The coronavirus pandemic continues to test humanitarian responses in 2021, while the world faces new questions about how to ensure equal access to vaccines.
Many countries are rolling out coronavirus vaccination plans, but it’s unclear when – and in some cases, how – these vaccines will reach people caught in crisis zones. The COVID-19 pandemic is driving record-breaking humanitarian needs: Global aid response plans total more than $35 billion this year.
Below you’ll find data exploring coronavirus trends and vaccine issues in key crisis areas, a table showing the worldwide picture, and a global map with select stories.
Data on this page is updated once a day, and other information is revised frequently.
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Trends in key crises
Parts of Central and South America have become the new pandemic epicentres, the head of the Pan American Health Organization warned on 3 March.
COVID-19 cases are rapidly rising in parts of Peru, Colombia, El Salvador, Panama, and Brazil – particularly in areas with large Indigenous populations.
“In Peru’s Amazonian state of Loreto, every ICU bed is occupied by a COVID patient,” said Director Carissa F. Etienne. “Meanwhile, Colombia’s department of Amazonas is reporting the country’s highest COVID rates.”
More than half of global COVID deaths in the previous week were in the Americas, Etienne said.
In 2020, the pandemic doubled the number of people who needed humanitarian aid worldwide, according to the UN, setting up this year’s record $35 billion appeal.
As of February 2021, the UN’s refugee agency, UNHCR, had tallied more than 49,000 COVID-19 cases among refugees and displaced people around the world, including 446 deaths.
Beyond the immediate humanitarian impacts, the cost of helping the world’s most vulnerable 10 percent facing COVID-19’s socio-economic repercussions could total $90 billion, according to UN estimates. The World Bank estimates the pandemic pushed between 119 million and 124 million “new poor” into extreme poverty last year – a shift unlikely to be reversed in 2021.
Vaccines: Queue-jumping, unequal rollouts, and humanitarian stockpiles
There’s a clear divide in who has early access to coronavirus vaccines.
Public health officials warn of “vaccine nationalism”, hoarding, and queue-jumping as wealthier countries buy up early supplies.
“The world is on the brink of a catastrophic moral failure – and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries,” said the WHO’s director-general, Tedros Adhanom Ghebreyesus.
As of mid-February, three quarters of all global doses were in only 10 countries, and more than 94 percent of countries beginning vaccinations were high-income or upper-middle-income. Some 130 countries hadn’t yet administered a single dose.
The WHO has inked agreements to reserve some 1.3 billion doses for 92 low- and middle-income countries under the COVAX programme, which was created with the goal of ensuring equal vaccine access, including doses for at least 20 percent of countries’ populations.
But Tedros said wealthier countries are circumventing COVAX by signing dozens of bilateral deals with manufacturers – driving up prices and potentially delaying COVAX deliveries. He urged countries to vaccinate health workers and older people, then share excess doses with COVAX.
Countries began receiving their first COVAX doses in late February and early March. Current planning calls for some 330 million doses – enough to cover 3.3 percent of participating countries’ populations – in the first half of 2021.
As of 12 March, funding for the Access to COVID-19 Tools (ACT) Accelerator, the WHO-led partnership that includes the COVAX programme, was short $22.1 billion – more than two thirds of the projected budget for 2021.
Beyond vaccine access at the country level, there are fears that marginalised groups often left out of government health planning at the best of times – migrants, refugees, and other people in crises, for example – may be at the very back of the queue.
“Those living in humanitarian emergencies or in settings that are not under the control of national governments are at risk of being left behind and must be part of COVID-19 vaccination efforts,” warned the Inter-Agency Standing Committee, an umbrella group for humanitarian responders.
The UNHCR says 110 of 157 countries developing COVID-19 vaccination programmes have explicitly included refugees. Another 36 are “in the process of doing so,” the agency said on 19 March.
The COVAX programme includes plans for a “humanitarian buffer”, which would see five percent of the total doses stockpiled for “acute outbreaks” or for use by humanitarian groups. Potential uses could include vaccinating “refugees who may not otherwise have access”, according to Gavi, the global vaccine alliance. However, the buffer is waiting for formal approval from Gavi’s board (this is expected later in March). The costs of actually delivering vaccines from this stockpile aren’t clear – current global humanitarian appeals do not include vaccine rollout costs.
At the same time, vaccine hesitancy is growing around the globe, according to researchers at the Duke Global Health Innovation Center, and could become “the primary obstacle to global immunity”. Researchers pointed to multi-country surveys that suggest rising reluctance to vaccinate. “If this is the case, we will soon find that producing enough vaccines does not translate to enough vaccinations,” the researchers said.
Other vaccine news:
– Nepal was the first country in Asia to give COVID-19 vaccines to refugees, the UNHCR said on 19 March. As of mid-month, 72 refugees, including 65 people from Bhutan, had received their first doses. Nepal’s vaccination campaigns started in January, and people older than 55 (and people with ”co-morbidities” between 40 and 54) are a second priority after health staff and other frontline workers. “Refugees who meet these conditions will be included,” the UNHCR said. There are at least 19,500 refugees and asylum seekers in Nepal, including people from Bhutan, Tibet, Pakistan, and Myanmar.
– Central African Republic aims to start COVID-19 vaccinations in April, the UN says. The country is slated to receive 312,000 doses by the end of May through the COVAX scheme. But recent surveys by Ground Truth Solutions have also reported negative personal opinions and misinformation about vaccines among religious and community leaders.
– Most countries have national vaccination plans in place, but fewer than a third have developed plans for training vaccinators or for public information campaigns to combat vaccine hesitancy, an 18 March World Bank study found. “Given worrying vaccine hesitancy, strategies to generate confidence, acceptance and demand for vaccines are urgently needed,” the report warned.
– Wealth and geography are determining where global vaccine stocks are going – not public health or human need, a 17 March editorial in the BMJ medical journal warned. The coronavirus, the editorial’s authors said, “is disproportionately affecting Black and ethnic minority communities. They have been excluded from accessing the benefits of science.” The authors said the COVAX targets of supplying countries with enough vaccines to cover 3 percent of populations by mid-year, or 20 percent by the end of the year, are unacceptably low.
– The AstraZeneca vaccine is safe to use and its benefits outweigh the risk of side effects, according to separate investigations by Europe’s drugs regulator and a WHO committee. Several European countries had temporarily suspended use of the vaccine after a handful of people reportedly developed blood clots. The Democratic Republic of Congo also delayed its vaccine rollout. But the European Medicines Agency said an investigation found “no evidence” tying the vaccine to an increased risk of blood clots, which can occur naturally – echoing findings from other health agencies. AstraZeneca is the main vaccine available to COVAX, meaning that the bulk of the world’s lower-income countries are relying on it to drive vaccination plans.
“Halving the number of injections needed to reach last-mile populations is no small thing.”
– The WHO approved the one-shot Johnson & Johnson vaccine for emergency use on 11 March, clearing the way for it to be included in COVAX rollouts. Médecins Sans Frontières is urging the company to prioritise lower-income countries rather than sell its stocks to the highest bidder. J&J has signed tentative agreements to distribute 100 million doses this year through the COVAX scheme, but MSF says most of J&J’s stocks are already pledged to wealthy countries. The J&J vaccine requires only one dose – most currently available vaccines need two. It can also be stored at normal refrigerator temperatures, making rollouts a “game-changer”, according to Duke University researchers: “Halving the number of injections needed to reach last-mile populations is no small thing. If there were one vaccine we wanted to prioritise for manufacturing and distribution to [low- and middle-income] countries, this is the one.”
– Papua New Guinea is imposing nationwide lockdowns as surging coronavirus cases threaten to overwhelm a meagre health system, while vaccine imports are still weeks away. On 17 March, Australia announced it would donate 8,000 doses of the AstraZeneca vaccine to target frontline health workers, who have high rates of infections. Doses from the COVAX scheme aren’t expected to arrive until late April at the earliest. The spiralling outbreak is another sign of the world’s “deeply unequal” vaccine rollout, Amnesty International’s Kate Schuetze said in a statement.
– North Korea, slated to receive at least 1.7 million vaccine doses through the COVAX scheme, should grant “full and unimpeded access” to medical and humanitarian staff, the UN’s special rapporteur for the country, Tomás Ojea Quintana, said in a March report to the Human Rights Council. North Korea says it has zero coronavirus cases (a claim many observers reject), but its economy has struggled amid closed borders, sanctions, and extensive agricultural damage caused by floods and storms in 2020. “Deaths by starvation have been reported, as has an increase in the number of children and elderly people who have resorted to begging as families are unable to support them,” Quintana said. At the same time, humanitarian access and programmes are at a near standstill, aid groups warn. There are only three international humanitarian workers in the entire country, Quintana said in his report.
– The COVAX vaccine rollout continues: Doses from the global programme continued to arrive in countries including Somalia, Peru, Guatemala, El Salvador, Eswatini, Ethiopia, Mali, Liberia, Afghanistan, Colombia, Nigeria, Senegal, Democratic Republic of Congo, Sudan, and Rwanda in March. On 2 March, COVAX officials released firmer numbers on vaccine deliveries through May 2021. Among the countries left out this round: Venezuela, which reportedly missed a payment deadline; Syria, for which COVAX allocations are still being reviewed; and the Marshall Islands, which dropped out of the programme after being promised supplies from the United States.
– Teachers should be prioritised for vaccines after frontline healthcare workers and vulnerable people, Save the Children said on 10 March, warning that hundreds of millions of children in Asia and the Pacific have gone without school for far too long. Pandemic school closures increase the risk of child marriage and exploitation, and drive dropouts among girls in particular, the NGO said.
“Nobody should be afraid to seek the care they need.”
– There must be “clear firewalls” between countries’ vaccination plans and immigration enforcement in order to reach migrant communities, the UN’s human rights body, OHCHR, said on 8 March. “Nobody should be afraid to seek the care they need,” rights officials said. Dozens of countries explicitly include migrants and refugees in their vaccination plans, but red tape and other roadblocks could prevent people from actually receiving doses, advocates warn. A Red Cross report said that many migrants struggled to get basic health services during pandemic lockdowns, especially if they didn’t have national ID numbers. This same “invisible wall” could block them from accessing vaccines, even if permitted by law, the report said.
The following sortable data shows the share of people who have received a COVID-19 vaccine dose. Countries with no information available are not displayed. The information is gathered by Our World in Data, a project run by University of Oxford researchers.
The global picture
Search this map for stats from specific countries, and click on the green markers for select humanitarian coverage from around the globe: