Part one: Global Trends

Kigali, Rwanda

A woman receives a COVID-19 vaccination in Kigali. Rwanda is sharing experiences in complex cold-chain logistics for WHO's Vaccines Learning Agenda - a database of valuable information for African countries, creating case studies on a range of positive vaccine experiences and overcoming risks and challenges. WHO/Andre Rugema

COVID-19 and its effects are taking a heavy toll on countries already struggling to cope with poverty, conflict, climatic shocks and other disease outbreaks. At least 20 million additional people are being pushed into extreme poverty in 17 countries with a Humanitarian Response Plan (HRP) in 2021, as a direct result of the economic impact of the crisis.

The virus has claimed at least 1.9 million lives, with 67 million cases reported across the 59 countries in the GHO as of November 2021. Two thirds of these deaths and cases were reported in 2021 alone, with a threefold increase recorded in over a third of countries compared to the previous year. Inadequate testing capabilities in many countries continue to veil the scale of the crisis, with figures expected to be much higher than official records show.

More easily transmissible variants, a lack of vaccines, and the easing of public health and social measures have increased the spread of the virus. The Delta variant has been confirmed in 80 per cent of GHO countries.

Evolution of COVID-19 cases (2020–2021)

Of the 7.5 billion COVID-19 vaccine doses administered globally, only about 4 per cent have been administered in the 30 countries with an inter-agency HRP. The number of doses delivered to countries has fallen far short of the number required to reach WHO’s goal of vaccinating 40 per cent of the population in every country by the year’s end, with the poorest and most fragile contexts the furthest behind. As of November 2021, over half of countries with a HRP were unable to vaccinate even 10 per cent of their population.

Supplies of COVID-19 vaccines are improving and will continue to increase in 2022. As they increase, the logistics of getting vaccines into people’s arms will likely become the main constraint to improving vaccination coverage. To ensure the most vulnerable countries are not left behind, it is imperative that countries and partners receive support to accelerate the administration of vaccines, including to populations of concern in humanitarian settings.

COVID-19 vaccine roll-out

Vaccine hesitancy remains a major hurdle. Early and continuous engagement of communities and local leaders, including women’s organizations, will improve vaccine uptake. Despite an increased vaccine supply, many countries with HRPs are not expected to have sufficient coverage of their population until mid-2022 or later. In the absence of adequate vaccines, severe outbreaks of COVID-19 can be expected in 2022. These countries will require continued support to respond to outbreaks, including through scaling up diagnostics, personal protective equipment and treatments such as oxygen. The delivery of COVID-19 vaccines must not compromise other essential health services and should go together with other life-saving support that communities are seeking.

Essential health services continue to be disrupted, including immunization campaigns, risking outbreaks of preventable diseases such as measles, polio and cholera. School closures have continued to interrupt education for millions of children and youth, many of whom will not return. Social cohesion has been stretched thin.

COVID-19 continues to exacerbate the political and socioeconomic conditions that increase humanitarian need and fuel conflicts. Economies and livelihoods have been devastated. Full financing of the GHO remains the best way to mitigate the secondary impact of the COVID-19 pandemic on humanitarian populations. However, these are not short-term challenges. Without an urgent and dramatically scaled-up response from the international community, the health, economic, development and security situation will worsen in the coming years.

Member States and international financial institutions must intensify and scale up responses that support countries to address and recover from COVID-19. Vaccines will save lives and boost economies. More than 1.3 billion doses are still needed to reach the WHO target of vaccinating 70 per cent of the population in HRP countries by mid-2022. At the same time, the allocation of US$650 billion in Special Drawing Rights and the G7’s call to reallocate $100 billion of those to poorer countries is a unique opportunity to support the global COVID-19 response and enable greener and more robust economic recoveries. It is critical that resources and initiatives benefit the poorest and most fragile contexts without adding to already high levels of debt burden.

Further reading


  1. World Bank, Poverty and Equity Data Portal. OCHA calculations.
  2. WHO, as of 15 November. COVID-19 Data Explorer. Note, El Salvador, Guatemala and Honduras included in calculations.
  3. Ibid.
  4. WHO, Weekly epidemiological update on COVID-19, 2 November 2021
  5. OCHA-HDX COVID-19 Data Explorer
  6. UNHCR, Mid-Year Results COVID-19 Multisectoral Monitoring. As of 27 September, UNHCR has confirmed vaccination of refugees and/or other persons of concern in 121 countries (UNHCR data from 59 countries reports that nearly 530,000 doses of vaccine have been administered to refugees and other persons of concern). In many host countries vaccine scarcity continues to present a significant barrier for refugees and IDPs, while vaccine hesitancy adds a second layer of complication.
  7. IMF, IMF Managing Director Announces the US$650 billion SDR Allocation Comes into Effect, 23 August 2021
  8. Reuters, G7 leaders urged to show solidarity on climate change and COVID-19 at summit, 7 June 2021