A country being buried twice

When education is taken away at the right age, it closes doors for life - to a job, to financial independence, to health, to any kind of self-determination. More than 2.2 million girls in Afghanistan are out of school today. If the Taliban's ban continues to 2030, that number will reach four million. The girls who missed school during the Taliban's first period of rule - the 1990s - mostly never recovered. An entire generation learned, as children, that the world had decided they did not matter. With nowhere to go and families under severe economic pressure, more girls are being married off before they turn sixteen. School was the alternative. Now it is gone.

The Taliban has banned women from studying medicine. It restricts their movement. It has shut down Afghanistan's last programme training community midwives - the women who, in rural areas, were often the only skilled health workers families could access. The result is measurable. Maternal mortality has risen from 521 deaths per 100,000 births in 2023 to approximately 620 in early 2025. Women are half the population. They are being erased from public life, and they are dying because of it.

Aid cuts

In 2025, humanitarian aid for Afghanistan was cut by 40% after the United States withdrew its funding. Other donors followed. More than 420 health facilities are closed, most of them providing maternal and newborn care. Close to three million people have lost access to basic healthcare.

But the system that collapsed was not a good system to begin with. After 2021, emergency money flowed in fast. What followed, however, was a machinery of coordination that seemed to exist for its own sake: 14 clusters, 141 international expatriate coordinators, each working in its own silo. Almost none of this was connected to the Basic Human Needs programmes that were meant to replace longer-term UN development work - partly because the system was never designed with donors' actual information requirements in mind, and partly because everyone was trying to work around Taliban-era sanctions.

Now the system is being reorganised into seven Area-Based Centres. In theory, the right idea. In practice, triage with a new label. There is still no coherent plan for humanitarian and development programmes to operate through a shared platform - no mechanism to establish the kind of coordination that would make aid more efficient and more accountable. Afghanistan has been stuck in emergency mode since 2021. The cuts have not fixed this. They have only made the emergency smaller.

The world’s choice

Protection and gender-based violence services have been hit harder than almost anything else. There were already too few service points - a consequence of Taliban restrictions on where women can go and who can help them. Budget cuts have made a dire situation worse. Communities are drawing their own conclusions: that aid is conditional, unreliable, and answerable to governments in distant capitals, not to the people it is supposed to reach. Once that trust is broken, every future response becomes harder to deliver.

The Taliban will not change because the world asks them to. Four years have demonstrated that clearly enough. What the world can control are its own choices where it sends money, who it holds accountable, whether it keeps showing up. Right now, it is choosing to look away. And the girls who will never go back to school, the mothers who will not survive childbirth, the communities that have stopped believing anyone is coming - they are the ones paying the price.

Dauod Khuram is an Afghan medical doctor and public health specialist with years of experience across Afghanistan's health and humanitarian system. He is co-author of Between a Rock and a Hard Place, a briefing paper on NGO–Taliban relations. He writes this blog post in his personal capacity.

Further information

TWG FCAS is preparing to deliver a session on the impact of aid cuts on health systems at HSR 2026.

We have also written on the topic of aid cuts here