Due to a fragile healthcare infrastructure, Afghanistan spends millions of dollars every year on pharmaceutical imports and medical treatment to neighboring countries. For many years, Pakistan has been the largest supplier of medicine and medical equipment to the Afghan market. Recently, the inseparable relations between the Taliban regime and Pakistan have changed on account of the Durand line dispute, mass deportation of Afghan refugees, and armed conflict, which led to the closure of the border by Pakistan, causing massive losses to Afghanistan traders and increased costs of all primary goods, including medicines. This issue prompted the Taliban authority to look for alternative routes and reduce medical dependency on Islamabad. Mullah Baradar, the Deputy Prime Minister of the Taliban for Economic Affairs, set a three-month deadline for pharmaceutical importers to establish alternative trade routes, asserting that, after this period, the Taliban customs office will not allow medicines to be imported from Pakistan[1]. A decision that forced the Taliban’s Ministry of Public Health to ban several categories of Pakistani medical imports.
Earlier, the Taliban Minister of Industry and Commerce traveled to India and met with Indian pharmaceutical companies and discussed the cooperation between Afghanistan and India medical sector. Mr. Azizi also called the Indian air freight companies to invest in Afghanistan’s Air corridors to facilitate the export-import between the two sides. The Taliban Commerce minister’s travel to India resulted in two major companies of India and Afghanistan signing a $ 100 million MoU, which signals the pharmaceutical trade shift to India[2].
After the trip made by the Taliban officials, “The regime’s Minister of Public Health, Noor Jalal Jalali, visited Delhi on December 17, which reflects the leadership’s ongoing strategy to find new partners for the pharmaceutical needs and healthcare sector. This move signals the group’s firm stand to fill existing vacuums and solidify new alliances.” Mr. Jalali, in this trip, met with India’s Minister of Public Health and Family Welfare and discussed expanding bilateral relations in the pharmaceutical sector. India’s side reaffirmed its commitment to humanitarian support, medical supplies to the people of Afghanistan, and, as a symbol of solidarity, a larger shipment including medicine, vaccines, and a 128-slice CT scan machine will soon be dispatched to Afghanistan.
India has continued its support to the medical sector of Afghanistan for the past years. Apart from the Indira Gandhi Child Care Hospital, a 30-bed hospital in Kabul’s Bagrami district, an Oncology Center, and five maternity clinics across the volatile eastern provinces are some of India’s healthcare cooperation since 2021. India has donated over 73 tonnes of life-saving medicines and vaccines, using the Chabahar Port and an active air freight corridor, and also 20 ambulances recently dispatched during Amir Khan Muttaqi’s visit to New Delhi to public hospitals as humanitarian goodwill [3].
For several years, Pakistan was the largest supplier of pharmaceutical and medical equipment to Afghanistan market. The Taliban authority claims that due to the low quality of medicine, it has decided to stop importing from Pakistan and replace it with high-quality medical products from India. India’s pharmaceutical sector now ranks 3rd worldwide by volume of production and 14th by value. The main destinations of India’s pharmaceutical export countries are the USA, UK, Belgium, Brazil, and South Africa. India’s pharmaceutical sector supplies more than 50% of the global demand for various vaccines, 40% of the generic demand in the United States, and 25% of all medicines in the United Kingdom. The pharmaceutical industry in this country comprises a network of around 3,000 pharmaceutical companies and 10,500 manufacturing units[4], while Pakistan covers only 0.046% of the world market and is ranked 59 out of 225 countries, and the main export destinations were Afghanistan, the Philippines, Sri Lanka, Uzbekistan, and Cambodia in 2023.[5]
Currently, India’s exports of pharmaceutical products to Afghanistan are around $100 million, which covers 12- 15% market shares of Afghanistan compared to Pakistan’s export of $186.67, which covers approximately 35 -40 %. By shifting trade routes, India is expected to increase its e-market share to over 50% in the coming year[6].
Medical Tourism Shifts from Pakistan to India
Because of low infrastructure and a lack of medical resources, many Afghans have sought medical treatment in neighboring countries like Pakistan, India, and Iran. For decades, Pakistan was a preferred medical tourism destination, leveraging its geographic proximity and cultural similarities as well as affordable healthcare services. The Kabul-Peshawar highway has been the primary route for medical treatments. Cities such as Peshawar have been a hub for medical tourists. Daily, 100s of Afghan patients were admitted to the local hospitals in various cities of Pakistan. The policy change that Pakistan introduced, stricter visa requirements for Afghan nationals, significantly impacted medical tourism. New policies mandated passports and visas, security checks, and police registrations, leading to a drastic reduction in Afghan medical tourists. Reports show that admissions in some hospitals dropped from over 500 to approximately 50 per month[7]. Changing policy shifted medical tourism from Pakistan to India by providing easy and free access to medical visas within one day and affordable, quality healthcare services for Afghan patients. Reports show that more than 61000 Afghans travelled for medical treatment to India from a total number of 200.000 international medical tourists in 2016, with projected revenues from medical tourism expected to rise from $3 billion in 2015 to $9 billion by 2020.[8]
The Taliban takeover in August 2021 affected the medical tourism sector of India negatively and paved the way for shifting to Pakistan. The recent border closure and Pakistan’s restricted visa policy on Afghansiatn citizens increased medicine prices and created various challenges for patients left behind the borders.
In order to re-emerge in the medical tourism of Afghanistan, apart from investing in the pharmaceutical sector, India should turn to its pre-2021 visa policy, provide affordable Packages for Afghan medical tourists, cost-effective medical packages including accommodation, increase flights with reduced cost, provide free translation for the patients, etc.
Despite advantages, there are challenges of high cost of flights, no land connectivity, and or high transport costs for pharmaceutical exports, accommodations, and language barriers compared to Pakistan, which should be addressed and render to Afghanistan both pharmaceutical and medical tourism markets.
References
[3] https://www.etilaatroz.com/246225/influenza-and-meningitis-vaccines/
[4] https://oec.world/en/profile/bilateral-product/special-pharmaceuticals/reporter/ind
[5] https://oec.world/en/profile/bilateral-product/pharmaceutical-products/reporter/pak
[6] Ibid
[7] Geo News. (2018, February 10). Afghan medical tourism: Pakistan’s missed opportunity. Geo TV. https://www.geo.tv/latest/184840-afghan-medical-tourism-pakistans-missed
[8] https://www.thehindu.com/news/national/medical-tourists-flocking-to-india/article24497896.ece
