Humanitarian officials and local observers argue that the situation on the ground tells a different story – one of rising malnutrition, increasing mortality, and collapsing service delivery.
The United Nations’ top humanitarian official has issued a stark warning that sweeping cuts to international aid funding are threatening the lives of millions of vulnerable people, with already-devastating consequences unfolding in crisis-stricken regions like Afghanistan.
Speaking from Mirwais Regional Hospital in the southern city of Kandahar, United Nations’ Emergency Relief Coordinator Tom Fletcher painted a grim picture of the collapse of essential health services. “Cutting funding for those in greatest need is not something to boast about,” he said. “The impact of aid cuts is that millions die.”
The funding crisis has already forced the closure of 400 primary health centers across Afghanistan in recent months, denying more than three million people access to basic healthcare. In Kandahar, Fletcher witnessed first-hand the overcrowded and under-resourced conditions in hospitals where doctors must decide, often in real time, which lives to save and which to let go.
“We often talk about funding cuts in general terms, in terms of numbers and statistics,” Fletcher said, standing in a ward where up to four patients share a single bed. “But I challenge anyone making these decisions to come and visit a hospital like this one.”
The humanitarian disaster is compounded by the collapse of salaries for healthcare workers, especially women, who have seen their wages slashed by up to 60 per cent. Fletcher stressed that without women working in health facilities and contributing to the economy, any hope of sustainable development is at risk.
His warning reflects the growing alarm among UN agencies over chronic funding shortfalls that have escalated into acute crises. Organisations, including World Food Programme (WFP), the World Health Organisation (WHO), the UN Children’s Fund (UNICEF), the UN Refugee Agency (UNHCR), and UNAIDS have all reported programme cuts and operational suspensions in recent months.
Overwhelming Need
The World Health Organisation has forecast that by June 2025, as many as 80 per cent of the health facilities it supports in Afghanistan will be forced to shut down. Save the Children has already confirmed the closure of 18 of its supported health facilities.
The cuts are coming at a time of overwhelming need. After four decades of conflict, Afghanistan remains one of the world’s most fragile states. Nearly half of the population (about 22.9 million people) require humanitarian assistance to survive. The arrival of a rising number of Afghan refugees expelled from neighbouring countries has added further strain to an already faltering aid infrastructure.
In April alone, over 250,000 Afghans were sent back, including 96,000 who were forcibly deported from Pakistan and Iran. The UN refugee agency has voiced particular concern about the plight of women and girls among the returnees, who face increasing repression under the Taliban regime.
During his visit, Fletcher met with Mullah Shirin Akhund, the de facto provincial governor, to raise the urgent need for humanitarian support. He also toured a UN-supported reception centre providing basic medical services and financial assistance to returnees.
Alternative Solutions
The devastating impact of aid withdrawal is not only being felt on the ground but is also reverberating across Afghanistan’s already fragile healthcare system. Sayed Abdullah Ahmadi, a local physician, underscored the need for system-level reforms in parallel with financial support.
“Even with foreign aid, without a structured system and legislation, healthcare services will fail,” Ahmadi said. “The Ministry of Public Health must empower domestic specialists skilled in system development.”
In response to growing concerns, Sharafat Zaman Amarkhil, spokesperson for the Ministry of Public Health, sought to reassure the public, insisting that core health services remain operational. “The central health system is still functioning, and there has been no disruption to essential services,” Amarkhil said. “We are working on alternative solutions for the supportive services that were previously provided by international organisations.”
But humanitarian officials and local observers argue that the situation on the ground tells a different story – one of rising malnutrition, increasing mortality, and collapsing service delivery. With reduced aid, already fragile services are deteriorating, and local efforts to compensate remain insufficient.
For Fletcher, the message is clear: time is running out. “We are facing a life-or-death moment, not in metaphor, but in reality,” he said. “Lives are already being lost. More will follow if we do not act with the urgency this crisis demands.” The UN is now urging international donors to reverse course and renew their commitments before the humanitarian toll becomes irreversible. Without a dramatic infusion of resources, aid officials warn, Afghanistan’s fragile lifeline could collapse entirely, pushing millions further into desperation.
