Global Humanitarian Response Plan: COVID-19
by UN Office for Humanitarian Affairs, agencies
3:39am 20th Jul, 2020
17 July 2020
The UN humanitarian chief, Mark Lowcock, has called on G20 nations to act now or face a series of human tragedies more brutal and destructive than the direct health impacts of the coronavirus as he released an updated US$10.3 billion appeal to fight the virus in low-income and fragile countries.
Without mitigating action, the pandemic and associated global recession are set to trigger the first increase in global poverty since 1990 and push 265 million people to the point of starvation by the end of the year. Recent estimates suggest up to 6,000 children could die every day from preventable causes as a result of direct and indirect impacts of COVID-19. Meanwhile, diverted health resources could mean the annual death toll from HIV, tuberculosis and malaria doubling.
COVID-19 is now present across the globe, with more than 13 million confirmed cases and more than 580,000 deaths worldwide. Last week the first confirmed case was reported in Idleb, Syria, sparking fears of a devastating outbreak in crowded camps holding displaced people. In Yemen, people’s immune systems are struggling to fight back after years of war and deprivation, and about a quarter of Yemenis confirmed to have COVID-19 have died – five times the rate globally.
“The pandemic and associated global recession are about to wreak havoc in fragile and low-income countries. The response of wealthy nations so far has been grossly inadequate and dangerously short-sighted. Failure to act now will leave the virus free to circle round the globe, undo decades of development and create a generation’s worth of tragic and exportable problems,” said UN Under-Secretary-General for Humanitarian Affairs Mark Lowcock.
He added: “It doesn’t have to be like this – this is a problem that can be fixed with money from wealthy nations and fresh thinking from the shareholders of international financial institutions and supporters of UN agencies, the Red Cross and Red Crescent movement, and NGOs.
“Rich countries have thrown out the rulebook when it comes to protecting their own economies. They must apply the same exceptional measures to countries that need help. The prospect of cascading crises more brutal and destructive than anything the virus alone can do must jolt us all out of our comfort zone.”
The COVID-19 Global Humanitarian Response Plan is the international community’s primary fundraising vehicle to respond to the humanitarian impacts of the virus in low- and middle-income countries and support their efforts to fight it. It brings together appeals from UN humanitarian agencies, WHO and NGOs.
Non-governmental organizations (NGOs) and NGO consortiums have been instrumental in helping shape the plan and deliver it, and they can access funding through it. The plan provides help and protection that prioritize the most vulnerable. This includes older people, people with disabilities, displaced people, and women and girls, given pandemics heighten existing levels of discrimination, inequality and gender-based violence.
Since the launch of the Global Humanitarian Response Plan (GHRP) for COVID-19 on 25 March and its first update on 7 May, the pandemic has rapidly expanded in most of the 63 countries it includes. With many countries still in the early stages of their outbreak, heightened implementation of public health measures is critical to save lives and suppress transmission.
Over the past 3.5 months from end March to mid July, the impacts of the pandemic on the lives and livelihoods of the most vulnerable people have worsened dramatically. Individuals and population groups who were already suffering from violence, stigma, discrimination and unequal access to basic services and living conditions, are bearing the brunt of this new crisis.
COVID-19 is deepening the hunger crisis in the world’s hunger hotspots and creating new epicentres of hunger across the globe. The number of acutely food insecure people in countries affected by conflict, natural disaster or economic crises is predicted to increase from 149 million pre-COVID-19 to 270 million before the end of the year if assistance is not provided urgently.
Recent estimates also suggest that up to 6,000 children could die every day from preventable causes over the next 6 months as a direct and indirect result of COVID-19 related disruptions in essential health and nutrition services.
Under the umbrella of the GHRP, Inter-Agency Standing Committee members and partners including FAO, IOM, UNDP, UNFPA, UN-Habitat, UNHCR, UNICEF, UNRWA, WFP, WHO, NGOs and the Red Cross and Red Crescent Movement have stepped up their response to address the most urgent humanitarian health, protection and socioeconomic needs caused by the pandemic.
The GHRP is targeting nearly 250 million people with COVID-19 assistance. From the US$6.7 billion needed last May to implement this response, funding requirements have risen to $10.26 billion. The spread of the pandemic necessitates more intensive health prevention and treatment measures and increasing investments to maintain other essential health services.
The deepening ripple effects of the pandemic are impacting all spheres of life and require substantially scaled up support to help the most vulnerable. The plan also includes a strategic envelope of $500 million to prevent famine from occurring in the most vulnerable countries.
One of the most nefarious consequences of the pandemic is the rise of gender-based violence (GBV). There has been a dramatic increase in reported cases of GBV and the number of calls to dedicated hotlines (60 to 770 percent increase in different countries), while the provision of GBV services has regretfully been curtailed.
UN Women estimates that globally in the past 12 months, 243 million women and girls aged 15–49 years were subjected to sexual and/or physical violence perpetrated by an intimate partner, while older women were also experiencing violence. Projections indicate that for every 3 months the lockdown measures continue, an additional 15 million cases of gender-based violence globally are expected.
GBV response services are facing major hurdles in their ability to reach survivors due to mobility restrictions and inadequate resources. The GBV response and funding allocation throughout the COVID pandemic have not been at the scale of the need. Across 40 reporting countries in the GHRP, 16 have reported significant interruptions in GBV services.
While humanitarian actors have recognised the magnitude of the problem and advocated for greater priority to be given to awareness-raising and services for GBV survivors, long-standing neglect of the issue and insufficient resourcing continue to limit the ability of responders to prevent and mitigate the problem.
Without targeted interventions, COVID-19 will heighten pre-existing risks of GBV due to increased exposure to abusers at home, mobility restrictions, and heightened household tensions from health and economic shocks.
Recognizing GBV response as an essential protection activity and service in the COVID-19 national response plans is required to facilitate the movement of GBV service providers. GBV messaging also needs to be mainstreamed in key entry points such as hospitals and drugstores, especially during lockdown situations, and GBV risk mitigation needs to be integrated in the response implemented in other sectors and continue to adapt service provision to remote modalities.
An immediate and substantial increase in the funding available to address issues of GBV is indispensable. As at end June, funding requirements for GBV in 16 countries with humanitarian response plans amounted to $487 million (including COVID-19 related-responses), of which only $34 million (7 percent) were funded, leaving a gap of $453 million.
The continuity of other essential health services is also being interrupted. Facilities are overwhelmed with pandemic response, healthcare staff lack necessary personal protective equipment, and people cannot access services or may fear contagion.
Across 26 countries that reported, 20 had facilities that showed a significant disruption in provision of maternal health care, with direct impacts on maternal and neonatal mortality and morbidity.
Several other especially vulnerable population groups hit hard with the effects of the pandemic are confronted with violence and abuse, such as older people, persons with disabilities, children and adolescents, particularly girls, as a result of prolonged lockdowns, harsh implementation of emergency measures by authorities, or being associated with COVID-19. Their access to preventative measures and treatment for COVID-19 is more difficult, as well as for other essential health services they may require.
Mental health and psychosocial support services are more than ever required for these and other vulnerable groups who are discriminated against or losing their livelihoods. These services are often grossly insufficient and tend to be under-resourced.
The cost of leaving the pandemic unmitigated to people’s lives and the economy is appalling. The COVID-19 virus could infect up to 640 million people and kill over 1.67 million of the world’s most vulnerable populations in 32 low-income countries. The direct medical costs of hospitalising 2.2 million patients in critical care beds could amount to an estimated $16.28 billion. At least 2 million preventable deaths could occur as a result of disrupted healthcare and resource diversion without appropriate mitigation.
The socio-economic impact of the pandemic is also becoming increasingly clear as domestic containment measures continue and economies are in deep recession. The cost of inaction against the public health, poverty, food security, education, economy, stability and conflict consequences will grow exponentially if the right combination of relief and recovery assistance, guided by human rights and the UN framework for the immediate socio-economic response to COVID-19, is not implemented quickly and at scale.
The COVID-19 pandemic jeopardises gains in poverty reduction made over the past decade. At least 100 million could be pushed into extreme poverty under the $1.90 per day international poverty line. If no action is taken, these poverty traps are likely to become permanent due to the aggregate nature and sheer size of the shock.
The social economic impact of the pandemic takes a heavy toll on women and girls in particular, as the vast majority of women’s employment – 70 per cent – is in the informal economy with limited access to social protection, safety nets and fiscal stimulus, including for women, migrants and refugees.
Further, if left unaddressed, the large economic shocks induced by the COVID-19 pandemic are likely to exacerbate drivers of conflict in the medium term and generate even larger welfare losses as a result.
The consequences would be huge as conflicts disproportionately affect vulnerable groups and drive 80 percent of all humanitarian needs. A surge in conflict and violence would further undermine the response to COVID-19 and its worst effects on vulnerable populations.
School closures are likely to affect future earnings and human capital for students, increase educational and broader inequalities particularly for the poorest students, girls, and students with disabilities, and contribute to hunger and malnutrition from the suspension of school feeding programmes.
School closures also increase harmful practices such as child marriage and negatively affect the mental and psychosocial health of students. The most vulnerable students such as adolescent girls and young people with disabilities, might not ever return to school, jeopardizing their future and the future of their families.
Job losses, lack of access to markets and productive inputs (e.g. in agricultural) are affecting informal workers (with a large share of which are women and living in dense urban settlements), small scale farmers, pastoralists and others dependent on an uncertain and meagre income. Many of these people were food-insecure before the pandemic due to insufficient income and limited food production.
The UN Secretary-General has warned of an impending global food emergency that could have long term impacts as COVID-19 challenges food systems, flattens the informal sector, and impacts economies – pushing millions more into extreme poverty and acute food and nutrition insecurity. Every low or middle-income country faces this growing threat.
As food security worsens and access to health and nutrition services deteriorates, malnutrition is increasing particularly among population groups whose nutritional needs are higher such as pregnant and lactating women, women of reproductive age, adolescent girls, sick people, and older people.
The number of severely malnourished children is projected to rise significantly. Recent estimates indicate that in the absence of timely action the number of children under 5 with severe acute malnutrition could rise globally by about 15 percent over the first 12 months of the pandemic. Certain areas in Africa may see up to 20-25 percent increase.
A significant portion of the population is at immediate risk of COVID-19 simply because they lack basic hand washing facilities. Worldwide, three billion people – 40 percent of the world’s population – do not have a place in their homes to wash their hands with water and soap, including three quarters living in the poorest countries and amongst the most vulnerable such as children and families living in in informal settlements, migrant and refugee camps, or areas of active conflict situations.
Refugees, asylum seekers, IDPs and migrants find themselves at the intersection of many of the health and socio-economic problems caused by the pandemic. Due to their status, they face greater difficulty to access essential health and other services and are often excluded from national social protection mechanisms where these exist.
Gender-based violence and food insecurity can be even worse in these population groups than in the host communities. Migrants also face increased protection risks when stranded at borders, placed in immigration detention or forcibly returned.
Limited capacities of health and social protection services before the crisis have constrained the ability of national governments to prevent, mitigate and respond to the health and socio-economic effects of COVID-19 for those most at risk.
Restrictions on mobility imposed to contain the spread of the virus added to the pass-through effects of the global economic recession and compounded risks and shocks including conflict, civil violence and natural disasters, have aggravated the situation and further hampered access and delivery of humanitarian assistance and protection services.
Despite numerous challenges, humanitarian actors have adapted and ramped up the provision of essential health, food, nutrition, cash, water, hygiene and sanitation, livelihoods and shelter assistance to the most affected people, in coordination with and support of governments’ own efforts.
The success of these efforts must be attributed to UN agencies as well as to national and international NGOs who are playing an indispensable role in outreach and ensuring that no one is left behind.
Innovations and adaptations have been made to help comply with physical distancing requirements and address mobility constraints when distributing goods and cash, and when providing healthcare, nutrition, sexual and reproductive health, mental health and psychosocial support, and gender-based violence services.
Digital technology and alternative means of communicating the direct and indirect risks of COVID-19 are being used. Increased efforts are being made to engage with diverse community and local actors to reach those most isolated with prevention and treatment messages on COVID-19 and assistance.
Significant challenges remain however to stem the spread of the pandemic in the most fragile contexts, many of which are affected by violence, armed conflict, floods, typhoons and desert locust infestation, among other scourges.
Funding for non COVID-19 humanitarian responses addressing these shocks must be sustained and increased. Resources required for the pandemic must be in addition, and not in substitution of this funding.
This additional funding is required for all the components of the humanitarian response to COVID-19, including funding for global services to enable the transportation of humanitarian personnel and cargo, and for medical evacuation services to allow for humanitarian actors to ‘stay and deliver’.
Adequate funding for famine prevention must also be urgently allocated to avoid a major catastrophe. Acute food insecurity and famine can and must be prevented. This requires scaling up interventions reaching the most food insecure populations.
Crucially, it also requires supply chains to function across borders, and markets to be functioning within countries, including green corridors for food items and for agriculture and humanitarian aid. Prepositioning of food and cash ready for delivery despite mobility constraints is also essential.
Donors and the UN must ensure a larger share of theresponse funding goes to NGOs directly. This can be done by channeling donor funds to NGOs, NGO consortia and NGO-managed pooled funds, as well as by using country-based pooled funds and flexible funding. This will enable an expansion of humanitarian interventions particularly for the hardest to reach population groups, as well as ensure that interventions also reflect the views and situations of affected populations.
The restrictions on movement of international staff imposed by the pandemic also means local actors are best placed to ensure the continuity of essential services at the community level. Funding for the GHRP should therefore be seen as an essential complement to recovery and ‘building back better’ efforts.
The OECD and the G20 countries have responded with a large stimulus package estimated at over $11 trillion. In comparison, the cost of protecting the most vulnerable 10 percent of the world from the worst impacts of COVID-19 today is estimated at an additional $90 billion – less than 1 percent of the current stimulus package.
It is better, cheaper and more dignified to frontload responses to the pandemic and the secondary impacts. Waiting until the full impacts are visible is a more expensive proposition as delaying action not only shifts the burden of payment to the future, but the price of the response will also exponentially increase. Acting now to mitigate the impact saves money in the long term.
Containing COVID-19 in poorer countries is in the national interests of richer countries. However, the economic toll of lockdown measures in low-income countries where the majority of the working population depends on the informal sector is unbearable. Low-income countries need the fiscal space to build up their health systems and capacities, improve and expand their social safety nets, and implement urgent economic stimulus in packages, particularly for small and medium enterprises.
Multilateral collaboration is also essential for increasing the limited global supply and access to vital medical and testing equipment.
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