This chapter offers an analysis of the relevance of international development co-operation provided during the COVID-19 crisis, in terms of how well assistance was designed to align with partner countries’ needs and priorities as the crisis unfolded. It begins by defining relevance in the crisis context and then looks at how needs and priorities were identified, including how uncertainty was managed and how lessons from past crises were used. It describes what influenced funding flows to different countries. The assessment then looks at where assistance went, assessing the potential of international assistance to align with COVID-specific needs, the needs of particular countries and the increasing needs of vulnerable populations.
Strategic Joint Evaluation of the Collective International Development and Humanitarian Assistance Response to the COVID‑19 Pandemic
Abstract
This chapter presents findings regarding the relevance of international assistance during the COVID crisis. For this evaluation, relevance is defined in terms of how well international assistance was designed to align with partner countries’ needs and priorities, including their national responses to the COVID-19 pandemic and the needs of vulnerable groups. The analysis focuses on the potential for assistance to meet these needs (was it aimed at doing the right things) while the following chapters look further at the extent to which these needs were met.
The chapter begins by looking at how needs were defined and identified, and the extent to which available evidence was used, as well as how ongoing programmes were adjust and funders and implementers worked to “keep the lights on” through new barriers – such as movement restrictions or school closures. The analysis then looks at overall alignment with country needs, including allocations by income category, COVID-19-specific vulnerabilities, other country vulnerabilities, and the targeting of specific vulnerable groups. In a context of uncertainty and changing needs and priorities, relevance also required assessing whether international assistance was delivered in ways that allowed flexible adaptation to evolving needs and priorities, which is explored as well. Throughout, case studies and other examples are used to identify key drivers of relevance during the crisis.
The findings reveal a mixed picture. In terms of the decisions made by individual development and humanitarian actors, assistance was relevant to the needs and priorities of countries, including providing critical health support and the expansion of social and economic programmes to meet broader needs. In addition, ongoing programmes and projects were adjusted to the crisis in ways that maintained relevance and delivery of critical services.
At the aggregate level, across countries, relevance of international assistance was high in regard to countries with the greatest overall vulnerability (least developed countries, fragile contexts and Small Island Developing States), with a distinct increase in funding in response to the crisis. The link between international assistance and COVID-19-specific needs is less clear. It does not appear that low-income countries with the greatest COVID-19 burden received significantly more support – overall or for the health sector – during the pandemic. The analysis finds that there was some level of “relevance by chance” in a context where all countries had growing needs, with new needs emerging across many sectors. Likewise, within countries, the collective response was also largely responsive to the needs of vulnerable populations that were already being targeted, but less well aligned with newly emerging needs overall.
The relevance of the collective international response hinged on reaching those in need – through targeting funding to known needs or funding in ways that allowed sufficient flexibility for implementing partners or other intermediary actors to identify and adapt to those needs.
The needs and priorities of different countries in 2020-2022 were linked to contexts at the outset of the pandemic, including income level, governance capacity geography, economic and political context, as well as their connections to the global economy and to international partners. The pandemic, and related measures, also created new needs and exacerbated existing needs.
During the 2020-2022 crisis, the needs assessed for relevance included:
needs related to the emergency health response, including measures to stop the spread of the virus and treat those infected with COVID-19
vaccine supply and vaccination programmes
socio-economic needs and broader development needs related to governance and capacities (both pre-existing and in a context of near universal economic contraction)
humanitarian needs, both generally and specific to the pandemic and its impacts.
The Netherlands’ crisis response strategy is typical of a relevant, multi-pronged crisis response across multiple needs. The Netherlands’ support was aimed around four objectives, and funding for each shifted over the course of the three years under study, which was important for maintaining relevance. Analysis of the Netherlands’ approach shows that the country both identified relevant needs and provided resources accordingly (Figure 3.1).
Note: The data, which include ODA and non-ODA contributions, are from 2020, 2021 and 2022 and include activities tagged as CRS code 12264-COVID-19 control as well as activities with the word COVID in the activity or budget description. The size of the circle indicates the size of the budget allocated for that specific objective as a share of the total budget of that year.
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52.
The novelty of the SARS-CoV-2 virus, along with the global scale and speed of the impact of the COVID-19 pandemic meant that decisions were made imperfectly. Countries along with their development and humanitarian partners often had to make trade-offs, sometimes with limited information. Development and humanitarian actors faced three challenges: 1) identifying how new needs and priorities specifically related to the pandemic (for example, public health communication campaigns to reduce spread, or training of healthcare workers to administer vaccines); 2) understanding the needs and priorities related to the secondary impacts of the pandemic including containment measures; and 3) managing the ways in which the pandemic was impacting ongoing programmes and the needs and priorities of those target populations (e.g. adjusting to remote schooling, and relocating school-based feeding programmes while schools were shut).
The initial approaches to responding to the needs and priorities of developing countries, including vulnerable populations, despite information limitations, were effective given the dynamic context and the level of uncertainty development actors were operating in at the start of the pandemic. This approach involved both mobilising new funding and allowing ongoing programmes or projects to adjust to meet newly emerging needs (or to continue working in different contexts, such as during movement restrictions).
In the early months of the pandemic, uncertainty and a desire to move quickly meant that providers preferred working through preestablished partnerships, building on existing networks and contextual understanding, using both formal and informal needs assessment processes to identify and understand needs. However, both at country level and globally, this resulted in some risks to relevance, or cases of “relevance by chance” rather than relevance by strategic design or decisions based on identified or assumed needs.
The UK government applied a “no regrets” decision-making approach in their development co‑operation assistance. In the face of uncertainty, it prioritised interventions that would benefit communities independent of the course of the pandemic, rather than delaying the response until more data were available. In evaluating the UK response, humanitarian actors were found to have adopted a similar approach, acting on imperfect data rather than risking loss of life, noting that it was widely attributed to having enabled timely action (ALNAP, 2024[2]).
Experiences from Germany and France (Box 3.1) identified the focus on existing priority countries as having been helpful in responding quickly but also limiting responsiveness to crisis-related needs. (DEval, 2024[3]; AFD, 2024[4]). The People’s Republic of China (hereafter ‘China’) also built on several existing partnerships and programmes. In June 2020, within the framework of the Forum on China-Africa Cooperation, a special China-Africa summit on solidarity against COVID-19 was held between China and the African Union. The corresponding joint statement explicitly outlined China's commitment to offering material, technical, financial, and humanitarian support to African countries through the African Union, aimed at helping countries in the region overcome COVID’s impact. China provided funding and supplies that were largely relevant to the health response (such as technical support from medical excerpts and provision of protective equipment), though these seem to have been based primarily on existing relationships and were not clearly linked to specific identified needs (CIKD, 2023[5]).
Japan was able to leverage its relationships constructed in the past and human resource development efforts over many years in Viet Nam and Malawi. Since 2007, Japan has provided ongoing technical co‑operation to Malawi to improve the quality of its healthcare services. The resulting good relationship with the Ministry of Health in Malawi enabled Japan to quickly understand the immediate needs and provide co-operation that was tailored to Malawi’s health system (Ministry of Foreign Affairs of Japan, 2025[6]). Other experiences – documented in evaluation reports and the case studies – support this finding that long-standing relationships were an advantage in respond effectively to the crisis.
As the pandemic evolved, so did the global approach to the identification of and disaggregation of needs and priorities. The second iteration of the World Health Organization’s (WHO) Global Health Response Plan marked a shift towards country-level analysis and planning, resulting in increased potential to engage with local and national actors, particularly in contexts where humanitarian co‑ordination structures and mechanisms already existed. This included special attention to fragile, conflict-affected and vulnerable settings, where limited capacity, fiscal space and ability to access the necessary equipment due to global supply bottlenecks were recognised as major constraints to managing the pandemic and maintaining service delivery. However, this was not uniformly the case.
Restrictions on movement – lockdowns, social distancing, boarder closures and withdrawals of staff from country offices – often constrained the ability to undertake local needs analyses and to understand new vulnerabilities in different communities. This was especially true for institutions that used international staff (many of whom were repatriated in some countries) or relied on externally conducted country visits to determine needs. health
Decentralised systems performed better, as there was greater scope for adjusting ways of working based on real-time information on what was happening in a particular context.
Many bilateral providers did undertake needs assessments or use country-level assessments conducted by the United Nations and national partners to understand in-country contexts and inform their allocation and programming decisions. For example:
Enabel, Belgium’s federal development agency, undertook a real-time exercise that allowed them to understand the decision-making mechanisms during the crisis, and the agility and capacity for innovation in times of crisis. It also allowed them to highlight what worked well and why, what required adaptation or further reflection, what facilitated the response, and the constraints and challenges encountered and how these were addressed (Vancutsem, 2020[7]).
In Bangladesh, providers engaged in a national needs assessment working group to inform targeted interventions (OECD, 2025[8]).
In Georgia, the government effectively identified the country’s needs and communicated them through various channels. Collaborating with the World Bank Group, they developed the Georgia Emergency Response Plan and utilised pre-existing IMF support to partially implement its anti-crisis plan, leveraging a donor co‑ordination platform and establishing a dedicated website to regularly communicate COVID-19 health-related needs (OECD, 2025[9]).
The Large Ocean Countries / Small Island Developing States (SIDS) case study noted that strong provider co‑ordination informed a more comprehensive understanding of the priorities and the ability to address emerging needs (European Commission, 2025[10]).
A significant challenge was the lack of funding for and structural weaknesses in data collection and analysis. Prior to the pandemic there were major challenges in the global data collection around Sustainable Development Goal (SDG) indicators, as well as fragmentation across different sources of data and evidence. The COVID-19 crisis compounded these challenges by the rising costs occasioned by the challenging operating environment. Much of the analysis of the impact was estimated and it quickly became clear that pre-2020 SDG data were out of date or unreliable. This limited the ability globally and nationally to assess impact against the SDGs and target the most effected groups including the most vulnerable.
Limited funding provided for results monitoring and evaluation hindered the ability of institutions and governments to understand the relevance of their strategy to national needs and priorities related to the pandemic response. More systematic investment in reflection and learning by some agencies showed the usefulness of such an approach which provided a deeper understanding of needs, improved targeting and gave clearer insights into outcomes. For example, the Food and Agriculture Organization (FAO) provided a positive example through its use of real-time data collection and its adaptation of existing data systems and tools to the COVID-19 context, which enabled timely decisions and appropriate course corrections (FAO, 2022[11]).
Even with these overarching challenges, there were many positive examples of the identification of needs or risks directly or indirectly related to COVID-19, with concerted action being taken to address them. For example, at the beginning of the COVID-19 pandemic, WHO predicted that malaria deaths in Africa could double if access to malaria prevention programmes and treatments were severely interrupted. However, in 2021, the African Leaders Malaria Alliance, with support from international partners, announced that an increase in deaths had been averted, with over 90% of planned net distribution campaigns being delivered, and more children in areas of highly seasonal transmission being reached with antimalarial medicines than in previous years (Devex, 2020[12]).
The World Bank is a good example in the approach to designing country-level responses in a two-fold manner, addressing both immediate COVID-19-related needs and a long-term view. In Afghanistan, for example, the first component was to urgently deliver essential primary and secondary health services, while the second component was longer term and included an element of preparedness, enhancing the health system capacity to prevent and respond to infectious disease outbreaks (World Bank, 2022[13]). In Paraguay, the first component focused on immediate containment strategies for COVID-19, while the second one focused on providing technical assistance for health system strengthening, including improving institutional arrangements for co‑ordination (World Bank, 2020[14]). In Burkina Faso, a logistics commission was established, which was responsible for providing logistical resources – such as wheels, protection, health products and diagnostic tools – and logistical co‑ordination. This was a way of ensuring that necessary resources were deployed to fill gaps, such as respiratory protection masks, the COVID-19 diagnostic test, rolling logistics for medical transport, technical medical equipment and materials, and patient biological monitoring reagents (Government of Burkina Faso, 2025[15]).
The international response of the United States was framed around its COVID-19 Global Response and Recovery Framework, released in July 2021 and updated in September 2022 (USAID, 2022[16]). It outlined the commitment to ending the emergency phase of the pandemic, integrating COVID-19 response activities into existing health systems, and strengthening global readiness for future pandemic threats by working with partners to vaccinate high-risk and vulnerable populations, scaling and integrating testing and treatment, and preparing for future variants. The US experience was one of remarkably few good examples of learning during the response and adjusting the strategy overtime (Box 3.2).
The African Development Bank (AfDB) is another interesting example as it responded to the COVID-19 crisis in Regional Member Countries through a phased deployment of policy-based operations (PBOs). Initial phases prioritised urgent health interventions and social protection for vulnerable groups. Subsequent phases shifted their strategic focus to economic stabilisation and recovery. This phased approach allowed the bank to address immediate public health needs while laying the groundwork for long-term economic resilience (AfDB IDEV, 2022[17]).
France’s Health in Common initiative provides a useful example of the challenge of matching continuity and speed with effectively aligning with priority needs. The relevance of the initiative to country needs and priorities was considered broadly satisfactory (AFD, 2024[4]). In line with the French Development Agency’s (AFD) intervention framework, African countries, particularly French-speaking ones, were prioritised, receiving respectively, 74% and 63% of the total amount allocated. The ocean basins where France has territories (Indian Ocean, Pacific Ocean and Atlantic Ocean) also received strong support.
While Mauritius and the Dominican Republic received substantial amounts in the form of loans, their geographical proximity to French territories would not appear to have been a determining factor. Madagascar also received a significant proportion of the initiative’s grants. However, in a context of crisis, and with future crises in mind, adhering strictly, without revision, to AFD’s overall intervention framework raises several questions. The priority given to French-speaking countries can be questioned. Multi-country projects could have targeted neighbouring countries (not necessarily French-speaking countries) to enable their governments to put in place more coherent and effective measures for the surveillance and control of the disease (AFD, 2024[4]).
Source: AFD (2024[4]), Evaluation of the Health in Common 2020 Initiative (HIC 2020), https://proparco-prod-waf.cegedim.cloud/en/ressources/evaluation-health-common-2020-initiative-hic-2020.
In April 2020, the United States Agency for International Development (USAID) conducted a best case/worst case exercise to project possible trajectories for the COVID-19 crisis and its impact. In August 2020, the agency evaluated the changing landscape against these scenarios as part of a strategic review. The analysis gathered information on the state of the pandemic at that time, including outlining the various impacts of the pandemic on different sectors and geographic areas.
USAID conducted follow-up landscape analyses in March 2021, January 2022 and November 2023, to provide high-level syntheses of data, both from its own data and that of external sources, to better understand the global impacts of the pandemic. The data included real-time daily updates on case numbers and second-order impacts, modelled forecasts of COVID-19’s impacts, quantitative estimates of underlying risks and vulnerabilities, high-frequency phone surveys of households, and qualitative research and reports from third-party institutions.
The analyses gathered information on the impacts of the health crises on partner countries, including their health systems; actual and projected cases and mortalities; vaccine distribution; impacts on governments, economies and households; mobility constraints and migration; education; and intersectional factors that exacerbated the impacts felt by certain groups. The reports did not offer recommendations for policy or programming but presented analysis on which areas were most heavily effected and the implications of the impacts.
In 2022, USAID conducted an agency-wide pause and reflect exercise on the COVID-19 response and how well the institution had adapted to the changing needs of the pandemic context. This was an iterative process to analyse evidence and insights to generate lessons learnt and inform future decision making on crisis readiness and responses. The focus of the exercise was on adaptations, second-order effects, unintended outcomes of pandemic responses, localisation and inclusive development.
Source: OECD (2022[18]), Development Co-operation Peer Reviews: United States 2022, https://doi.org/10.1787/6da3a74e-en; USAID (2022), COVID Big Picture Reflection: Lessons Learned Report.
There was mixed evidence on the uptake of lessons from other crises to inform the design of the pandemic response, and the extent to which ongoing learning was integrated into development and humanitarian actors’ activities to enable identification to improve the ongoing response or future responses.
Although many development actors and national governments explicitly called for and worked to apply lessons in the early stages of the pandemic, there was still a consensus among interviewees that some mistakes were made that could have been avoided with greater attention to the available evidence base. The COVID-19 response suffered from an underinvestment in preparedness and adaptations to be ready to respond before the crisis hit, as well as relatively weak support for locally led action and community engagement. There was insufficient attention to protecting vulnerable groups or to sexual and gender-based violence (SGBV) and mental health needs. These findings echoed challenges from previous crises (ALNAP, 2024[2]).
Key lessons from previous crises, such as outbreaks of Avian Influenza, SARS, Ebola and Cholera, included providing a response that went beyond just health needs and acknowledged the need for large volumes of flexible funds. Successes in applying these lessons included the mobilisation of large volumes of funding, the reallocation of funding to enable timely responses, and the inclusion of water, sanitation and hygiene (WASH) activities in community outreach. There was an unprecedented number of rapid evidence reviews and syntheses from global evaluation communities with evaluators putting on hold evaluation plans to focus on supporting the ongoing response (OECD, 2021[19]),drawing lessons from past crises affecting health and food systems, including the global HIV/AIDS pandemic (UNEG, 2021[20]). This included providing context specific social protection measures (with considerations to economic, financial, infrastructural, political, environmental and social factors), utilising cash transfers and broadening scope to include not only core target beneficiaries but also the most vulnerable when tackling food insecurity (UNEG, 2021[20]). UNAIDS was pro-active in identifying key messages to inform the COVID response (see Box 3.3). In 2011, a crisis response window (CRW) was established by a World Bank fund to provide prompt support to eligible countries experiencing severe crises caused by natural disasters, economic shocks, or public health emergencies. For example, an allocation in 2017 to Yemen helped them deal with a Cholera outbreak amid continuous conflict (IEG/World Bank, 2019[21]). This was mirrored in the Fast-track COVID-19 Facility that the World Bank established to address immediate needs from COVID-19 (World Bank, 2020[22]).
During the Avian Influenza outbreaks from 2006-2014, weak connections between the government and grassroots organisations in some countries hindered the reporting of critical case information for disease monitoring (IEG/World Bank, 2014[23]). Reporting was also affected by limited behaviour change among affected communities, who often downplayed the risk of human disease (FAO, 2010[24]). This lack of timely and reliable access to community-level data undermined the effectiveness of investments in formal disease monitoring and surveillance systems, highlighting the need for the mobilisation and co‑ordination of civil society and community-based organisations for effective COVID-19 monitoring. Coalition participants reported many examples of where these lessons were used to inform COVID-19 response strategies, though there is limited evidence to assess the full effectiveness of these efforts.
The Ebola crises proved that co‑operation and coalition building between countries can strengthen response performance and address longer-term needs; the Africa Centres for Disease Control and Prevention (Africa CDC) was set up as a regional network after Ebola to improve the response of public health institutions to disease outbreaks or public health threats across the continent (see Box 3.2 and (Gold and Hutton, 2020[25])). Kenya’s experience also highlighted how the government developed a COVID-19 contingency plan very early in the pandemic (January 2020) by adapting its existing National Ebola Virus Disease co‑ordination structures (OECD/AfDB, 2025[26]).
However, interviews and multiple evaluations show many examples where available evidence was not sufficiently applied and mistakes were made that could have been avoided (OECD, 2022). For example, a lack of attention to the needs of children – especially girls – out of school was cited by many respondents as insufficiently addressed, despite knowledge from past crises about the often-devastating impacts of school closures (including regressive effects). An opinion survey, which mainly captured the views of staff working in bilateral development co-operation agencies, found that of ten areas identified, the “use of evidence from previous crises” and the “need for consultation of partner country stakeholders” were the areas where most felt improvement was needed (OECD/DEval, unpublished[27]).
Many countries support the COVID-19 Global Evaluation Coalition project as a means of promoting learning and accountability (Box 3.4), and about half of DAC members evaluated their COVID response or carried out other structured learning exercises (OECD, 2022[28]). Evaluation units of UN agencies and multilateral banks reported many evaluations related to COVID response projects and strategies.
Still, all partners identified a key weakness in the lack of instruments or mechanisms for learning from the crisis and deriving lessons. Case studies and additional evidence also show that experience from past emergency responses, such as from the 2014-2015 Ebola pandemic in West Africa or the HIV/AIDS pandemic, was not systematically applied due to weak knowledge management systems. Instead, knowledge use was largely ad hoc and person to person, based on staff’s prior professional experience. Notably, weaknesses in knowledge management had been highlighted by evaluations of previous crisis responses, and yet still proved to be a weakness during the COVID-19 crisis (WFP, 2022[29]).
The learning-related and evidence use challenges faced in international cooperation mirrored the broader crisis context where many governments struggled to account for the multiple negative effects of pandemic-related restrictions, and to balance efforts to contain the disease with broader socio-economic harm (Williamson et al., 2022[30]). Likewise in international development and humanitarian agencies, the crisis response highlighted persistent gaps in mechanisms to inform decision making with existing evidence, enable ongoing learning, monitor results, gather impact data, and use cost-benefit analysis (OECD/IOB, 2025[31]). Exploring ways to make monitoring, learning and evaluation actionable and realistic in times of crisis – especially for implementing partners – could improve future accountability and facilitate learning.
Some relevant key messages on relevance and learning emerged from the case studies:
South Africa’s evaluation found that “Having means for monitoring and evaluating the implementation of an international relations strategy would enable policymakers and implementers to understand in real time if their strategy is achieving the intended results and, if not, to make mid-course corrections. […] It allows them to learn lessons about managing such crises and so develop the institutional memory that will lead to more effective responses to any future crisis.” (Presidency of South Africa, 2021, p. 599[32]).
The German case study and an evaluation of AFD’s crisis response both identified the lack of a cross-government body to monitor and identify lessons, as weaknesses (DEval, 2024[3]; AFD, 2024[4]). In the German case, the COVID-response mechanism was wrapped up quickly and did not have a clear mandate to capture lessons or support ongoing reflection beyond the immediate response period.
The national report on China’s international pandemic assistance provides a description of funding and supplies but does not provide much detail in terms of lessons or areas that could be improved in future crisis responses (CIKD, 2023[5]).
The Spanish case study recommended that future similar strategies have a results framework to allow for a better assessment of achievements and areas for improvement (Ministerio de Asuntos Exteriores, Unión Europea y Cooperación, 2024[33]).
According to the findings from the Netherlands’ study, an overarching strategic crisis response plan based on lessons learned and with high-level political support could improve the crisis preparedness of the Ministry of Foreign Affairs and minimise risks of institutional memory loss and strategic uncertainties following ad hoc political decision making. Task forces set up to respond to the crisis were disbanded before capturing formal operational lessons for future crises. Further, the evaluation team did not find institutionalised lessons from past crisis responses (HIV/AIDS and Ebola in particular), and the use of previous experience likely depended on decisions of individual policy officers.
Establishing crisis response plans ahead of time could assist in capturing and making available key insights from past experiences. Such pre-plans could also provide guidance on the basic elements of a crisis response such as which partnerships and channels to leverage, which co‑ordination mechanisms to activate, and how to establish feasible monitoring and reporting requirements. Finding a balance between strategic planning and a timely response could lead to benefits in terms of relevance, coherence, efficiency and effectiveness (OECD/IOB, 2025[31]).
In 2020, UNAIDS published seven key takeaways from its work with the HIV crisis to inform the COVID-19 response, providing a useful example of learning from previous crises. Though it is difficult to determine the extent to which these were fully incorporated into the COVID response, many stakeholders highlighted that these lessons later proved to be highly relevant and were useful when applied, for example as part of public health communication around vaccination campaigns:
1. Engage affected communities from the beginning in ALL response measures – to build trust, ensure suitability and effectiveness, and to avoid indirect or unintended harms and ensure the frequent sharing of information.
2. Combat all forms of stigma and discrimination, including those based on race, social contacts, profession (healthcare workers), and those directed towards marginalised groups that prevent them from accessing care.
3. Ensure access to free or affordable screening, testing and care for the most vulnerable and hard to reach.
4. Remove barriers to people protecting their own health and that of their communities: fear of unemployment, healthcare costs, presence of fake news/misinformation, lack of sanitation infrastructure and so forth.
5. Restrictions to protect public health must be of limited duration, proportionate, necessary and evidence-based and reviewable by a court. Put in place exceptions where necessary for vulnerable groups and to ameliorate the consequences of such restrictions. Blanket compulsory bans are rarely effective or necessary. Individuals should not be criminalised for breaching restrictions.
6. Countries must work to support each other to ensure no country is left behind, sharing information, knowledge, resources and technical expertise.
7. Support and protect health care workers. Be kind to each other. Join and support efforts that build trust and amplify solidarity, not sanctions.
Source: UNAIDS (2020[34]), “Rights in the time of COVID-19: Lessons from HIV for an effective, community-led response”, https://www.unaids.org/sites/default/files/media_asset/human-rights-and-covid-19_en.pdf.
In 2020, the participants of the COVID-19 Global Evaluation Coalition worked together to rapidly synthesise and communicate relevant evidence from previous evaluations to inform the pandemic response as it unfolded. The Coalition carried out a mapping of synthesis work to support the harmonisation of shared lessons. It also produced its own “Lessons from Evaluation” series. Many participants saw an uptick in requests from evaluation units to provide evidence to inform the unfolding response efforts. They noted an openness to drawing on lessons and a measure of humility in the face of an unprecedented crisis.
Five briefs in the Lessons from Evaluation series were produced in an average of 10-15 days, pulling together evidence on topics that were being discussed in meetings of development ministers convened by Canada and the United Kingdom. Through the evaluation department of Global Affairs Canada, the evidence briefs were fed into preparatory reading packs and helped create more informed discussions of response strategies.
The UNDP Independent Evaluation Office produced a series of lesson briefs on topics including social protection and health sector support, by May 2020.
Building on the Coalition’s initial brief, four UN agency evaluation departments joined forces to develop the “Evidence Summary on COVID-19 and Food Security” report which was used widely to inform nutrition and food security related efforts (UNEG, 2021[20]).
The Independent Evaluation Office of the Asian Development Bank used findings from past evaluations to support the vaccine roll out efforts (ADB, 2021[35]).
Note: Norad and Norway’s Public Health Agency worked with the OECD to synthesise findings on digital tools for supporting vaccine uptake, communicating with the public about vaccines and the effects of digital interventions for promoting vaccination uptake (Glenton and Lewin, 2020[36]; Lewin and Glenton, 2020[37]).
When looking at international assistance, needs and priorities are understood not only in terms of the pandemic risks themselves and general needs including population vulnerabilities, the fiscal capacity of the government, and higher needs related to overall income levels. Whilst the pandemic had a global impact, both the pandemic and response measures impacted countries very different, and countries had different levels of resources, readiness and capacity to respond.
Provider response to the pandemic needed to reflect the diversity of emerging needs (and a high level of uncertainty about how specific needs might change) as well as a general understanding of a country’s vulnerabilities (for example prioritising SIDS or least developed countries).
Multiple factors drove allocations, including historical ties and existing co‑operation relationships (as illustrated by Türkiye’s pandemic assistance in Figure 3.2); geopolitical dynamics between countries; perceived levels of vulnerability to the pandemic, including response capacities; and practical considerations such as access and proximity. Dynamic exchanges resulted in requests for support and responses, sometimes with consolidated requests and sometimes bilateral. For example, Finland received and responded to several requests for assistance, including from long-standing partners such as Nepal, as well from some countries with whom they did not regularly collaborate (Ministry of Foreign Affairs of Finland, 2022[38]). Mexico and New Zealand both provided support primarily to neighbouring countries in their respective regions. The United States and China both provided assistance to a large number of countries, including major support to historic partners (CIKD, 2023[5]); (USAID, 2022[16]). France’s Health in Common pandemic initiative prioritised Africa and the three ocean basins in line with its overarching co-operation strategy (AFD, 2024[4]).
In the aggregate there was only a weak correlation between regional or country risk and funding provided. In some cases, total funding did align well with pandemic-related indicators of needs (such as total cases or fatalities) but this seems to have been more as a result of happenstance, rather than of strategic targeting.
Meeting needs globally involved matching needs to funding sources available for different countries. For example, in Nicaragua, where most large funders were not operating bilaterally in 2020, the Central American Bank for Economic Integration (CABEI) provided Nicaragua with a USD 300 million loan to support projects on education, health, housing, road infrastructure, agriculture/rural development, fishing, climate change, and micro and small businesses (OECD, forthcoming[39]). Spain’s ODA allocations showed a relevant split across sectors targeting the COVID-19 response, particularly social services (Ministerio de Asuntos Exteriores, Unión Europea y Cooperación, 2024[33]). However, this was not always the case. For example, in SIDS there was less of a concerted effort to proactively address the broader socio-economic impacts beyond immediate public health needs such as testing, PPE and vaccines (European Commission, 2025[10]).
Case studies and peer reviews show that bilateral support was only partially needs based. In the Netherlands, for example, the bilateral response involved interministerial co‑ordination, which experienced some challenges due to ad hoc political decision making. The lack of needs assessments to assist in determining which countries to support bilaterally led to some internal incoherence. In France, the reliance on existing partnerships was more of a driver of funding decisions than needs assessments.
Source: Güngör (2021[40]), Foreign aid during the COVID-19 pandemic: Evidence from Turkey, https://www.graduateinstitute.ch/library/publications-institute/foreign-aid-during-covid-19-pandemic-evidence-turkey.
Support by country income group
Despite early indications in 2020 that rates of COVID-19 infection and mortality were higher in high-income countries (HICs), in 2021, there was an increase in cases in lower-middle-income countries (LMICs). Lower vaccination rates in middle-income countries (MICs) compared with HICs, meant they had a higher share of cases and mortality. Surges in case numbers and recorded deaths in low- and medium-income countries, including in Latin America and Asia, occurred at different times. The timing of lockdowns and other public health measures also varied.
While, overall, low- and middle-income countries reported relatively fewer deaths, the cascading socio-economic impacts of policy decisions related to the pandemic were very high in poorer countries and the averages obscure significant variation between countries (Our World in Data, 2024[41]). There is ongoing research and debate about the suitability and effectiveness – including unintended effects – of various policy responses (e.g. school closures, support to businesses and social protection), which created the backdrop for international co-operation efforts, including efforts to serve as trusted advisors and technical partners. The ultimate potential effectiveness of international efforts was considerably constrained by these broader contexts.
Building on existing relationships – the approach taken by all bilateral providers studied – had advantages in terms of efficiency (particularly speed) and effectiveness, even if it meant there was less room for increasing relevance through allocation decisions. This observation was supported by several other evaluations, as well as the global analysis of where assistance was spent in 2020-2022. The New Development Bank’s (NDB) provision of USD 1-2 billion loans to its members countries, was another example of existing relationships underpinning rapid, large-scale funding that was broadly targeted and highly relevant, while not being specifically needs-based (Box 3.5).
An example comes from Lebanon, a country significantly affected by COVID-19 and other crises, which depended on outside support to address the needs of those most vulnerable people including refugees and host communities. Prior to the pandemic, Lebanon was among the top five recipient countries of German development co-operation. From 2020-2022, Germany provided EUR 144 million to support Lebanon through one of its main response programmes, the Emergency COVID-19 Support Programme (DEval, 2024[3]).
The New Development Bank (NDB)’s Emergency Assistance Programme Loan was approved 19 March 2020. Its financing facility approved up to USD 10 billion in loans to support the COVID-19 response in its founding member countries of Brazil, China, India, Russia and South Africa.
An evaluation report by NDB’s Independent Evaluation Office (IEO) estimates that through this financing, the member countries were able to provide much needed support to 2.2 million health workers, as well as USD 4.17 billion in income support to 206.5 million women, and ex-gratia payments of USD 13.5 each to 28.1 million senior citizens, widows, and individuals with disabilities. Additionally, the COVID-19 Response Programmes targeting India were estimated to have contributed to generating 5.4 billion person-days of employment, with 52% going to women. It ensured that 100% of district hospital doctors and nurses were trained to meet WHO standards, with 61% of them being women.
Source: NDB (2023[42]), ‘’Evaluation of NDB’s Fast-Track Support To The Covid-19 Emergency’’, https://www.ndb.int/wp-content/uploads/2024/02/COVID-19_Evaluation-Report_Feb20_final.pdf.
Responding to COVID-19-specific needs
While country contexts and relationships between providers and recipients vary significantly, analyses show that COVID-19-related needs did impact funding decisions. Through a combination of adjusting ongoing programmes and funding new initiatives, providers were able to support relevant activities to meet changing needs.
Existing health conditions and social vulnerabilities led to higher rates of COVID-19 infection, hospitalisation, morbidity and mortality. Globally, the number of new deaths attributed to the pandemic generally decreased with the reduced severity of newer variants, improved treatment approaches, shifts in the affected population towards younger cohorts, higher COVID-19 vaccination rates and population immunity from previous waves, as well as hospitals becoming gradually less overwhelmed (Horwitz et al., 2021[43]; Eggermont, 2021[44]).
Several countries saw significant increases in the amount of health-related assistance received, with Colombia seeing a 15-fold increase from 2019-2020. In some cases, this funding seems to have effectively targeted countries the most impacted by the pandemic. For example, Iran and Peru – both of which were among the hardest-hit countries in terms of COVID-19-related deaths (Johns Hopkins, 2023[45]) – saw 10-fold increases in support from 2019-2020. Other notable increases in health-related assistance in LICs include Mauritania (299% increase from 2019-2020), Cambodia (126% increase), and Madagascar (87% increase). An analysis of health funding flows for the ten low-income countries1 with the highest cases or deaths per capita shows an increase in health-related assistance to these countries between 2020-2022. However, assistance for these high-need countries was already growing by an average of 12.8% per year from 2014, showing that ODA was likely already targeting the high levels of health needs.
The decrease in health disbursements beginning in 2022 may reflect the transition from the emergency response to the recovery phase, which prioritised economic recovery. Russia’s full-scale war of aggression against Ukraine also significantly shifted spending starting in 2022. For many recipient countries, however, sustained funding remained essential. The rapid reduction in assistance to health highlights the challenge of sustaining large volumes of funding outside of a crisis response.
The case studies also highlight how COVID-19 unfolded differently across countries. Georgia experienced the highest disease burden among the case study countries, with 489 351 cases and 4 517 deaths per million, more than double the figures reported in the next most-affected country, Lebanon (Our World in Data, 2025[46]). Lebanon and Cabo Verde also had high disease burdens and received relatively high levels of ODA per capita. They were able to vaccinate 35% and 56% of their populations, respectively (WHO, 2025[47]). However, in Lebanon, while some new funding announcements were made during the COVID-19 pandemic, overall development finance continued to decrease over this period, despite the increasing needs in the country (OECD, 2025[48]). Interestingly, Bangladesh, which received the lowest ODA per capita among the case study countries, achieved a vaccination rate of 86% of its population completing a primary series (WHO, 2025[47]). In contrast, Cambodia had similar levels of COVID-19 cases and vaccination rates but received more than twice as much ODA compared to Bangladesh.
In Burkina Faso, a logistics commission was established, responsible for logistical co‑ordination as well as ensuring that necessary resources were deployed to fill gaps, such as respiratory protection masks, COVID-19 diagnostic tests, rolling logistics for medical transport, technical medical equipment and materials, and patient biological monitoring reagents (Government of Burkina Faso, 2025[15]) .
Several evaluations, including the COVAX evaluation, the system-wide evaluation of the UN development response, and those by Finland, France, and Germany highlighted that multilateral actors played an important role in achieving a relevant, effective, cost-efficient and timely crisis response as they were able to call on existing systems, long-term contracts and comprehensive experience in humanitarian aid (DEval, 2024[3]; AFD, 2024[4]; Itad, 2022[49]; UNSWE, 2022[50]).
The COVID-19 response programmes of France, Germany, the Netherlands, Spain and Saudi Arabia all found that the distribution of most funds to existing partnerships was found to contribute to enhancing the efficiency of the programme in terms of timeliness but also the relevance of the programme as most existing partners were highly vulnerable and in need of support during the pandemic (Ministerio de Asuntos Exteriores, Unión Europea y Cooperación, 2024[33]). These underlying drivers of timeliness and relevance were broadly applicable and can apply to future support.
Flexibility to respond to needs: the use of budget support
Budget support and policy-based lending became key instruments during the emergency phase of the COVID-19 response, in contrast to a low and stable use before the pandemic (OECD, 2025[1]). Budget support was used to increase the fiscal space in countries, thereby maintaining macroeconomic stability in recipient countries. While much of this support was not specifically tagged as COVID-19-related, it had an important role in stabilising government spending in the face of economic contraction and the need to quickly fund pandemic-related priorities, including the health sector and social protection measures (Figure 3.3).
Budget support and macro-financial assistance helped partner governments to finance their emergency fiscal and socio-economic packages and created a platform for policy dialogue. Budget support was a major channel used by many bilateral providers, as well as the European Union and multilateral development banks to ensure timely and effective delivery of flexible support to partner countries packages (European Commission, 2022[51]; OECD, 2021, p. 6[52]). In some countries, this built on existing partnerships and provided continuity for ongoing reforms. In other cases, the exceptional circumstances led to the use of budget support where it had not previously been provided – showing the increased flexibility demonstrated in the crisis setting.
All donors, USD billion disbursements, constant 2023 prices
Note: This graph was created by filtering a combined 2016-23 CRS dataset for co‑operation modality. General budget support was then split by COVID-19-related assistance using purpose code 12264 and keywords containing “COVID”.
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52.
In Cambodia, development partners provided significant budget support and macroeconomic support packages, creating much-needed fiscal space and contributing to both an effective pandemic response and the economic rebound of the country. They collaborated with the Cambodian government to enhance social protection policies, implementing cash transfers and cash-for-work programmes that targeted the poor and vulnerable populations, mitigating the secondary social and economic effects of COVID-19 (OECD, forthcoming[53]).
In the Africa region, the African Development Bank’s (AfDB) support enabled the provision of services, such as water and electricity, either for free or at reduced rates while also supporting humanitarian efforts. Nigeria was among the countries that were able to develop a social safety net register for transient vulnerable and poor populations, increasing the number of beneficiaries of support. It continues to provide information on vulnerable households that are likely to be affected by similar crises in the future (AfDB IDEV, 2022[17]).
Bangladesh, with a general government gross debt in 2020 of 34.5%, actively sought budget support from providers for its response and recovery plan for the education sector and cash support programmes (World Economics, 2025[54]; IMF, 2025[55]). The AFD provided essential budget support to Bangladesh, specifically directed towards strengthening the healthcare system and reinforcing non-contributory health protection mechanisms (OECD, 2025[8]). The majority of Saudi Arabia’s aid to Bangladesh in 2020-2021 consisted of budget support whereas in previous years aid was predominantly geared towards infrastructure.
In Nicaragua, which faced a particularly challenging context in 2020 due to political rupture with several key partners, the IMF provided multi-sector budget support of USD 464 million in Rapid Credit Support, along with Rapid Financing Instrument support of USD 124 million. This was conditional on enhancing fiscal transparency, especially related to COVID-19 spending (IMF, 2020[56]).
New Zealand developed a series of emergency budget support packages to respond rapidly to COVID-19 in the Pacific Small Island Developing States (SIDS) and helped to preserve countries’ cash reserves and government revenues, allowing partner governments to finance priority measures, such as economic stimulus packages, social protection payments, and support for small businesses, particularly in tourism Box 3.6.
Japan provided a 50 billion yen “COVID-19 Crisis Response Emergency Support Loan” to the Government of Viet Nam enabling measures such as deferring consumption tax, corporate tax, rent and other payments in specific sectors affected by the COVID-19 pandemic; subsidizing loan interest payments; and providing low-interest loans to ethnic minorities and residents of mountainous areas. Such financial support also served as a social safety net for industries and vulnerable groups in the country that were severely affected by the pandemic and contributed to the development of an environment that is resilient to infectious diseases.
The use of budget support depended on the overall governance and public financial management context of the country, as well as partner relationships and the risk appetite of providers. Budget support was provided most often in settings where it was already being used by the two involved partners and the governance context was favourable. It was less available to poorer countries and those with weaker institutions where there was a lack of trust between providers (Wilton Park, 2020[57]).
Budget support was particularly relevant in contexts where pre-existing high levels of debt limited access to other sources of financing for the COVID-19 response (Centre for Disaster Protection, 2023[58]). In Cabo Verde, which had a high general government gross debt of 143.8% in 2020, the bulk of pandemic aid was provided through budget support, with the central government securing more than 86% of COVID-19 assistance through this means. This approach was relevant as it significantly expanded the country’s fiscal space, preventing any further extension of its debt-stress and enabling the Government of Cabo Verde to implement its national pandemic response, improve its health and social responses and ease the impact on the most vulnerable. Despite budget support forming the bulk of assistance, the debt-to-GDP ratio went up sharply, from 109% to 144% in 2020, and then decreased to 121% in 2022, leaving the country vulnerable to global economic challenges, including inflation (OECD, 2025[59]).
Unearmarked and pooled funding played an important role for the flexibility of funding during the crisis. The case study from the Netherlands found that the decision to primarily provide unearmarked and pooled funding granted useful flexibility that enabled partners to provide relevant support as circumstances changed. The Spanish case study recommended that in the future the government use general contributions to multilateral organisations, which then decide on priorities, to avoid an imbalance between pillars, with overfunding of some over others, as happened with the vaccine pillar compared to diagnosis, treatment or strengthening of health systems pillars. It was also found that some of the instruments of Spanish co‑operation are too rigid to respond to emergency situations, which limits support to non-targeted interventions or generic funds.
The evaluation found that pooled funds were another important part of the funding landscape in responding to the pandemic, particularly due to the flexibility, timeliness and responsiveness that they provide (DEVNIT, 2022[60]). For example, the UN Central Emergency Response Fund (CERF), a global pooled fund designed to provide rapid access to flexible funding for countries in crisis, was used to support lifesaving activities in response to the COVID-19 pandemic. The provision of unearmarked, core funding for national and international non-governmental organisations (NGOs) and multilateral organisations, was emphasised across several evaluation reports and studies as a key enabler of flexibility and adaptation (Norad, 2020[61]; ICAI, 2022[62]; UNICEF, 2020[63]; OCHA, 2021[64]; EBA, 2022[65]; Sida, 2021[66]).The availability of flexible funding was fundamental for a timely response, particularly in the early stages of the pandemic.
New Zealand provided emergency fiscal budget support to help 12 Pacific Small Island Developing States to maintain stability and recover from the COVID-19 pandemic. This included four countries where New Zealand did not have reform-linked budget support programmes in place. Whilst rapid deployment precluded in-depth dialogue on policy reform, the approach allowed partner governments to finance priority measures. As a result, a COVID-19 package of NZD 50 million was rapidly delivered, allowing partner government-driven recovery and facilitating governments to finance priority measures such as economic stimulus packages, social protection payments and support for small businesses, particularly those linked to tourism.
New Zealand’s support not only maintained the stability of state institutions and public services, but it strengthened relationships between its Ministry of Foreign Affairs and Trade (MFAT) and affected partner countries. New Zealand intends to increasingly use this experience of emergency fiscal budget support, as well as its existing reform-lined budget support, to channel part of its scaled-up climate financing.
To ensure the economic and social resilience of the Pacific SIDS during the pandemic, this funding was provided in addition to New Zealand’s existing reform-linked budget support as a complementary measure to avoid undermining pre-existing reform focused budget support. New Zealand’s years of experience in delivering reform-linked budget support was seen as a crucial factor in the success of this approach as it ensured familiarity with partner government systems and helped Pacific SIDS maintain stability and recover from the crisis. (OECD, 2023[67]).
Source: OECD (2023[67]), Using Budget Support to Respond Rapidly to COVID-19 in Pacific Small Island Developing States, https://www.oecd.org/en/publications/2021/03/development-co-operation-tips-tools-insights-practices_d307b396/using-budget-support-to-respond-rapidly-to-covid-19-in-pacific-small-island-developing-states-sids_10d612ff.html; New Zealand Ministry of Foreign Affairs and Trade (2025[68]), New Zealand’s International Development and Humanitarian Response to the COVID-19 Pandemic (2020-2022), https://www.mfat.govt.nz/assets/Aid-Prog-docs/Evaluations/2025/OECD-COVID-19-Global-Evaluation-Coalition-New-Zealand-Case-Study.pdf.
Targeting vulnerable countries
Certain countries and territories are generally considered more vulnerable based on economic, geographic, political, and societal factors (OECD, 2024[69]). The four categories of countries and territories most in need are LDCs, landlocked developing countries, SIDS and fragile contexts (some of these categories overlap and a country can be counted in more than one).
The surge in support during the COVID-19 crisis is more pronounced when looking at vulnerable countries (heavily indebted poor countries, LDCs, land-locked developing countries and SIDS) (Figure 3.4), with ODA as a percentage of GNI increasing in 2020 due to both economic constriction and increased assistance. However, funding for these groups of vulnerable countries quickly returned to pre-pandemic levels or in most cases dropped below those levels in 2022.
For heavily indebted poor countries (HIPCs), there was a small uptick in aid received in 2020, from 5.41% to 6.84%, likely reflecting emergency COVID-19 support. However, this quickly tapered off, falling to 5.75% in 2021 and declining further to 4.79% by 2023, below pre-pandemic levels. A similar pattern was observed for landlocked developing countries (LLDCs), where ODA as a share of GNI rose from 3.63% in 2019 to 4.35% in 2020, before steadily decreasing to 2.95% in 2023.
Least developed countries (LDCs) saw a slight pandemic increase of ODA, from 4.67% in 2019 to 5.61% in 2020. But again, this was not sustained, falling back to 4.09% in 2022, before edging up slightly to 4.26% in 2023, broadly in line with pre-pandemic trends. Small Island Developing
States (SIDS) experienced greater volatility. After dipping in 2019, ODA rose to 2.28% in 2020, declined slightly in 2021 and 2022, and then rebounded to 2.19% in 2023.
Figure 3.5 shows a different perspective on this trend, based on the amount of assistance received by groups of countries and territories most in need. Each of these classifications experienced a similar trend from 2016-2023 with assistance increasing steadily from 2016-2019. They then experienced a larger than usual increase in 2020, a slight decrease between 2020-2021, and a relative stabilisation in 2022-2023.
All providers, USD millions, constant 2023 prices
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52; OECD (2024[69]), Countries and territories most in need, https://web-archive.oecd.org/temp/2024-03-07/380032-countries-most-in-need.htm.
All donors, all flows, net disbursements using constant USD
Notes: Graph created using data as per source, which calculates the figure as net official development assistance (ODA) divided by gross national income.
Source: Our World in Data (2025[70]), Foreign aid received as a share of national income, https://ourworldindata.org/grapher/foreign-aid-received-as-a-share-of-national-income-net?tab=chart&time=2016..latest&country=Heavily+indebted+poor+countries~Least+developed+countries+%28OECD%29~Land-locked+developing+countries+%28OECD%29~Small+island+states+%28OECD%29.
Reaching vulnerable populations
The pandemic had distinct impacts on different groups of people, including different ages and social groups (unhoused, mentally ill or disabled people). Men were affected more than women by the COVID-19 disease, in terms of incidence, hospitalisation and death, especially in South Asia and Latin America (Grown and Sánchez-Páramo, 2021[71]; Flor et al., 2022[72]). However, women and young people were more negatively impacted in terms of jobs, income and safety, with women more likely to lose their jobs in developing countries (Bundervoet and Davalos, 2021[73]). This was attributed to the higher number of women working in the informal and social sectors than men, as well as women engaging in higher levels of unpaid work at home, including caregiving (Georgieva et al., 2020[74]). Many women and girls faced disproportionate increases in caregiving demands, with the crisis deepening unequal intrahousehold power dynamics and existing inequalities (OECD, 2020[75]).
Addressing the unequal impacts of the pandemic – particularly in terms of gender inequality – and targeting marginalised people and communities, was a high-level priority for many development and humanitarian actors. This was in line with broader trends in the strategic priorities of development agencies leading up to the pandemic, which increasingly emphasised inequality and leaving no one behind. While the evidence shows that the crisis response did not see a step change in the approach, it does provide many positive examples of how vulnerable populations were reached, such as that of Ireland (Box 3.8).
There is limited evidence and data on how well the COVID-19 response addressed the needs of vulnerable groups in different contexts, including people living with disabilities, the elderly, Indigenous populations, and the lesbian, gay, bisexual, transgender, intersex, and queer or questioning (LGBTIQ+) community (ALNAP, 2024[2]). Assessments occasionally considered vulnerable groups, but few applied a systematic protection, gender, or inclusion lens, often relying on rough estimates for disability data (IAHE, 2022[76]). The specific needs arising from intersecting factors such as age, gender and disability were poorly understood and inconsistently addressed.
Evaluations highlighted weaknesses in the needs analyses of vulnerable groups and in the availability of gender-based analyses, such as the needs of children with disabilities, women subject to gender-based violence (GBV), and female-headed households. Gaps were also noted in the availability of disaggregated data, with the humanitarian needs of older people and people living with disabilities being given insufficient attention, despite it being known that they were particularly vulnerable to COVID-19 (IAHE, 2022[76]). The case study of Georgia illustrates well the dynamic seen across many crisis responses: a strong emphasis at the political level, but unclear implementation and results of the commitment to an equitable crisis response (OECD, 2025[77]).
This lack of robust needs analyses was compounded by the scale of the need, limitations in movement, difficulty in accessing vulnerable populations and a lack of disaggregated data by vulnerability indicators (e.g. age, gender and disability). The evaluation carried out for the Inter-agency Standing Committee (IASC) highlighted that in countries where access to the most vulnerable people was already constrained or denied before the pandemic, such as in Somalia, Syria and Nigeria, there was little mention and limited understanding of the needs of these acutely vulnerable communities (IAHE, 2022[76]).
In all countries, there was a worrying rise in gender-based and intimate partner violence, sometimes referred to as a “shadow pandemic”. Access to services supporting survivors of domestic violence was reduced due to pandemic-related movement restrictions, and in some cases, people were forced to lock down at home with abusers (U.S. Global Leadership Coalition, 2022[78]; UN, 2020[79]).
Development partners made important efforts to scale up support and ensure continuity of services – especially in 2021 when the scale of the problem became clear. For example, UNICEF advocated for social workers to be classified as essential staff in Sri Lanka and China, ensuring they had permits to allow them to continue their work with GBV survivors in Zimbabwe, and supporting a helpline in Mauritania, which has responded to hundreds of calls about rape, domestic violence and harassment (UNICEF, 2021[80]).
Multilateral agencies provided positive examples of advocating for and working to include the needs of the most vulnerable in their responses. Given the increase in GBV, many agencies, including UNFPA, advocated for the necessity of sexual and reproductive health rights and GBV services, despite the difficult circumstances. UNFPA’s approach to assessing the needs of populations was multifaceted and tailored to the specific contexts of different countries (UNFPA, 2024[81]). The WFP stressed the importance of recognising shifts in patterns of vulnerability and identifying new populations in need of its support. It worked to ensure that beneficiary targeting was adapted to needs, including through the identification of new beneficiaries and the transfer of existing beneficiaries to new forms of assistance, such as from school feeding to social protection schemes (WFP, 2022[29]).
The system-wide evaluation of the UN’s socio-economic response to COVID-19 found that the level of attention paid to gender equality, human rights, disability inclusion, and the “leave no one behind” principle in the socio-economic response plans (SERPs) and other planning documents varied across countries. A review of SERPs found a lack of focus on important vulnerable groups, such as Indigenous people, minorities, people living with HIV/AIDS, people with disabilities and the LGBTIQ+ communities (ICAI, 2022[62]). In Cabo Verde, an After-Action Review convened by WHO highlighted challenges faced by vulnerable people including the homeless and mentally ill within the healthcare system.
In terms of philanthropic support, foundations supported global health initiatives such as vaccine research and vaccination rollout, and provided more targeted support to the regions, communities and individuals who were most vulnerable during the pandemic. For many philanthropies, this involved a specific focus within their healthcare interventions, such as LDCs, racial and social minorities, refugees and migrants, and at-risk workers (OECD, 2025[82]). It also meant looking beyond the healthcare sector to address the socio-economic impact of the pandemic on other sectors and areas of life. The two largest providers of global philanthropic support for COVID-19 – the Gates Foundation and the Mastercard Foundation – aimed at supporting the poorest and most vulnerable countries, particularly those in Sub-Saharan Africa (Dowell, 2023[83]). This prioritisation is reflected in the regional distribution of funding: USD 1.8 billion (55% of all COVID-19 philanthropic funding in 2020-2022), went to Sub-Saharan Africa.
An evaluation of the International Organization for Migration’s (IOM) COVID-19 response found its existing work with vulnerable populations largely continued, adapting to the context in which many existing vulnerabilities were exacerbated, and new needs were created. The IOM advocated for the inclusion of all populations in response planning, based on needs and not population groups. As a result, migrants’ needs were included in national COVID-19 response and recovery plans, as well as in the GHRP. Programmatically, many projects were adapted or designed specifically to address the needs of vulnerable populations. In Mexico, the Country Office worked with the shelters and child protection authorities to design internal protocols that focused on protecting women and children and identifying situations where people were at risk, particularly children and victims of violence (including sexual violence).
A Rapid Gender Assessment of the COVID-19 situation in Georgia (carried out in March 2021) found widespread disparities between men and women, with women falling behind in vaccination rates. The Government of Georgia developed an anti-crisis package for vulnerable groups, which emphasised women in the informal sector and those who were unemployed.
An ordinance passed in October 2020 to increase the salaries of healthcare workers was reported to have particularly benefited woman in the industry. Georgia had a very high pre-COVID-19 incidence rate of gender-based violence (GBV).
The Georgian government was praised for continuing to enforce rigorous measures against GBV throughout the pandemic through emergency assistance and human trafficking hotlines.
Source: OECD (2025[9]), “The Development and Humanitarian Response to the COVID-19 Pandemic in Georgia (2020-2022)”, https://doi.org/10.1787/a56d49ff-en.
Reaching the furthest behind first is the overarching frame of Ireland’s international development policy. “Furthest behind” is a context-specific and relative term describing those people and groups in a society that are most disadvantaged. This commitment informed Ireland’s pandemic response.
The COVID-19 pandemic strengthened Ireland’s understanding of and commitment to global solidarity, cooperation, and multilateralism. As well as working to secure health for all domestically, Ireland’s Departments of Foreign Affairs and Health collaborated on multiple projects to improve access to medical countermeasures such as vaccines, diagnostics, and medicines in low-income countries. The approach focused on the furthest behind and built on lessons from the HIV and Ebola crises.
In addition to global level engagement and support for the WHO and COVAX, across the network of Ireland’s embassies in low-income countries, multiple programmes were supported to help protect disadvantaged communities from the worst effects of the pandemic. For example, in Tanzania, the Embassy worked with Cardinal Rugambwa Hospital in Dar es Salaam to provide lifesaving treatment, including oxygen, PPEs and patient monitors. In Malawi, the Embassy worked with the Ministry of Health, UNICEF and UNDP to enhance the capacity of health workers in the provision of critical care, supported large scale community vaccination campaigns, disease surveillance, and provided PPE and equipment for cold chain storage of vaccines.
Source: Government of Ireland (2025[84]), Irish Support for Global Responses to COVID-19 Reaches €123 Million, https://www.gov.ie/ga/an-roinn-gn%C3%B3tha%C3%AD-eachtracha/preaseisiuinti/irish-support-for-global-responses-to-covid-19-reaches-123-million/.
References
[35] ADB (2021), Learning Lessons: International Finance Institutions’ Support to the Deployment of COVID-19 Vaccines in Low- and Middle-Income Countries - 10 Lessons from Evaluation, Asian Development Bank, https://web-archive.oecd.org/site/covid19-evaluation-coalition/documents/ll-corona-vaccine.pdf.
[4] AFD (2024), Evaluation of the Health in Common 2020 Initiative (HIC 2020), Agence française de développement, https://proparco-prod-waf.cegedim.cloud/en/ressources/evaluation-health-common-2020-initiative-hic-2020.
[17] AfDB IDEV (2022), Evaluation of the African Development Bank Group’s support to its Regional Member Countries in Response to the COVID-19 Pandemic, Independent Development Evaluation, https://idev.afdb.org/en/document/evaluation-afdb-groups-crisis-response-support-regional-member-countries-face-covid-19.
[2] ALNAP (2024), The humanitarian response to COVID-19: Lessons for future pandemics and global crises, Active Learning Network for Accountability and Performance, https://alnap.org/help-library/resources/the-humanitarian-response-to-covid-19-key-lessons-from-covid-19-for-the-next-pandemic/the-humanitarian-response-to-covid-19-lessons-for-future-pandemics-and-global-crises/ (accessed on 30 July 2025).
[73] Bundervoet, T. and M. Davalos (2021), “Developing countries: The COVID-19 crisis has not affected everyone equally”, World Bank Blogs, https://blogs.worldbank.org/en/voices/developing-countries-covid-19-crisis-has-not-affected-everyone-equally (accessed on 1 August 2025).
[58] Centre for Disaster Protection (2023), Opportunity Cost of COVID-19 Budget Reallocations: Cross-Country Synthesis, https://www.disasterprotection.org/publications-centre/opportunity-cost-of-covid-19-budget-reallocations-cross-country-synthesis-report (accessed on 1 August 2025).
[5] CIKD (2023), International Development Cooperation: China’s Practice—COVID-19 Assistance, Center for International Knowledge on Development, https://en.cikd.org/ms/file/getimage/1659463086722162689.
[3] DEval (2024), Evaluation of the BMZ Emergency COVID-19 Support Programme, https://www.deval.org/fileadmin/Redaktion/PDF/05-Publikationen/Berichte/2024_CSP/2024_DEval_CSP_EN_WEB_barrierefrei.pdf.
[12] Devex (2020), COVID-19: A timeline of the coronavirus outbreak, https://www.devex.com/news/covid-19-a-timeline-of-the-coronavirus-outbreak-104923 (accessed on 1 August 2025).
[60] DEVNIT (2022), ODA 2020–2021: key trends before and during emerging crises - Development Initiatives, https://devinit.org/resources/oda-2020-2021-key-trends-before-during-emerging-crises/nav-more-about/.
[83] Dowell, S. (2023), BMGF’s COVID-19 Response. (Module 2 (Philanthropy) report, Pos. 254).
[65] EBA (2022), “EBA 2022 Annual Report”, https://www.eba.europa.eu/sites/default/files/document_library/About%20Us/Annual%20Reports/2022/1056351/EBA%202022%20Annual%20Report.pdf.
[44] Eggermont, D. (2021), Why are COVID-19 deaths falling even as cases are rising?, International SOS, https://www.internationalsos.com/insights/why-are-covid-19-deaths-falling-even-as-cases-are-rising (accessed on 2 August 2025).
[10] European Commission (2025), Global case study on small island developing states contributing to the stategic evaluation of the collective international development response to the COVID-19 pandemic, https://international-partnerships.ec.europa.eu/publications-library/global-case-study-small-island-developing-states-contributing-strategic-evaluation-collective_en#:~:text=Description,COVID%2D19%20Global%20Evaluation%20Coalition (accessed on 2 August 2025).
[51] European Commission (2022), Fast-Track Assessment of the EU Initial Response to the COVID-19 Crisis in Partner Countries and Regions (2020), https://international-partnerships.ec.europa.eu/publications-library/fast-track-assessment-eu-initial-response-covid-19-crisis-partner-countries-and-regions-2020_en (accessed on 2 August 2025).
[11] FAO (2022), Real-time evaluation of FAO’s COVID-19 Response and Recovery - Hundred and Thirty-fourth Session, 7-11 November 2022, Food and Agriculture Organization, https://openknowledge.fao.org/server/api/core/bitstreams/53055d9b-d477-48be-bb30-e151d69009da/content.
[24] FAO (2010), Second Real Time Evaluation of FAO’s Work on the Highly Pathogenic Avian Influenza, FAO Office of Evaluation, Food and Agriculture Organization, https://openknowledge.fao.org/server/api/core/bitstreams/9dc4c3c6-7350-4d42-866f-a269b528f1b2/content.
[72] Flor, L. et al. (2022), “Quantifying the effects of the COVID-19 pandemic on gender equality on health, social, and economic indicators: A comprehensive review of data from March, 2020 to September, 2021”, The Lancet, Vol. 399/10344, pp. 2361-2397, https://doi.org/10.1016/S0140-6736(22)00008-3.
[74] Georgieva, K. et al. (2020), “The COVID-19 gender gap”, IMF Blog, International Monetary Fund, https://blogs.imf.org/2020/07/21/the-covid-19-gender-gap/ (accessed on 2 August 2025).
[36] Glenton, C. and S. Lewin (2020), COVID-19 Global Evaluation Coalition Brief: Communicating with the public about vaccines: Implementation considerations, Prepared for Norad and the Norwegia Institute of Public Health, https://epoc.cochrane.org/sites/epoc.cochrane.org/files/uploads/PDF_summaries/brief_1_communicating-with-the-public-about-vaccines-implementation-considerations.pdf.
[25] Gold, J. and S. Hutton (2020), 3 lessons from past public health crises for the global response to COVID-19 (coronavirus), Independent Evaluation Group/World Bank Group, https://ieg.worldbankgroup.org/blog/3-lessons-past-public-health-crises-global-response-covid-19-coronavirus (accessed on 23 January 2025).
[15] Government of Burkina Faso (2025), Evaluation of Burkina Faso’s National Response Plan to the COVID-19 Pandemic, https://www.oecd.org/content/dam/oecd/en/toolkits/derec/evaluation-reports/derec/covid19coalition/%C3%89valuation%20du%20Plan%20National%20de%20R%C3%A9ponse%20%C3%A0%20la%20Crise%20de%20la%20Pand%C3%A9mie%20de%20COVID-19%20du%20Burkina%20Faso.pdf.
[84] Government of Ireland (2025), Irish Support for Global Responses to COVID-19 Reaches €123 Million, https://www.gov.ie/ga/an-roinn-gn%C3%B3tha%C3%AD-eachtracha/preaseisiuinti/irish-support-for-global-responses-to-covid-19-reaches-123-million/.
[71] Grown, C. and C. Sánchez-Páramo (2021), “COVID-19 casts different shadows over the lives of men and women”, World Bank Blogs, https://blogs.worldbank.org/en/voices/covid-19-casts-different-shadows-over-lives-men-and-women (accessed on 2 August 2025).
[40] Güngör, B. (2021), “Foreign aid during the COVID-19 pandemic: evidence from Turkey”, Southeast European and Black Sea Studies, Vol. 21/3, pp. 337-352, https://doi.org/10.1080/14683857.2021.1900668.
[43] Horwitz, L. et al. (2021), “Trends in COVID-19 risk-adjusted mortality rates”, Journal of Hospital Medicine, Vol. 16/2, pp. 90-92, https://doi.org/10.12788/jhm.3552.
[76] IAHE (2022), Inter-Agency Humanitarian Evaluation of the COVID-19 Humanitarian Response, Inter-Agency Humanitarian Evaluation, https://interagencystandingcommittee.org/sites/default/files/migrated/2023-03/Inter-Agency%20Humanitarian%20Evaluation%20COVID-19.%20Main%20Report.pdf (accessed on 24 January 2025).
[62] ICAI (2022), The UK’s humanitarian response to COVID-19 – literature review, https://icai.independent.gov.uk/html-version/the-uks-humanitarian-response-to-covid-19-literature-review/#section-0 (accessed on 24 January 2025).
[21] IEG/World Bank (2019), IDA’s Crisis Response Window, Independent Evaluation Group/World Bank Group, https://ieg.worldbankgroup.org/sites/default/files/Data/reports/syn_idacrisisresponse.pdf (accessed on 15 January 2025).
[23] IEG/World Bank (2014), Responding to Global Public Bads, Learning from Evaluation of the World Bank Experience with Avian Influenza 2006-13, Independent Evaluation Group/Workd Bank Group, https://ieg.worldbankgroup.org/sites/default/files/Data/Evaluation/files/avian_flu1.pdf.
[55] IMF (2025), General government gross debt, International Monetary Fund, https://www.imf.org/external/datamapper/GGXWDG_NGDP@WEO/BGD/CPV (accessed on 2 August 2025).
[56] IMF (2020), IMF Executive Board Approves US$185.32 million in Emergency Support to Nicaragua to Address the COVID-19 Pandemic, International Monetary Fund, https://www.imf.org/en/News/Articles/2020/11/20/pr20349-nicaragua-imf-executive-board-approves-us-185-3m-emergency-support-to-address-covid19#:~:text=The%20IMF%20Executive%20Board%20approved,health%20related%20and%20social%20spending (accessed on 2 August 2025).
[49] Itad (2022), COVAX Facility and COVAX Advance Market Commitment (AMC): Formative Review and Baseline Study, https://www.gavi.org/our-impact/evaluation-studies/covax-facility-and-covax-advance-market-commitment-amc-formative-review-and-baseline-study.
[45] Johns Hopkins (2023), Mortality Analyses - Johns Hopkins Coronavirus Resource Center, https://coronavirus.jhu.edu/data/mortality.
[37] Lewin, S. and C. Glenton (2020), COVID-19 Global Evaluation Coalition Brief: Effects of digital interventions for promoting vaccination uptake, Prepared for Norad and the Norwegian Institute of Public Health, https://epoc.cochrane.org/sites/epoc.cochrane.org/files/uploads/PDF_summaries/brief_2_effects-of-digital-interventions-for-promoting-vaccination-uptake.pdf.
[33] Ministerio de Asuntos Exteriores, Unión Europea y Cooperación (2024), Evaluación de la Estrategia de Respuesta Conjunta de la Cooperación Española a la Crisis del COVID-19 y del Plan Acceso Universal 2020-2022, https://cpage.mpr.gob.es.
[38] Ministry of Foreign Affairs of Finland (2022), “Finland sends material assistance to help Nepal fight COVID-19 epidemic”, https://um.fi/current-affairs/-/asset_publisher/gc654PySnjTX/content/suomi-l%C3%A4hett%C3%A4%C3%A4-materiaaliapua-nepaliin-vaikean-koronatilanteen-hoitoon-1/35732.
[6] Ministry of Foreign Affairs of Japan (2025), Evaluation of Japan’s COVID-19 Related Cooperation, https://www.mofa.go.jp/policy/oda/evaluation/FY2024/pdfs/covid-19.pdf.
[42] NDB (2023), Evaluation of NDB’s Fast-Track Support To The Covid-19 Emergency, New Development Bank, https://www.ndb.int/wp-content/uploads/2024/02/COVID-19_Evaluation-Report_Feb20_final.pdf.
[68] New Zealand Ministry of Foreign Affairs and Trade (2025), New Zealand’s International Development and Humanitarian Response to the COVID-19 Pandemic (2020-2022), https://www.mfat.govt.nz/assets/Aid-Prog-docs/Evaluations/2025/OECD-COVID-19-Global-Evaluation-Coalition-New-Zealand-Case-Study.pdf.
[61] Norad (2020), “Responding to the Covid-19 pandemic – early Norwegian development aid support. Oslo: Norad Evaluation Department”, Norwegian Agency for Development Cooperation, https://www.norad.no/contentassets/b62a8597ee5d4b96a6701b3ca51a3b6e/background-study-1-20-responding-to-the-covid-19-pandemic/.
[64] OCHA (2021), “Country-Based Pooled Funds 2020 in Review”, https://www.unocha.org/publications/report/world/country-based-pooled-funds-2020-review.
[1] OECD (2025), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52.
[8] OECD (2025), The Development and Humanitarian Response to the COVID-19 Pandemic in Bangladesh (2020-2022), OECD Publishing, Paris, https://doi.org/10.1787/c3e42f6f-en.
[59] OECD (2025), The Development and Humanitarian Response to the COVID-19 Pandemic in Cabo Verde (2020-2022), OECD Publishing, Paris, https://doi.org/10.1787/b763ab50-en.
[77] OECD (2025), The Development and Humanitarian Response to the COVID-19 Pandemic in Georgia (2020-2022), OECD Publishing, Paris, https://doi.org/10.1787/a56d49ff-en.
[9] OECD (2025), The Development and Humanitarian Response to the COVID-19 Pandemic in Georgia (2020-2022), OECD Publishing, Paris, https://doi.org/10.1787/a56d49ff-en.
[48] OECD (2025), The Development and Humanitarian Response to the COVID-19 Pandemic in Lebanon (2020-2022), OECD Publishing, Paris, https://doi.org/10.1787/f8f7325c-en.
[82] OECD (2025), The Response of International Philanthropic Organisations to the COVID-19 Pandemic (2020-2022), OECD Publishing, Paris, https://doi.org/10.1787/c4510e5a-en.
[69] OECD (2024), Countries and territories most in need, OECD Publishing, Paris, https://web-archive.oecd.org/temp/2024-03-07/380032-countries-most-in-need.htm (accessed on 2 August 2025).
[67] OECD (2023), Using budget support to respond rapidly to COVID-19 in Pacific small island developing states (SIDS), OECD Publishing, Paris, https://www.oecd.org/en/publications/2021/03/development-co-operation-tips-tools-insights-practices_d307b396/using-budget-support-to-respond-rapidly-to-covid-19-in-pacific-small-island-developing-states-sids_10d612ff.html (accessed on 24 January 2025).
[18] OECD (2022), OECD Development Co‑operation Peer Reviews: United States 2022, OECD Development Co-operation Peer Reviews, OECD Publishing, Paris, https://doi.org/10.1787/6da3a74e-en.
[28] OECD (2022), Snapshot Update: How are COVID-19 response and recovery efforts being evaluated?, COVID-19 Global Evaluation Coalition, OECD Publishing, Paris, https://web-archive.oecd.org/site/covid19-evaluation-coalition/documents/Landscape%20paper%20update%20-%20Final%20December%202022%20.pdf.
[52] OECD (2021), Bilateral Donors’ Responses to the COVID-19 Pandemic: Insights from the OECD DAC Peer Reviews, OECD Publishing, Paris, https://web-archive.oecd.org/site/covid19-evaluation-coalition/documents/How%20COVID-19%20response%20and%20recovery%20efforts%20are%20evaluated_Nov%202021.pdf.
[19] OECD (2021), Summary Record of the 27th Meeting of the DAC Network on Development Evaluation, DCD/DAC/EV/M(2021)3, OECD, Paris, https://one.oecd.org/document/DCD/DAC/EV/M%282021%293/en/pdf.
[75] OECD (2020), “Women at the core of the fight against COVID-19 crisis”, OECD Policy Responses to Coronavirus (COVID-19), OECD Publishing, Paris, https://doi.org/10.1787/553a8269-en.
[53] OECD (forthcoming), The Development and Humanitarian Response to the COVID-19 Pandemic in Cambodia (2020-2022).
[39] OECD (forthcoming), The Development and Humanitarian Response to the COVID-19 Pandemic in Nicaragua (2020-2022).
[26] OECD/AfDB (2025), The Development and Humanitarian Response to the COVID-19 Pandemic in Kenya (2020-2022), OECD Publishing, Paris, https://doi.org/10.1787/21d3dca0-en.
[27] OECD/DEval, unpublished (2023), Survey on the international response to COVID-19, https://s2survey.net/covid_evaluation_survey/.
[31] OECD/IOB (2025), The Netherlands’ International Development and Humanitarian Response to the COVID-19 Pandemic (2020-2022), OECD Publishing, Paris, https://doi.org/10.1787/322da298-en.
[46] Our World in Data (2025), COVID-19 Pandemic, https://ourworldindata.org/coronavirus (accessed on 2 August 2025).
[70] Our World in Data (2025), Foreign aid received as a share of national income, https://ourworldindata.org/grapher/foreign-aid-received-as-a-share-of-national-income-net (accessed on 2 August 2025).
[41] Our World in Data (2024), Cumulative confirmed COVID-19 deaths and cases, World, https://ourworldindata.org/grapher/cumulative-deaths-and-cases-covid-19 (accessed on 2 August 2025).
[32] Presidency of South Africa (2021), Development of a Country Report on the Measures Implemented to Combat the Impact of Covid-19 in South Africa, https://www.gov.za/sites/default/files/gcis_document/202206/sa-covid-19-reporta.pdf.
[66] Sida (2021), “Evaluation at Sida Annual Report 2021”, https://cdn.sida.se/app/uploads/2023/03/07071233/STUD2023_1_62609en.pdf.
[78] U.S. Global Leadership Coalition (2022), COVID-19 BRIEF: Impact on Women and Girls, https://www.usglc.org/coronavirus/women-and-girls/ (accessed on 2 August 2025).
[79] UN (2020), Policy brief: The impact of COVID-19 on women, United Nations, https://www.un.org/sites/un2.un.org/files/policy_brief_on_covid_impact_on_women_9_apr_2020_updated.pdf.
[34] UNAIDS (2020), Rights in the time of COVID-19 - Lessons from HIV for an effective, community-led response, https://www.unaids.org/sites/default/files/media_asset/human-rights-and-covid-19_en.pdf.
[20] UNEG (2021), Evidence Summary on COVID-19 and Food Security, United Nations Evaluation Group, https://www.unevaluation.org/uneg_publications/evidence-summary-covid-19-and-food-security.
[81] UNFPA (2024), Formative evaluation of the organizational resilience of UNFPA in light of its response to the COVID-19 pandemic, United Nations Population Fund, https://www.unfpa.org/sites/default/files/2024-05/Covid-19_Org_Resilience_evaluation_report.pdf (accessed on 24 January 2025).
[80] UNICEF (2021), Continuity through change: Adapting programmes and services to ensure the protection of children during COVID-19, Child Protection Learning Brief 4, United Nations Children’s Fund, https://www.unicef.org/media/102216/file/Child-Protection-Services-Learning-Brief.pdf (accessed on 24 January 2025).
[63] UNICEF (2020), Responding to COVID-19: UNICEF Annual Report 2020, United Nations Children’s Fund, https://www.unicef.org/media/100946/file/UNICEF%20Annual%20Report%202020.pdf.
[50] UNSWE (2022), Final Report: System-Wide Evaluation of the UN Development System Response to COVID-19, United Nations Office for the Coordination of Humanitarian Affairs (OCHA), https://reliefweb.int/report/world/final-report-system-wide-evaluation-unds-response-covid-19-october-2022.
[16] USAID (2022), U.S. Covid-19 Global Response & Recovery Framework, U.S. Agency for International Development, https://bidenwhitehouse.archives.gov/wp-content/uploads/2022/09/U.S.-COVID-19-GLOBAL-RESPONSE-RECOVERY-FRAMEWORK-_clean_9-14_7pm.pdf.
[7] Vancutsem, S. (2020), Evaluation of Enabel’s Response to the COVID-19 Pandemic, Main Lessons Learned, Enabel, Cota, https://www.enabel.be/app/uploads/2022/10/evaluation-covid-lessons_learned-en_0.pdf.
[29] WFP (2022), Evaluation of WFP Response to the COVID-19 Pandemic, World Food Programme, https://docs.wfp.org/api/documents/WFP-0000136269/download/?_ga=2.216756630.1019358213.1737736218-106602539.1737736217 (accessed on 24 January 2025).
[47] WHO (2025), “COVID-19 vaccination, Georgia data”, WHO COVID-19 Dashboard, World Health Organization, https://data.who.int/dashboards/covid19/vaccines?m49=268 (accessed on 2 August 2025).
[30] Williamson, A. et al. (2022), “Effective post-pandemic governance must focus on shared challenges”, The Lancet, Vol. 399/10340, pp. 1999-2001, https://doi.org/10.1016/s0140-6736(22)00891-1.
[57] Wilton Park (2020), The Future of Aid: Crisis and Opportunity – How the COVID-19 moment will catalyse change in the aid sector, https://collections.unu.edu/eserv/unu:8590/WP1766V2-Future-of-Aid-dialogue-two-report.pdf.
[13] World Bank (2022), Afghanistan – Health Emergency Response Project, World Bank Group, http://documents.worldbank.org/curated/en/099935006132231254.
[14] World Bank (2020), Paraguary – COVID-19 Emergency Response Project, World Bank Group, http://documents.worldbank.org/curated/en/395651585951332792.
[22] World Bank (2020), Proposal for a World Bank COVID‑19 Response under the Fast‑Track COVID‑19 Facility, World Bank Group, https://documents1.worldbank.org/curated/en/260231584733494306/pdf/Proposal-for-a-World-Bank-COVID-19-Response-under-the-Fast-Track-COVID-19-Facility.pdf.
[54] World Economics (2025), Bangladesh: Key Insights, https://www.worldeconomics.com/GrossDomesticProduct/Debt-to-GDP-Ratio/Bangladesh.aspx (accessed on 2 August 2025).
← 1. The following low income countries were included in the top ten either in terms of cases per capita or deaths per capita, with significant overlap between the two groups: Afghanistan, Burundi, Ethiopia, Gambia, Guinea-Bissau, Mozambique, Malawi, Rwanda, Sudan, Somalia, Syria, Togo and Uganda.