An airstrike hit a large drug addiction treatment hospital in Kabul on Monday night, around 9 pm. The facility, known for treating thousands of patients, was badly damaged, with entire sections brought down. By early Tuesday, the death toll had climbed. Afghanistan’s deputy government spokesman, Hamdullah Fitrat, said at least 400 people had been killed. Around 250 others were injured.

In a post on X, he said, “large sections of the hospital have been destroyed,” adding that rescue teams were still trying to control the fire and pull bodies out from the debris. Most of those inside were patients undergoing treatment.

Here’s everything we know so far

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Afghanistan airstrike kills 400 – ‘All parts of the hospital destroyed’

Earlier, the numbers were already grim. Health Ministry spokesman Sharafat Zaman had said more than 200 people were killed. Speaking in a video shared online, he said the strike left no part of the hospital untouched. Firefighters were later seen battling flames as the building lay in ruins.

Government spokesman Zabiullah Mujahid also shared the footage and strongly condemned the attack, calling it a violation of Afghanistan’s territory.

Pakistan rejects the claim

Pakistan, meanwhile, has denied targeting any hospital. A spokesman for Prime Minister Shehbaz Sharif, Mosharraf Zaidi, called the accusations baseless. Pakistan’s Ministry of Information said its strikes were aimed at “military installations and terrorist support infrastructure,” including equipment and ammunition storage sites in Kabul and eastern Afghanistan, AP reported.

It insisted the operation was “precise and carefully undertaken to ensure no collateral damage is inflicted.” It also called Afghanistan’s claims “false and misleading,” AP reported.

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Fighting had already been escalating between Pakistan and Afghanistan – Timeline

Loud explosions shook Kabul just after people had stepped out following their Ramadan fast. Anti-aircraft fire followed, and many ran for cover in panic. Television footage later showed chaos at the site,  flames, smoke, and rescuers working through the wreckage.

The strike did not come out of nowhere. For weeks, tensions between Afghanistan and Pakistan have been rising. Just hours before the hospital attack, both sides had exchanged fire along the border. That clash killed four people in Afghanistan, including two children, and injured at least 10 others when mortar shells hit homes in Khost province.

A day earlier, Pakistan said a mortar from Afghanistan hit a house in Bajaur, killing four members of a family and injuring two others, including a young child.

Pakistan has long accused Afghanistan’s Taliban government of sheltering militant groups, especially the Pakistani Taliban, who carry out attacks inside Pakistan. Kabul has repeatedly denied this. After the latest escalation, Pakistan described the situation as an “open war.” It has carried out multiple airstrikes in recent weeks, including in Kabul.

Pakistani President Asif Ali Zardari even said Afghanistan had crossed a “red line” by using drones that injured civilians in Pakistan. In response, Pakistan said it struck targets in Kandahar over the weekend. Kabul, however, claimed those strikes hit civilian-linked sites, including a rehabilitation centre.

Meanwhile, the United Nations Security Council recently passed a resolution urging Afghanistan’s Taliban rulers to step up efforts against terrorism. The resolution also extended the UN’s political mission in the country for three months.

Amid the crisis, Afghanistan’s Deputy Prime Minister Abdul Salam Hanafi said the country was being forced into conflict. Speaking at a meeting in Kabul, he expressed regret over civilian deaths and said defending the nation’s sovereignty was the responsibility of every citizen.

The current round of fighting began in late February, after Afghanistan launched cross-border attacks in response to earlier Pakistani strikes it said had killed civilians.

That escalation broke a ceasefire brokered by Qatar last October. Since then, both sides have traded claims over casualties. Pakistan says it has killed hundreds of Afghan Taliban fighters. Afghanistan rejects that, saying the numbers are far lower, while claiming it has killed more than 100 Pakistani soldiers.