1. Home
  2. Middle East and North Africa
  3. Iraq

Tracking the coronavirus pandemic and vaccine rollouts

Vaccine inequality, health systems under pressure, socio-economic fallout.

(TNH)

The coronavirus pandemic continues to test humanitarian responses, while the world faces 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.

Jump to sections:

Data: Trends in key crises · News: Vaccine access · Data: The global picture · Map: Global coverage

 

South Asia is veering toward a “catastrophe” as coronavirus infections fuel health crises in India and beyond, aid groups say. Countries like Afghanistan, Bangladesh, the Maldives, Nepal, Pakistan, and Sri Lanka are also facing worrying caseloads or overstretched health systems.

“Hospitals are overwhelmed, there is an acute lack of oxygen and other life-saving medical supplies, and there is a real risk of fragile health systems collapsing,” UNICEF said on 21 May, as it called for $164 million in emergency funding across the region.

In Nepal, the virus has overwhelmed hospitals and pushed authorities to warn that the health system can’t cope. Countries like Nepal and Bangladesh have essentially “run out of vaccines”, the International Federation of Red Cross and Red Crescent Societies said.

In mid-June, countries in Central and South America – including Argentina, Brazil, Chile, Colombia, Costa Rica, Paraguay, and Uruguay – had some of the world’s highest weekly caseloads per capita. 

Countries in Africa saw a 25 percent rise in cases in the week leading up to 6 June, while new infections were dropping in other regions, according to World Health Organization statistics.

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.

 

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 access to coronavirus vaccines.

Public health officials warn of “vaccine nationalism”, hoarding, and queue-jumping as wealthier countries buy up supplies. 

“Most countries do not have anywhere near enough vaccines to cover all health workers, or all at-risk groups, never mind the rest of their populations,” said the WHO's director-general, Tedros Adhanom Ghebreyesus. “There remains a shocking imbalance in the global distribution of vaccines.”

As of early May, low-income countries had received just 0.3 percent of the 1.1 billion doses administered worldwide. The vast majority of doses – 80 percent – were in high-income or upper middle-income countries.

The WHO 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 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. Initial planning called for some 330 million doses – enough to cover 3.3 percent of participating countries’ populations – in the first half of 2021. In March, India restricted exports to deal with its worsening second wave, adding to global shortages. India’s Serum Institute was slated to supply 70 percent of COVAX’s initial pipeline. As of late May, COVAX had delivered about 72 million doses worldwide. It had aimed for 100 million doses by the end of March.

As of late May, funding for the Access to COVID-19 Tools (ACT) Accelerator, the WHO-led partnership that includes the COVAX programme, was short $18.5 billion – more than half of the projected budget for 2021.

 

 

There are many factors driving global vaccine shortfalls and slow rollouts. There’s also a worldwide shortage of the raw materials needed to produce vaccines, which has affected all manufacturers, for example. Trade barriers, export controls, and logistics have created bottlenecks that restrict global supply and distribution.

Despite having access to limited stocks, some countries have struggled to get their rollouts off the ground because of weak healthcare infrastructure, inadequate funding, or vaccine hesitancy.

There’s not enough focus on how to distribute vaccines once they arrive – moving doses from airport tarmacs and into people’s arms – the International Federation of Red Cross and Red Crescent Societies warns.

There’s not enough focus on how to distribute vaccines once they arrive – moving doses from airport tarmacs and into people’s arms.

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 – are at the very back of the queue. Some 60 to 80 million people live in areas controlled by non-state armed groups, the International Committee of the Red Cross estimates.

“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. Some 167 million people worldwide could be excluded from COVID-19 vaccination programmes, the IASC estimates.

At least 54 countries had started vaccinating refugees as of the end of May, according to the UN’s refugee agency. Jordan, Nepal, Rwanda, and Serbia were among countries where refugees were receiving COVID-19 vaccines “on an equal footing to citizens”, the UNHCR said in April. At least 153 countries include refugees in their immunisation plans, but in practice, vaccine shortages, shorthanded health systems, red tape, or fear of arrest also keep refugees and migrants on the outside.

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. The buffer was formally approved by the board of Gavi, the global vaccine alliance, on 23 March. The buffer is a “last resort” for people with no access to vaccines – especially in areas controlled by armed groups that are out of reach of government health systems. Countries can apply for vaccines from the buffer, as can humanitarian groups – including UN agencies, Red Cross and Red Crescent societies, local and international NGOs, and civil society groups. Assuming COVAX secures its goal of two billion doses in 2021, the humanitarian buffer would equate to 100 million doses. 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:

- Plans to allocate up to 100 million COVID-19 vaccine doses to humanitarian troublespots by the end of 2021 could be derailed because neither drug companies nor aid groups want to shoulder the risk of potential lawsuits. COVAX has opened up applications to aid groups wanting vaccine stocks from its so-called humanitarian buffer – a planned stockpile of emergency doses. But humanitarian agencies – including the World Health Organization, UNICEF, the Red Cross movement, and Médecins Sans Frontières – say they worry they won’t be able to apply for or administer the vaccines if they're expected to take on legal liability if things go wrong. Their concerns were summed up in a 2 June position paper written by a working group of health agencies, and obtained by The New Humanitarian.

- The United States will supply 500 million more vaccine doses through COVAX, on top of 80 million previously announced, President Joe Biden said on 11 June. Deliveries are expected to start in August 2021. The United Kingdom will also donate 100 million excess doses “within the next year”, Prime Minister Boris Johnson announced. These doses would dwarf the COVAX programme’s current supplies – essentially turning a programme meant to ensure equal global access into a vehicle for donations. Aid group Médecins Sans Frontières said the donations were welcome, but not urgent enough. “Sharing vaccine doses is the most expeditious way to save lives right now, but we cannot vaccinate the world through donations alone, nor will donations address the underlying systemic flaws that landed us in this dire situation of vaccine inequity,” said Carrie Teicher, director of programmes for MSF in the US.

“We cannot vaccinate the world through donations alone, nor will donations address the underlying systemic flaws that landed us in this dire situation of vaccine inequity.”

- It will take years to control COVID-19 in Latin America and the Caribbean without a boost in vaccine supplies, the Pan American Health Organization warned on 9 June. In countries like Guatemala, Honduras, and Trinidad and Tobago, less than 1 percent of the population has been vaccinated. “The inequities in vaccination coverage are undeniable,” said PAHO director Carissa F. Etienne. “Unfortunately, vaccine supply is concentrated in a few nations while most of the world waits for doses to trickle out.”

- Facing surging infections, a battered health system, and vaccine shortages, Afghanistan’s government asked its ambassadors to “seek help” to obtain emergency oxygen supplies on 4 June. Amnesty International said both oxygen and vaccines are urgently needed. Afghanistan is one of dozens of countries facing vaccine shortages due to global supply failures and export restrictions in India. As of 3 June, Afghanistan had enough doses to fully vaccinate fewer than half a million people – about 1.3 percent of the population. Some 630,000 people had been vaccinated with at least one dose as of 3 June.

- The US laid out plans to share 19 million vaccine doses through COVAX. It’s part of a cache of 80 million doses the US plans to donate to other countries – three quarters of this through the UN-backed sharing scheme. The US has repeatedly said it will not use vaccines “to secure favors from other countries” – an apparent shot at so-called vaccine diplomacy bilateral donations employed by countries like China and Russia. Still, the US has picked where the first 19 million doses will go, and donations will be branded to “convey that they are from the American people”, a US State Department official said on 4 June: “We have identified the countries we want these vaccines to go to, and we’ll work with COVAX to have them delivered.” The US is also reserving six million doses for “regional priorities and partner recipients”.

- The WHO approved the Sinovac vaccine for emergency use on 1 June – the second Chinese-made jab to get the green light. Easy storage could make the vaccine a valuable addition to COVAX’s barren pipeline. A Chinese government spokesperson said the first batch of Sinopharm, the other vaccine, “rolled off production” on 31 May, though neither Sinopharm nor Sinovac have distribution deals with COVAX.

- Vaccine shipments to Africa have ground “to a near halt” even as several countries are facing rising cases, the WHO said on 3 June. “COVID-19 vaccine shipments continue to slow down,” the health agency said.

- Bangladesh received 100,000 Pfizer-BioNTech vaccine doses on 1 June – the country’s first shipments through the COVAX programme. The government earlier suspended vaccination plans for Rohingya refugees, citing shortages. Bangladesh had been scheduled to receive nearly 11 million AstraZeneca doses by the end of May, but India’s coronavirus crisis and export restrictions have depleted COVAX stocks. It’s still unclear when vaccinations for refugees will begin. “Among the Rohingya refugees in the camps in Bangladesh, not a single vaccine has been administered yet, given the scarcity of supplies in the country,” the UNHCR said in a 1 June statement, which warned of vaccine shortages in countries hosting millions of refugees.

- Countries in Africa need 20 million AstraZeneca doses within six weeks to complete immunisations, the WHO warned on 27 May, calling for urgent vaccine sharing amid global shortages. The WHO also called for another 200 million doses of any kind in order to vaccinate 10 percent of the region’s population. The global agencies behind COVAX, the vaccine-sharing programme, are urging countries with surpluses or higher coverage rates to share their doses and swap places in supply queues. “If we do not address the current, urgent shortfall, the consequences could be catastrophic,” they said in a statement. The programme had planned to secure 1.3 billion doses for lower-income countries by the end of 2021. As of late May, it had delivered about 5.5 percent of this target.

- In India, a stark digital divide determines who has better access to vaccines, as surging caseloads expose shortfalls and overwhelm hospitals. Activists say onerous online procedures have turned vaccine access into an exclusionary, often lottery-like process in a country where about half the population lacks internet access. “We want to get vaccinated, but we have no idea how to go about it. No one has reached out to us,” Sarfaraz Ahmed, a driver in Mumbai, told The New Humanitarian. By the end of May, India’s second wave started to stabilise in cities like Delhi, but activists fear the divides could grow even more acute as the pandemic swells in rural areas – where health systems and resources are more fragile, and internet connectivity more sporadic. “People are forgetting a basic fact that vaccination is to be carried out by healthcare workers, not by IT engineers,” said Srinivas Kodali, a researcher with the Free Software Movement of India.

- Sri Lanka is short 600,000 AstraZeneca doses needed to finish a second COVID-19 vaccination round, the UN reported on 24 May. The island nation received a quarter million doses through COVAX in March, with another 1.1 million doses expected by the end of May. But vaccine shortages and export restrictions in India, where the Serum Institute manufactures the bulk of early COVAX supplies, have triggered shortfalls across the globe. Like several South Asian nations, Sri Lanka faces a rapid rise in infections.

- India’s Serum Institute won’t restart vaccine exports, including to the COVAX programme, until the end of the year, the manufacturer said in a 18 May statement. The announcement from the world’s largest vaccine manufacturer – and the main supplier for the COVAX pipeline – comes as global shortages hit predominantly lower-income countries struggling with soaring COVID-19 caseloads. The Serum Institute’s missed deliveries means COVAX will have a vaccine shortfall of 190 million doses by the end of June, UNICEF said on 17 May. The UN-backed scheme is rushing to get other vaccines into its pipeline, but the vast majority of these doses won’t be available until late 2021 or next year. The WHO has urged manufacturers to prioritise COVAX and move deliveries forward to 2021. “We need doses right now,” said Tedros, the WHO’s director-general. Also on 17 May, the US pledged to share 80 million vaccine doses for global use.

“As people living in richer countries hit the reset button this summer and their lives start to look normal, in Africa our lives will stay on hold.”

- Global bottlenecks could dangerously stall vaccine plans in Africa in the coming months, but funding shortages are also delaying larger rollouts in countries that have supplies, the WHO said on 20 May. Eight countries have used up all their initial vaccine doses after India stopped vaccine exports, but at least 20 have administered less than half their stocks. The WHO said some $3 billion is needed to actually get vaccines into people’s arms – from hiring and training vaccinators, to logistics and better communication to combat vaccine hesitancy. But most countries on the continent have financial plans to cover rollouts to only three percent of their populations, the agency said. However, there’s still a clear shortage of vaccines: The continent received only a quarter of 66 million projected COVAX doses between February and May. “As people living in richer countries hit the reset button this summer and their lives start to look normal, in Africa our lives will stay on hold,” said Dr Matshidiso Moeti, the WHO’s director for Africa.

- Government policies are blocking access to vaccines for migrants in at least 53 countries, the UN’s migration agency, IOM, said on 18 May. Many nations have promised to include refugees, asylum seekers, migrants, and other groups in their vaccine rollouts, but red tape and bureaucracy are frequent roadblocks. Basic issues like requiring national identification or residence permits in order to register for vaccines are common, the IOM found.

- Discrimination may block transgender women in Indonesia from getting vaccinated, the International Commission of Jurists warned on 17 May. Indonesians will need an electronic identity card to enrol in vaccine rollouts planned for July, but many trans women lack the “family cards” needed to register if they have fled their homes due to violence and persecution.

- Health organisations working in Myanmar’s ethnic border areas are calling for international support for COVID-19 prevention, testing, and vaccines. The Ethnic Health Committee, which comprises several groups delivering healthcare in areas controlled or contested by ethnic armed organisations, said they’re facing growing medical shortages and rising displacement since Myanmar’s 1 February coup. In a 6 May statement, the committee called for “increased international support directly to [ethnic health organisations] who bear responsibility for the growing displaced populations in their areas, while combating the pandemic”. The statement asked neighbouring China, Bangladesh, India, and Thailand to allow COVID-19 vaccines into border areas “as a humanitarian gesture”. Myanmar’s public health system has virtually collapsed since the coup, aid groups say, and coronavirus testing and treatment has been severely disrupted.

- Refugees and asylum seekers in Serbia are receiving their first COVID-19 vaccine doses, the WHO said on 12 May. Many countries have promised to include these groups in vaccination rollouts, but far fewer have followed through. A WHO advisory committee recommends countries include displaced people, refugees, asylum seekers, and vulnerable migrants among priority groups in countries’ vaccine planning, often after frontline health workers and older people.

- Money can only go so far. Facing rapidly surging infections and overloaded hospitals, Nepal is in “desperate need” of oxygen supplies, equipment, and vaccines rather than funding, Human Rights Watch said on 10 May. Countries like Nepal often depend on India for medical equipment and vaccines, but both are in short supply as India’s COVID-19 crisis continues. “Money is no use,” one official said.

- There is a rush to diversify the COVAX pipeline amid India’s supply shortages. A WHO committee approved the Chinese-made Sinopharm vaccine for emergency use on 7 May, adding another candidate that could be included in global rollouts. The WHO approved the US-made Moderna vaccine on 30 April, and Gavi announced it had struck a deal to buy 500 million doses for COVAX. But the first 34 million Moderna jabs aren’t expected to be available until the last quarter of 2021. On 6 May, Gavi also announced an agreement to buy 350 million doses of the Novavax vaccine candidate, which hasn’t yet received emergency approval from the WHO. The WHO approved the single-shot Johnson & Johnson vaccine in March, though these jabs are still pending a supply agreement and wouldn’t be available until the second half of the year, the Gavi spokesperson said. Current COVAX stocks comprise only three vaccines – two versions of AstraZeneca including the Serum Institute’s, and the Pfizer-BioNTech jab.

- The US will support temporarily waiving intellectual property rights on COVID-19 vaccines, officials announced on 5 May. Advocates for a so-called “people’s vaccine” believe trade protection is a major barrier to widespread availability. The WHO called it “a bold move to end the pandemic as quickly as possible”. Oxfam India said a waiver will open up production to more manufacturers in the Global South and “help us end the current vaccine apartheid”. But a pharmaceutical industry group said that waiving patents will not address other problems: trade barriers, supply chain bottlenecks, global shortages of raw materials, “and a willingness by rich countries to start sharing doses with poor countries.”

- India’s COVID-19 burden has direct repercussions for global vaccine rollouts – from postponed vaccinations in refugee camps to shortages in dozens of countries still waiting for doses. India is the leading vaccine supplier to much of the world through COVAX, and touted generous donations as part of its “vaccine diplomacy” push. Now, it’s struggling to vaccinate its own population amid shortages and the world’s fastest-rising COVID-19 caseload. In recent weeks, it has fast-tracked foreign-made vaccines and restricted exports – delaying COVAX deliveries to many countries almost entirely reliant on the UN-backed programme.

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

 

 

Global coverage

Search this map for stats from specific countries, and click on the green markers for select humanitarian coverage from around the globe:

 
 

il/ag

Share this article

Help make quality journalism about crises possible

The New Humanitarian is an independent, non-profit newsroom founded in 1995. We deliver quality, reliable journalism about crises and big issues impacting the world today. Our reporting on humanitarian aid has uncovered sex scandals, scams, data breaches, corruption, and much more.

 

Our readers trust us to hold power in the multi-billion-dollar aid sector accountable and to amplify the voices of those impacted by crises. We’re on the ground, reporting from the front lines, to bring you the inside story. 

 

We keep our journalism free – no paywalls – thanks to the support of donors and readers like you who believe we need more independent journalism in the world. Your contribution means we can continue delivering award-winning journalism about crises. Become a member of The New Humanitarian today

Become a member of The New Humanitarian

Support our journalism and become more involved in our community. Help us deliver informative, accessible, independent journalism that you can trust and provides accountability to the millions of people affected by crises worldwide.

Join