 2009 and 2011 may have been indicative of lower incomes for most of the farming communities in the district.

There are other theories, too, as to why polio has persisted in Nad-e Ali. UNICEF’s communication specialist for polio eradication, Sayed Kamal Shah, told AAN that, of the 80 positive polio cases in Afghanistan in 2011, 11 in Helmand were transmitted by people who often go to Pakistan. According to this theory, cross-border transmission played a key role in spreading the virus. Helmand’s provincial WHO coordinator, Tahsil Khan, offered a more comprehensive explanation. He told AAN that the reasons for the 2011 polio cases were the bad quality of the vaccination campaign, the lack of cooperation from communities, fighting and the negligence of polio vaccinators and supervisors.

Cultural considerations also play a role, according to one of the interviewees from the province consulted as part of AAN’s service delivery in insurgent-affected areas research:

Because of traditional restrictions, families do not want their women going out of their homes. The people are poor, and the male members of the families are busy in daily labouring or working their lands. Therefore, a number of children have been deprived of immunisation. It is why we have polio positive cases in Helmand province.

According to the national eradication programme, Nad-e Ali’s poor immunisation record is mainly due to persistent access problems caused by insecurity. Added to this, the illicit nature of most of Nad-e Ali’s agriculture also ensures farmers and their families stay away from government-provided health services.

At the same time, the Taleban, who have controlled most of the district since 2016, do not generally oppose polio vaccinations. On the contrary, according to the respondents in AAN’s research, they recommended their own people for hire by the health department. Despite this, the Taleban have imposed occasional bans on immunisation, the most recent one, between May and December 2018, covered four provinces – Helmand, Kandahar, Ghazni and Uruzgan. According to Taleban spokesman Zabihullah Mujahed, the decision to ban vaccinators was made by the movement’s health commission and approved by the Emirate’s leadership and was motivated solely by security. He repeated the Taleban’s allegation that immunisation staff doubled as ‘spies’:

The enemy was misusing the polio vaccination process in Helmand, Kandahar, Ghazni, Uruzgan and all other areas where the fighting was intense. The enemy was misusing vaccinators for collecting intelligence data. […] We have witnessed some night raids and bombings in some areas where the enemy had collected intelligence information via the polio vaccination process. In such raids, commanders of the Islamic Emirate were targeted and their houses identified.

Yet, Mujahed also underlined the general need for vaccination:

At the same time, there is a serious need for people to vaccinate their children. Therefore, the [Taleban] Health Commission worked on another solution. They decided that, as every village has a mosque and a malek, so the children should be vaccinated either in the house of the malek or in the mosque of the village. This way, the vaccinators will go to the mosque or the malek’s house where people will bring their children to vaccinate them. The commission also told the people that when vaccinators come to a village, a public announcement should be made via the mosque loudspeakers. […] When it was decided, mujahiden [sic] go from village to village and inform the villagers about the new procedure for vaccinating children.

However, he said the ‘intelligence collecting’ had not been witnessed in other parts of the country in 2018, so in other provinces, health staff were allowed to go door-to-door to vaccinate children. (9)

Public health officials and other stakeholders AAN spoke to in Nad-e Ali said the Taleban plan was inadequate. They said that most people, especially women, cannot bring their children to the mosque. Because of the difficulty of getting to a central location, all parties agreed to open polio vaccination centres in each village on 25 February 2019, when the last polio campaign resumed in Nad-e Ali.

Nad-e Ali district is an example of how polio-related politics in Afghanistan work and the array of actors involved. It is also interesting that the Taleban sometimes take a regional approach in their health-related decision-making and that bans are not left only to the will of the local commander, as was the case in Dasht-e Archi in Kunduz province in 2017 (more on which below). It also shows that polio policies have consequences. The form of polio vaccination favoured and supported by the Taleban was implemented too late for one three-year-old from Nad-e-Ali, who became the latest positive case from the district and who will remain permanently paralysed. 

3. Dasht-e Archi, Kunduz province

Dasht-e Archi, a district in the northeastern corner of Kunduz province, is almost entirely controlled by the Taleban (see this AAN report). They have established shadow sub-national governance structures, while most Afghan government officials are absent and work remotely from the provincial capital. Although the Taleban do not provide any services themselves, they have co-opted many governmental and non-governmental organisation (NGO) services in the district and these continue to run.

According to the WHO database, Dasht-e Archi had one positive polio case in February 2017. This happened after a local Taleban Committee for the Prevention of Vice and Promotion of Virtue introduced a district ban on Kunduz’s door-to-door campaign between March 2016 and February 2017. There were two reasons for this ban, according to AAN sources in the district. First, the local Taleban representatives had argued that the polio vaccination was “harmful” for children and the vaccine “useless.” The second reason was security-related – the Taleban said the vaccinators took photos of their location and shared it with the government. According to WHO estimates, because of this ban, 176,000 children were unable to access the vaccination programme in 2016 and 2017. As seen in the 2016 UNAMA Civilian Casualties report, during the November 2016 vaccination campaign “50 per cent of children missed vaccination due to active fighting while the remaining half missed it due to a ban on the house to house polio vaccinations imposed by Anti-Government Elements.”

The ban was lifted after the intervention of local elders who put pressure on the Taleban, locally, to allow vaccinators to carry on with their campaign. The solution at the local level ie, between community elders, provincial government officials and Taleban shadow provincial government officials, shows how powerful and successful communities can be, if united on an issue of concern. It was essentially local elders who stood firm for vaccinations to be carried out, in opposition to the Taleban committee’s decision.

Conclusion

The three case studies show that local security and political context plays an important role in any successful immunisation campaign. In Achin district in Nangrahar, a complicated and often brutal conflict between three warring parties has been the main obstacle for the delivery of health services, and, in particular, the timely immunisation of children. In Nad-e Ali and Dasht-e Archi, which are also sites of armed conflict (although only between two parties) and political tensions, a combination of fighting and bans have been the main obstacles. Bans may be imposed locally (and may be resolved at a local level) or regionally, covering several provinces.

It may be that in the country’s south (Uruzgan, Helmand, Kandahar and Ghazni), bans are mainly imposed by Taleban central command, based on a strategic approach to safeguarding territorial gains and not allowing any suspected intrusion of the government’s security apparatus. The 2018 ban in four provinces for a particular method of immunisation indicates that the Taleban there may be ready to propose and accommodate different solutions to the problem of getting children immunised during the conflict, ie immunisation in mosques or maleks’ homes, rather than the more intrusive, as they see it, door-to-door campaigns. That the Taleban should want to try to accommodate polio vaccinations should not come as a surprise, as the historical records on polio immunisation in Afghanistan show that the first national supplementary campaigns were carried out during their rule in the late 1990s, when the south was firmly under Taleban control. As the door-to-door campaign has become a cause of tensions since 2001, this approach probably requires some rethinking. While such campaigns would ideally guarantee that the majority of children are immunised, they may ultimately fail if both insurgents and communities perceive them as intrusive and harmful.

Fundamental for carrying out a successful door-to-door campaign would seem to be focused interaction between government and Taleban stakeholders on the timing and planning of the campaigns to build up trust and ensure better information. The examples of the past indicate that solutions were generally found, but post-facto, rather than in a pre-emptive fashion. Even if the Taleban are not part of the discussion on the timing of national immunisation days, health providers could consider including them at the planning phase and seek their consent and get guarantees of support for the campaigns.

The eradication of the poliovirus in Afghanistan will remain a top health priority in years to come. A reduction in violence, or indeed an end to the conflict, would be the single most useful factor for ensuring success in immunising Afghan children. However, regardless of how well or badly the current talks on a political settlement go, there are still changes that could be made to how immunisation is carried out to make better coverage more likely.

The AAN series on service delivery in insurgent-affected areas found that in most districts, health services at the local level are sub-standard. Health facilities lack the basics, from a scarcity of female health workers to a scarcity of electricity for the refrigerators used to store vaccines. In some districts, health facilities have been destroyed by fighting or temporarily occupied by parties to the conflict. Especially in remote villages, health facilities may not be available at all.

Afghan women, who are the primary target group for the timely vaccination of their children, face an additional obstacle: they lack the power to make health-related decisions due to ‘traditional’ cultural norms which mean men are responsible for the decisions affecting the health of their women and children. If more women had access to skilled health personnel during child delivery then compulsory vaccination at birth could easily be achieved. However, given that education of girls is often poor in these districts as well – often because of conflict and the same conservative norms – there are not the educated young local women coming through who could become midwives, nurses or doctors. Meanwhile, women from outside the districts do not want to work there.

The reasons for the persistence of polio in Afghanistan are many, but basically boil down to several difficult-to-tackle issues – conflict, poverty and lack of women’s rights – and the geographical fact that Pakistan and Afghanistan continue to provide a reservoir of the poliovirus for the other.

Maybe it is time in Afghanistan to rethink the delivery of health services in general and consequently to mend the health of the nation, which is still characterised by one of the highest rates of maternal mortality at birth and children’s mortality in the first five years. Empowering women and educating both men and women on health-related issues through all available channels, such as through radio, television and mosques, could also be used in a bottom-up approach to achieve a society that is more gender equal and thus more equitable

* Rohullah Sorush and Said Reza Kazemi reported on service delivery in Achin district in Nangrahar province, Obaid Ali reported on Dasht-e Archi in Kunduz province, Ali Mohammad Sabawoon who will be publishing on Nad-e Ali in Helmand province, and Fazal Muzhary helped with additional research.

 

Edited by Christian Bleuer and Thomas Ruttig

 

(1) Enteroviruses belong to a group of ribonucleic acid (RNA) viruses which typically occur in the gastrointestinal tract and sometimes spread to other parts of the body, including the central nervous. They also include Hepatitis A (see here).

(2) This is not a low percentage. By way of comparison, in high-income countries, the average health expenditure is just above 12 per cent of GDP.

(3) Life expectancy in Afghanistan remains low, for women it is 63.2 years and for men a little higher, at 63.6 years. Interestingly, while in most countries, female life expectancy is higher, in Afghanistan, it is men who tend to live a little longer.

(4) According to The Guardian report from 2017, the real number of maternal deaths at birth could be much higher. The newspaper quoted an unpublished report which said that the Afghan government found an average level of maternal deaths between 800 and 1,200 for every 100,000 live births.

(5) For the 2015 Afghanistan Demographic and Health Survey, 24,395 households were interviewed, including individual interviews with 29,461 married women age 15-49.

(6) The routine immunisation schedule in Afghanistan includes: Bacillus Calmette-Guérin (BCG) against tuberculosis; a pentavalent or five individual vaccines given in one go, intended to protect against Haemophilus influenza type B (bacteria causing meningitis, pneumonia and otitis), whooping cough (or pertussis), tetanus, hepatitis B and diphtheria; oral poliovirus vaccine (OPV); and the first dose of the measles vaccine.

The interviews for the study published in the BMC Public Health journal were conducted in 34 Afghan provinces with 6,125 caregivers of children aged 12–23 months at the time of the survey who were identified as eligible.

(7) In 2003, the government of Afghanistan introduced the Basic Package of Health Services (BPHS) programme. BPHS was established to improve access to healthcare services in rural areas, which account for more than 70 per cent of Afghanistan’s population. BPHS comprises several key elements, including maternal and newborn care, child health and immunisation, and communicable disease control. These services are provided through different tiers of the primary health sector, ranging from small health posts catering to approximately 100–150 families to district hospitals, which serve populations of tens of thousands of people. Health services administered through BPHS are provided on a graduated scale, with the higher tiers of health facilities providing a more comprehensive package of services compared with smaller health facilities. The tiers of BPHS facilities include: health sub-centres (HSCs) that represent the smallest and lowest levels of service delivery, with higher levels of services offered by basic health centres (BHCs) and comprehensive health centres (CHCs). District hospitals (DHs) represent the highest level of service delivery. All tiers provide immunisation services.

(8) In an attempt to confirm their suspicions that al-Qaeda’s leader was living in a compound in Pakistan, the US launched an immunisation scheme in 2011 with the objective of obtaining DNA from a resident in the property that would confirm any family link (see here and here). This event fuelled conspiracy theories about vaccines in Pakistan and Afghanistan (see here), and communities sometimes refuse vaccinations on the grounds that the government is collecting biodata.

(9) On 11 April 2019 the Taleban said that it has temporarily stopped the International Committee of the Red Cross (ICRC) and the World Health Organisation (WHO) from carrying out relief work in the areas it controls in Afghanistan and it has revoked security guarantees for their staff. The Taleban said in a statement that they have found WHO staff involved in “some suspicious activities” during vaccination campaigns and that the ICRC failed to practically implement pledges given to the Taleban. (see more here).

 

 

 

 

 

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