The coronavirus pandemic continues to test humanitarian responses, while the world faces questions about how to ensure equal access to vaccines.
Most countries are rolling out coronavirus vaccination plans, but it’s unclear when – and in some cases, how – vaccines will be widely available or 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
Cumulative global COVID-19 cases topped 200 million in August.
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.
Warnings of “vaccine nationalism”, hoarding, and queue-jumping have come to fruition as wealthier countries that scooped up early supplies gradually re-open and relax restrictions – while others face repeat waves and dangerous new variants with few vaccines.
As of mid-September, roughly 80 percent of the 5.5 billion COVID-19 vaccine doses administered around the world have been in high- and upper-middle income countries, according to the World Health Organization.
“Variants are currently winning the race against vaccines because of inequitable vaccine production and distribution,” said the WHO's director-general, Tedros Adhanom Ghebreyesus. “… It didn’t have to be this way and it doesn’t have to be this way going forward.”
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 circumvented 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.
Dose deliveries picked up speed in July and August as wealthier nations that bought up early supplies began donating excess jabs. As of mid-September, COVAX had shipped 240 million doses – still short of its mid-year targets. High-income countries have promised to donate 1 billion doses, but only 15 percent of these have materialised, the WHO said.
As of mid-June, funding for the Access to COVID-19 Tools (ACT) Accelerator, the WHO-led partnership that includes the COVAX programme, was short $16 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 91 of 162 countries monitored by the UN’s refugee agency had started vaccinating refugees or asylum seekers as of late June. 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 123 countries include refugees in their immunisation plans on paper, 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. Drug manufacturers also want aid groups to take on legal liabilities if they source vaccines through the buffer – an early stumbling block in getting the would-be stockpile up and running.
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:
- Rohingya in Bangladesh’s camps received their first COVID-19 vaccines on 10 August – nearly five months after the government postponed rollouts for refugees. Rohingya are meant to be included in Bangladesh’s national vaccine plans, but the government postponed a March start date in the camps because it hadn’t received any deliveries from the COVAX vaccine sharing scheme (national rollouts were launched in January with jabs that were bought or donated). The UNHCR said some 48,000 Rohingya older than 55 are eligible for the initial vaccine drive; the camps have a population of roughly 900,000. This comes as the Delta variant continues its surge in Bangladesh and beyond. The Rohingya camps recorded more than 2,500 cases as of early August, but test-positivity rates were higher in the surrounding Cox’s Bazar district and nationwide. “People in these camps are living in the shadow of the global vaccine divide,” said Hrusikesh Harichandan of the IFRC. “Widespread vaccinations are critical to contain this deadly virus.”
- Haiti, which has seen recent spikes in COVID-19 cases, received its first delivery of 500,000 vaccines in July. Haiti is one of the last countries in the Americas to start its vaccination campaign, which initially targeted workers in clinics and hospitals. Earlier in the year it rejected a shipment of AstraZeneca vaccines.
- Pfizer and BioNTech announced plans to manufacture their COVID-19 vaccine at South Africa’s Biovac Institute. The first doses will be produced in 2022 and will be available exclusively to African countries. However, Médecins Sans Frontières described the deal as “restrictive”, and said it wouldn’t be enough “to achieve vaccine independence on the African continent”.
- The United States plans to donate half a billion COVID-19 vaccine doses around the globe, but North Korea won’t be on the gift list. “We do not currently have plans to share vaccines with the DPRK,” a State Department spokesperson said on 22 July, using an abbreviation of the country’s full name. “We very much remain concerned about the human rights situation.” North Korea has claimed it has no COVID-19 cases, though many are sceptical. Its borders have been mostly closed since early 2020, and the country is veering toward food shortfalls later this year, analysts warn. North Korea has rejected AstraZeneca vaccines through the COVAX sharing scheme, Reuters reported, though it may be considering donations from Russia.
- The health agencies behind COVAX have inked supply deals with Chinese manufacturers Sinovac and Sinopharm, expanding the vaccine sharing scheme’s pipeline amid global shortages. The agreements would see 110 million doses made available between July and September, with an option for millions more through early 2022. While still struggling with late deliveries and global shortfalls, COVAX has expanded its longer-term pipeline to more than 2.8 billion doses – largely through pledges from wealthier nations who scooped up early supplies and rolled out vaccines first. However, severe short-term shortages continue in most countries that are buckling under new outbreak waves. COVAX is also warning countries and donors to prepare health systems to handle what could be a sudden jump in vaccine supplies in late 2021.
- Vaccine scepticism is frustrating COVID-19 immunsiation plans around the globe, but there’s nuance behind the doubt. Hesitancy about vaccines is high in Papua New Guinea, for example, despite outbreaks that triggered a national emergency and aid pledges. One June survey suggested most respondents wouldn’t take a vaccine. Rather than clear opposition, however, many are still making up their minds. A separate poll of university students allowed respondents to choose “unsure” rather than simply “yes” or “no”, and nearly half did so. Many said they were influenced by social media debates and a shortage of clear information from the government. This suggests that opposition to vaccines isn’t so clear cut – and that better information and public health campaigns that build trust can put a dent in the hesitancy: “Many minds are not made up on the issue of vaccination,” researcher Rohan Fox said, writing on the Pacific-focused Devpolicy Blog.
- Red tape, onerous registration systems, long distances, and language barriers still keep vaccines from refugees and asylum seekers, the UNHCR said on 24 June. Most countries the agency monitors explicitly include refugees and asylum seekers in their COVID-19 vaccination plans, though only 91 of 162 countries had started vaccinating these groups as of late June. What does better inclusion look like? For starters: Breaking down registration roadblocks and making it easier to get jabs. Moldova and Serbia, for example, brought vaccines directly to people in asylum centres, the UNHCR said, while Senegal and Cameroon let refugees register in nearby health centres.
- There’s a glaring gender divide in the COVID-19 vaccine rollout in Indian-administered Kashmir. More men than women are getting vaccinated, a medical officer working on Kashmir’s immunisation campaign told The New Humanitarian. Health workers attribute this in part to rampant rumours tying vaccines to infertility, though there’s no evidence to support a link. Vaccine hesitancy has been exacerbated by widespread mistrust of the central government in a heavily militarised region.
- Facing surging infections, a battered health system, and vaccine shortages, Afghanistan's COVID-19 caseload has risen to "alarming levels", the UN said in a 1 July briefing. 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 1 July, some 898,000 people had been vaccinated with at least one dose – about 2.3 percent of the population.
- Global vaccine shortages are costing lives as coronavirus waves surge in under-immunised areas. But some countries are also lagging behind on rollouts with doses they’ve already received. At least 14 countries in Africa have used up all or most of their vaccine stocks, but at least 23 others have used less than half their doses, the WHO said on 17 June. Roughly 1.25 million AstraZeneca doses in 18 countries are set to expire by the end of August, the agency said.
- G7 countries have pledged to share at least 870 million vaccine doses, with “at least half” to be delivered by the end of the year. The WHO said many countries will need help to ensure their health systems can conduct large-scale rollouts with the expected deliveries. It urged multilateral banks to “urgently release” promised funding.
- Uganda has exhausted its vaccine supply, but faces an exponential rise in cases with an overwhelmed health system, aid group Mercy Corps warned on 18 June. Only 2 percent of the population has been vaccinated, said the group’s country director, Edward Simiyu. “We have no way to know how far the virus has spread in Uganda because of the low testing capacity in the country,” he said. “The health systems are overwhelmed, and sooner or later, there will be no space or adequate healthcare staff to admit severely ill patients who need emergency and critical care services. It's a ticking time bomb.”
- 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.
“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.”
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:
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