Afghanistan has the highest proportion of opiate users in the world (B. Rasekh et al. Nagoya J. Med. Sci. 80, 329–340; 2018). We call on the Afghan government and its health allies to ensure that people who use drugs are given priority for COVID-19 vaccination. This is justified by the size and spread of the group and its extreme vulnerability to infection.
People in this group are typically criminalized, stigmatized and marginalized (S. E. Wakeman et al. Nature Med. 26, 819–820; 2020). Weakened immune systems and chronic conditions such as hepatitis and infection with HIV mean that people who use drugs are at high risk of contracting COVID-19, especially if they are homeless and living in densely populated and insanitary urban areas.
Access to vaccines during a pandemic is a human right, so no groups should be left out (J. N. Nkengasong et al. Nature 586, 197–199; 2020). The United Nations’ 2030 Agenda for Sustainable Development recommends that the most disadvantaged and marginalized people should be the first to receive the help they need. No one is safe until everyone is safe.
