Part one: Global trends

Disease Outbreaks are Increasing, Hard-won Gains are at Stake Amid COVID-19

Cox's Bazar, Bangladesh

IOM is supporting or operating 35 health-care facilities in Cox’s Bazar, contributing to infection prevention and control, risk communication, community engagement and case management. Despite the provision of personal protective equipment to healthcare providers, staff have been infected with COVID-19. As well as personal suffering, the infection of health staff also results in a vacuum in the workforce and interrupted health services. IOM/Nate Webb

The past decade has seen a steady increase in disease outbreaks, with an average annual growth of 6.9 per cent.¹ Over the past five years, 94 per cent of the countries with inter-agency humanitarian appeals have recorded at least one disease outbreak.²

Globally, over 5 million children under 5 years of age face the threats of cholera and acute watery diarrhoea.³ WHO, UNICEF and Gavi, the Vaccine Alliance, reported that by August 2020, routine immunization services had been disrupted in at least 68 countries due to the COVID-19 pandemic, putting approximately 80 million children under 1 year of age at increased risk of contracting vaccine-preventable diseases.⁴

COVID-19 has hindered essential health services in almost every country (90 per cent), with the greatest impact being felt in low- and middle-income countries.⁵ Non-communicable disease diagnosis and treatment have been disrupted by 69 per cent, family planning and contraception by 68 per cent, antenatal care by 56 per cent, and cancer diagnosis and treatment by 55 per cent.⁶ Mental health treatment has experienced a 61 per cent disruption (see Mental Health and Psychosocial Support in Humanitarian Emergencies on this report). In terms of communicable diseases, health-care disruptions caused by the pandemic are reversing hard-won gains in the fight against human immunodeficiency virus (HIV), tuberculosis (TB) and malaria. Analyses from WHO, UNAIDS, the Stop TB Partnership and others suggest that the annual death toll due to HIV, TB and malaria could nearly double due to COVID-19, wiping out up to 20 years of progress.⁷

Aid in action

Ensuring equitable access to a COVID-19 vaccine

An effective and fairly distributed COVID-19 vaccine will be key to turning the course of the pandemic, in addition to infection prevention and control measures. The Access to COVID-19 Tools Accelerator (ACT-A) is a global collaboration to accelerate the development, production of and equitable access to COVID-19 tests, treatments and vaccines. ACT-A has three pillars: vaccines, diagnostics and therapeutics. It acts as a connector of health systems. The vaccine pillar, i.e. the COVAX facility, aims to ensure the global distri-bution of vaccines by acting as a platform that will support the research, development and manufacturing of a wide range of COVID-19 vaccine candidates, and negotiate their pricing. All participating countries, regardless of income levels, will have equal access to these vaccines once they are developed. The initial aim is to have 2 billion doses available by the end of 2021, which should be enough to protect high-risk and vulnerable people, as well as frontline health-care workers. Inter-Agency Standing Committee mem-bers are working closely with the COVAX facility to ensure that a ‘humanitarian buffer’ of the eventual vaccine is available for at-risk populations.

UNICEF/Ahed Izhiman

The pandemic has shown how disease can drive humanitarian needs, sharpening the focus on ongoing structural and societal inequalities.⁸ Lower-income groups usually face higher rates of chronic health conditions, such as diabetes or heart disease, and they are likely to suffer from underlying conditions such as diarrhoea, gastroenteritis, malaria and TB.⁹