EACH YEAR the United Nations puts out a carefully crafted state-of-the-world assessment from a humanitarian perspective. It considers how much help is needed to stave off disaster in the most vulnerable countries. According to its latest “Global Humanitarian Overview”, released on December 1st, the state of the world is stark.
A year ago the UN projected that 168m people would need assistance in 2020. For 2021 the number is 40% higher: a record 235m. That is almost as many people as there are in Indonesia, the world’s fourth-most-populous country. The UN says it will need $35bn to support the neediest 160m of these—about four in five of them in Africa and the Middle East—across 56 countries. Extreme poverty has risen for the first time in 22 years. Women and young people are the hardest-hit.
The main cause of the increase is covid-19—not the health effects of the virus itself but its toll on economies, with recession, food-price rises and a decline in remittances from abroad adding to the millions of people who are so poor they will not survive without help. The UN fears a near doubling of the number of people at risk of starvation. “Famine is back,” says Mark Lowcock, the UN’s humanitarian chief. Famines had seemed largely a thing of the past: the only significant one this century was in 2011-12 in Somalia, where about a quarter of a million people died. Now Yemen, north-east Nigeria, Burkina Faso, South Sudan and half a dozen other countries are vulnerable. “If we get through 2021 without major famines, that will actually be quite a result,” believes Mr Lowcock.
The pandemic is also having a knock-on effect on health beyond the virus’s immediate toll. In vulnerable places it is causing a contraction in life-saving services such as immunisation, malaria prevention and neonatal care. The result, predicts Mr Lowcock, will be a reduction in life-expectancy—not as visible or concentrated as famine, but another unhappy reversal after decades of progress.
Vaccines offer hope in the fight against covid-19, yet rich countries are bound to roll them out fastest, paying too little heed to the amounts and most appropriate types available for the poorest places. The Moderna and Pfizer-BioNTech vaccines need to be stored at very low temperatures. “Frankly, we don’t think anywhere where we work is going to be able to very quickly put in place cold-chain requirements,” says Mr Lowcock. He also cautions against a rush to channel efforts into covid at the expense of routine immunisation (against measles, say) with a higher life-saving impact in many poor and crisis-hit places.
The pandemic may be the biggest reason for the rise in humanitarian stress, but two longer-term factors are also pushing it up. One is global warming. Many of the countries most at risk from the effects of climate change already have big humanitarian problems (with extra risks in the coming months from the La Niña weather system). The other is conflict, which is spreading trouble in a growing number of places, including Western Sahara and the Sahel, Ethiopia and northern Mozambique as well as Nagorno-Karabakh. Syria, which looms large in the UN’s humanitarian efforts, has seen no peace: the UN expects an extra 1.9m people will need humanitarian assistance there. Overall, the number of people displaced within countries because of conflict and violence has reached a new high of 51m, and over the past decade the number of refugees crossing borders has doubled to 20m.
Will a cash-strapped world be willing to provide anything like the $35bn the UN says it needs for the coming year? The amount of humanitarian aid co-ordinated through the UN (about 70% of the global total) has been rising. The bad news is that the needs have been rising faster, so the funding gap has been growing, to $22bn (see chart).
America’s spending has been robust, and Germany’s has been increasing. But the Gulf countries have grown less generous, and last week Britain announced that it was slashing £4bn ($5.3bn) of its foreign aid, suspending its commitment to devote 0.7% of GDP to international development (it will now drop to 0.5%, though humanitarian spending within the total may be protected as far as possible). “A small budgetary saving for the UK will have large impacts for the world’s most vulnerable people,” laments Mr Lowcock, himself a former head of Britain’s Department for International Development.
If, as seems likely, the UN ends up far short of its $35bn target, it will have to channel the money it has towards alleviating the worst of the distress. The focus on emergency relief leaves little room for more lasting support. The result is more places on the verge of famine for longer: that is, a rising humanitarian caseload.
A few bits of brightness can be discerned. First, experiments in “anticipatory action”, where the UN acts early when key indicators suggest releasing funds can help prevent a deeper disaster, have shown encouraging results. This approach has been tried this year to pre-empt the impact of floods in Bangladesh and hunger in Somalia. Anticipatory action against cholera might be tried next. Donors seem keen to see more such interventions.
Second, adjustment to the pandemic has speeded up change in the humanitarian sphere, just as it has in other industries. Cash is being deployed more effectively. So is technology: artificial intelligence is being used to map outbreaks of disease, and drones deployed to deliver medical supplies and testing samples. Even the UN’s bureaucracy is pushing less paper, and its staff are travelling less manically. More important, the value of building up local organisations in the field has become even clearer, with the prospect of improved capacity to deliver relief in future. Local capacity-building was recognised as vital at the World Humanitarian Summit in Istanbul in 2016, but the pandemic has given this a renewed sense of urgency, according to Dr Esperanza Martinez, head of health at the International Committee of the Red Cross: “Covid-19 is an accelerator,” she says, for example causing the ICRC to bring forward the building of surgical capacity from 2023 to 2021 in a project spanning Nigeria, South Sudan and the DRC.
Third, the incoming Biden administration could make a difference. It is likely to give greater weight to places President Donald Trump called “shithole countries”. One of Jake Sullivan’s first tweets after he was named as Mr Biden’s choice for national security adviser was about Ethiopia. Linda Thomas-Greenfield, the nominee for UN ambassador, served as the top official for Africa under the Obama administration. Mr Biden plans to put America back into the Paris agreement and has signalled the priority he attaches to tackling climate change by naming John Kerry, a former secretary of state, as his climate envoy.
But all these changes will take time to show results. In the meantime, 235m people are at risk in 2021. The bright spots are mere glimmers in the gloom.