The COVID-19 pandemic was not only a public health emergency but also a test of global solidarity and financial resilience. This chapter outlines the global response architecture and the roles of the United Nations - including the World Health Organization (WHO) - and international financial institutions. It examines efforts to ensure equitable COVID-19 vaccine access through the Access to COVID-19 Tools (ACT) Accelerator and the COVAX facility. It describes how international development co-operation and assistance responded, exploring the commitments and policy shifts made by providers of development assistance, including DAC members and South-South providers. It provides a comprehensive overview of international development finance flows during the COVID-19 crisis 2020-2022, including shifts in funding allocations by channel, sector and type of finance.
Strategic Joint Evaluation of the Collective International Development and Humanitarian Assistance Response to the COVID‑19 Pandemic
Abstract
The COVID-19 pandemic triggered an unprecedented response by international development assistance, as governments, international organisations and development agencies mobilised to address urgent humanitarian and health needs and mitigate the economic and social fallout from the crisis.
This chapter outlines key events in the international co-operation crisis response, and lays out the global response architecture, including the global effort to support equitable access to COVID-19 vaccines. Next it explores the commitments and policy shifts made by providers of development assistance, highlighting their overall objectives and strategies for maintaining ongoing programmes and meeting the new needs of vulnerable countries and populations. Finally, the chapter provides a comprehensive overview of international development and humanitarian finance1, including allocations by country, channels, funding types and sector, as well as funding for vaccines and funding from philanthropic providers. This descriptive analysis lays the groundwork for the analysis of relevance, coherence, effectiveness and efficiency in subsequent chapters.
COVID-19 first emerged during late 2019 with the outbreak in Wuhan, the People’s Republic of China (hereafter ‘China’), followed by WHO declaring it a Public Health Emergency of International Concern on 30 January 2020. From February 2020 the international response started at scale. Governments enacted travel bans, lockdowns and other emergency health measures to try to contain the spread of the virus and provide testing and treatment. Urgent, co‑ordinated vaccine development efforts culminated in mass immunisation campaigns by late 2020. Domestic social and economic support packages were ramped up to address the far-reaching consequences of both the pandemic and the prevention and control measures – and international assistance was mobilised to support governments responding to the crisis (OECD, 2025[1]).
The global response was framed within the UN pandemic response architecture. This was quickly established and underpinned by the following four overarching global frameworks:
1. The World Health Organization (WHO) developed the 2019 Novel Coronavirus Strategic Preparedness and Response Plan (SPRP) (WHO, 2020[2]) and provided the framework for the international health response. It was subsequently revised in 2021 and again in 2022 to reflect new knowledge and the ways in which the pandemic had evolved.
2. The Global Humanitarian Response Plan COVID-19 (GHRP) (UNOCHA, 2020[3]) set out the Inter-agency Standing Committee (IASC) strategy for addressing needs in humanitarian contexts, with priorities on containing the spread of COVID-19; decreasing the deterioration of human assets and rights, social cohesion and livelihoods; and protecting and assisting refugees, internally displaced persons (IDPs), and migrant populations.
3. The UN framework for the immediate socio-economic response to COVID-19 (UNSDG, 2020[4]) set out an approach for ensuring that five key pillars were addressed in the international socio-economic response: 1) the protection of health services and systems as a first priority; 2) support for social protection and basic services; 3) support for jobs, small and medium-sized enterprises (SMEs), and the informal sector; 4) support for the macroeconomic response and multilateral collaboration; and 5) social cohesion and community resilience.
4. The Access to COVID-19 Tools Accelerator (ACT-A), was a broad framework supporting vaccines, diagnostics, therapeutics and health systems strengthening (HSS), with COVAX as its vaccine pillar. Launched in April 2020, it brought together governments, philanthropies, UN agencies and multilateral institutions. COVAX was co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance, and WHO, with the United Nations Children’s Fund (UNICEF) serving as the main delivery partner. COVAX aimed to accelerate vaccine development, secure doses, and ensure equitable distribution to all countries, focusing on low-income countries (LICs) through its Advance Market Commitment (AMC).
These frameworks interacted with existing global and country-level development and humanitarian co‑ordination mechanisms including UN Country Teams (UNCTs),2 the Humanitarian Cluster System3 as well as donor co‑ordination mechanisms and technical working groups within individual national governments. In addition to individuals, religious groups and local communities who played significant roles in responding to the pandemic in every country, the private sector and philanthropic actors played a major role in partner countries by providing funding and other support for vaccine development, supply and logistics, production and supply chain operations, and health system financing (OECD, 2025[5]).
In the early months of 2020, international development and humanitarian actors (including development agencies and ministries of provider countries) began taking specific steps to: 1) identify needs – both new or linked to existing programmes – and support needs assessments and the development of national and institutional response plans; 2) develop their own institutional responses, including forming decision making bodies and activating crisis response mechanisms; 3) adjusting existing programmes; and 4) mobilising or reallocating funding to respond to the skyrocketing needs.
While the COVID-19 crisis affected all countries, the intensity of its impacts came in waves, arriving at different times in different regions and countries. There was an outpouring of support and solidarity, with a huge amount of domestic and international support from not only the public sector, but also the private sector, non-governmental organisations, faith-based institutions, individuals and communities. Assistance flowed between countries of all different income groups.
Statements by leaders from many countries – for example China, France, Germany, Mexico, Saudi Arabia, South Africa, and Türkiye – expressed similar sentiments of urgency and global solidarity, and commitments to act quickly, supporting global action to leave no one behind.
In early April 2020, DAC members, who historically represent the largest providers of official development assistance (ODA), met to collectively set out their intended policy and programmatic direction for the pandemic response. In a joint statement, DAC members articulated that the pandemic would have profound economic consequences, which would severely impact the poor, especially those in fragile states. DAC members outlined the following commitments (OECD, 2020[6]):
protecting official development assistance (ODA) budgets, while acknowledging the pressures on domestic public finances – which implies maintaining or increasing funding levels and making COVID-related support “additional” to existing funding
supporting least developed countries (LDCs) and other “countries with specific needs” (including Small Island Developing States [SIDS]), with a coherent and co-ordinated response
taking a “humanitarian-development-peace nexus” approach.
The intention was to respond to immediate needs (e.g. health, social safety nets and humanitarian needs) and to support recovery. Members called for support from all development actors, including the private sector and civil society organisations (CSOs), which are critical in providing support to vulnerable people. Strengthening health systems, sharing epidemiological and clinical data, as well as sharing materials necessary for research and development, including on vaccines, were highlighted as priorities. Finally, members committed to sharing evidence and best practice data “on what works to counter the virus” (OECD, 2020[6]).
The co-chairs of the Global Partnership for Effective Development Co-operation also made a statement on the global pandemic, stating that “Efforts to provide support need not only be increased, they must also become more targeted and co-ordinated to reach those most in need.” (GPDEC, 2020[7]). They outlined the importance of country ownership, inclusive partnerships, focusing on results, and transparency and accountability to work together effectively.
DAC members also agreed to freeze ODA statuses and graduations, to ensure that no country would lose ODA eligibility during the pandemic, making it easier for countries to receive the funds (OECD, 2022[8]).
Overall international assistance (2020-2022)
The pandemic saw an increase in all types of international assistance, including official development finance (ODF) and philanthropic flows, with a record-high level of flows to developing countries in 2020 totalling USD 289 billion. Overall, from 2020 to 2022, international assistance to developing countries from all official providers and philanthropic foundations amounted to USD 886 billion in net terms (USD 1.1 trillion in gross terms). Within this broader assistance, ODA and other concessional finance remained almost constant in 2021 and then rose sharply again in 2022 (largely due to support for Ukraine and unrelated to the COVID pandemic). Other official flows (OOF) also rose in 2020 but then dropped in 2021 before increasing in 2022, while philanthropic flows also increased in 2020 and then fluctuated slightly (Figure 2.1).
The largest providers of ODF across the 2020-2022 period were the United States (USD 136 billion); Germany (USD 83 billion); EU Institutions (USD 72 billion); and the World Bank’s IDA (USD 52 billion). While China does not report to the OECD, estimates based on reporting by the China International Development Cooperation Agency (CIDCA) show that considerable international assistance was deployed, including in-kind donations of equipment and vaccines (CIKD, 2023[9]). Other major non-DAC providers over 2020-2022 were Türkiye (USD 27.8 billion), Saudi Arabia (USD 14.9 billion), the United Arab Emirates (USD 5.8 billion), Qatar (USD 2.0 billion), and Kuwait (USD 1.1 billion). These countries mainly targeted humanitarian aid (49% of the total among these providers, in gross terms) and general budget support (25%) among all sectors (OECD, 2025[1]).
Total COVID-19-related funding, including outflows from multilateral organisations and philanthropic foundations, amounted to USD 126 billion (of which USD 89 billion was ODA) (OECD, 2025[1]).
In terms of net disbursements, multilateral agencies played a significant role in responding to the COVID-19 crisis in 2020-2022 with both concessional and non-concessional financing. The World Bank Group disbursed USD 98 billion in net terms (USD 47 billion from the International Bank for Reconstruction and Development [IBRD] and USD 523 billion from the International Development Association [IDA]). The International Monetary Fund (IMF) mobilised a massive COVID-19 support package with concessional outflows jumping from USD 274 million in 2019 to USD 9.4 billion in 2020 (OECD, 2025[1]).
As Figure 2.2 shows, net ODA disbursements from provider countries (DAC and non-DAC) had plateaued in the years immediately preceding the pandemic, with a slight drop from USD 187 billion in 2018 to USD 182 billion in 2019. The COVID-19 pandemic drove up funding commitments and disbursements from bilateral providers as a group. Total net ODA disbursements from these providers reached USD 194 billion in 2020 and USD 209 billion in 2021. ODA from official bilateral providers then witnessed a sharper increase in 2022, reaching USD 247 billion, mainly due to support provided to Ukraine in response to Russia’s full-scale war of aggression.
During the crisis period, COVID-19-specific bilateral funding amounted to USD 66 billion (of which USD 65 billion was ODA). The largest providers of COVID funding in 2020 were Germany and Japan. Over the three-year period, the largest were the United States, Germany, and Japan.
These overall trends include considerable variation across provider and recipient countries, as needs and priorities of both recipients and providers changed (at times directly linked to the pandemic, and at times reflecting the country context or other crises). Chapter 3 on Relevance discusses this further.
For example, assistance to the Philippines roughly tripled in 2019-2020, propelling it into the top three recipient countries, despite not featuring in the top ten recipient countries prior to the pandemic. Kenya also saw a substantial increase in assistance in 2020 compared to previous years; however, unlike the Philippines, this spike was short-lived, with funding returning to pre-pandemic levels from 2021 onwards. In contrast, Egypt experienced a decline in assistance, dropping from USD 6.8 billion in 2019 to USD 5.5 billion in 2020, before rebounding to USD 12 billion in 2021 with a sizeable influx of budget support. Trends in assistance flows to other countries remained consistent throughout the pandemic period. For example, assistance to India remained at a high level; Bangladesh experienced steady increases in funding that aligned with the pre-pandemic trajectory; and Afghanistan, Lebanon and Viet Nam all saw continued declines in assistance, in keeping with trends observed prior to 2020 (OECD, 2025[1]).
USD billion net disbursements, constant 2023 prices
Notes: ODA = official development assistance; OOF = other official flows; PSI = private sector instruments (not measured prior to 2023). ODA includes concessional outflows from the core budgets of multilateral organisations.
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52.
All official bilateral providers, USD billion net disbursements, constant 2023 prices
Notes: COVID-19 support is defined by filtering for activities that are assigned either the COVID-19 control purpose code (12264) or the “COVID-19” hashtag in the Creditor Reporting System (CRS) database. In-donor refugee costs are defined by filtering for activities that are assigned the co-operation modality H02-H06. All flows are shown in net terms.
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52.
Providers’ relative levels of effort during the pandemic
In 2020, five countries – Norway, Luxembourg, Sweden, Germany and Denmark – met the ODA target of 0.7% of GNI. During the crisis, the DAC average increased from 0.30% in 2019 to 0.33% in 2020, and a peak of 0.37% in 2022, showing that many overcame economic challenges and huge levels of domestic spending to protect or increase development assistance. Ireland, the Netherlands and Türkiye all maintained their ODA as a percentage of GNI close to their 0.7% targets, at 0.67%, 0.66% and 0.62%, respectively. Conversely, many other providers, remained well behind – or dipped further below – the ODA/GNI target.
Contrasting changes to gross national income (GNI) and ODA volumes suggest varying levels of effort among providers during the crisis. Figure 2.3 shows rates of change in individual providers’ GNI and ODA from 2019 to 2020. While the crisis’ economic impact and national COVID responses determined the fiscal space available, the choice to allocate ODA in line with increasing global needs reflected deliberate policy decisions made by providers.
Several providers stand out for increasing international assistance substantially despite experiencing economic contractions. Among DAC members, France, Germany, Latvia, the Slovak Republic and Sweden all increased their ODA by 10% or more between 2019 and 2020, even as their economies contracted. France increased its assistance by 10%, despite an 8% drop in GNI, with much of this coming in the form of ODA loans. Similarly, Germany (+14.5% ODA, -4.6% GNI) and Sweden (+16.6% ODA, -2.1% GNI) increased aid levels even amid economic decline. Among non-DAC providers, Hungary, Chinese Taipei, Malta, Bulgaria and Romania also increased their ODA by 33.4%, 26.4%, 26.4%, 23.4% and 16.9%, respectively (although it should be noted that some of these changes involve small absolute amounts).
Ireland (+0.3% ODA, +3.7% GNI) and Türkiye (+0.9% ODA, +1.7% GNI), both increased ODA, while also experiencing economic growth in the first year of the crisis. Other providers, however, reduced ODA levels even as their economies remained on a stable to positive trajectory, as was the case for Denmark (-0.9% ODA, +1.3% GNI), and New Zealand (-5.1% ODA, +0.5% GNI).
Finally, some providers experienced both economic decline and a sharp reduction in aid. The United Arab Emirates and Greece experienced the most dramatic contractions, reducing ODA by 19.7% and 12.7%, respectively, alongside a 15.5% and 11.7% drop in GNI. The United Kingdom, historically one of the largest providers, reduced ODA by 9.1% in the context of an 8.4% fall in GNI due to a policy decision taken to reduce international aid in the face of the pandemic crisis (ICAI, 2023[10]).
All official bilateral providers, percentage change from 2019 to 2020
Sources: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52; World Bank Development Indicators https://databank.worldbank.org/source/world-development-indicators.
Targeting gender equality and the rights of people with disabilities
The CRS database tracks data for targeting of gender equality and disability. During COVID-19, many governments, providers and implementing agencies actively sought to reach these vulnerable populations and adapted their programmes over time to enhance inclusivity (ALNAP, 2024[11]).
Figure 2.4 shows that while the absolute amount of assistance with gender as a significant objective increased from USD 50.2 billion to USD 54.2 billion in the first biennium of the pandemic (2020-2021)4, its share remained essentially the same, at 43.8%.
All official bilateral providers, two-year average, constant 2023 prices
Note: Estimates are based on two-year averages of bilateral allocable commitments to account for volatility in the use of commitments data. The line shows ODA with a gender objective as a percentage of the total assistance.
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52.
The bars in Figure 2.5 show the amount of ODA that includes disability as either a principal or significant objective, while the line shows the amount as a percentage of total assistance. The absolute amount of disability-related ODA almost doubled between the 2018-2019 and 2020-2021 biennia (+97%) from USD 5.8 billion to USD 11.3 billion. The percentage of assistance that included disability objectives also increased during the pandemic, from 11% in 2018-2019 to 21% in 2020-2021. This reflects a positive trend in ODA with a disability objective, with the 2022-2023 biennium also witnessing a large increase both in terms of total amounts and percentage.
All official bilateral providers, constant 2023 prices
Note: Estimates are based on two-year averages of bilateral allocable commitments to account for volatility in the use of commitments data.
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52.
Sector-specific allocations – which represent about half of total ODA – varied significantly during the crisis, with assistance allocated across all sectors. This reflects the far-reaching, multidimensional impacts of the COVID-19 crisis and continued attention to overall sustainable development priorities.
There was an increase in funding for the health sector, and other sectors indirectly impacted by the pandemic containment measures, such as education and food security (Figure 2.6).
Health funding commitments increased by 73% from 2019 to 2020 (USD 49 billion), reaching a record high of USD 59 billion in 2022. Health took a more predominant place in the sector mix overall, ranking third in 2020 and 2021 by total commitments. Health funding represented 11% and 16% of ODF respectively, compared to 8% in pre-pandemic years. After these first two pandemic years, the situation almost returned to pre-pandemic levels, with health representing 9% of ODF in both 2022 and 2023.
While health was the primary focus of COVID-19-specific spending, overall assistance was highest in the social infrastructure and services sector (the largest sector in 2020), followed by humanitarian aid and economic infrastructure. Economic and social infrastructure continued to be the main sectors by total commitments, 28% and 24% of commitments, respectively. In 2020, support targeting social infrastructure (including support for water and sanitation, and education) surpassed economic infrastructure, which was the top sector throughout the rest of the observed period.
The sectoral funding patterns of individual providers highlight diverse strategies and variation in how sectoral allocations changed (or not) from 2019 to 2022. (Annex C provides figures for each country.)
Germany maintained relatively stable distributions across sectors, except for an increase in health commitments between 2020-2022. New Zealand, also elevated health-related spending in 2020-2021 (from USD 37 million in 2019 to USD 66 million in 2020), making it the third-largest sector in 2021, reflecting its assistance strategy in the Pacific region. Similarly, Spain increased its health-related commitments both absolutely and relative terms, in 2021-2022, with health becoming the third-largest sector for both years. In 2021, the United States increased both humanitarian aid, which rose to second place, and health commitments, which climbed to fourth position. The Netherlands’ allocations also demonstrated a shift, with commitments to social service sectors surging so substantially in 2020 that they surpassed the typically dominant “other sectors” category (due to the inclusion of in-donor refugee costs and administrative expenses in this category).
From 2020-2023, Korea and Japan committed over 40% of their assistance to economic infrastructure and services – well above the DAC average and consistent with their pre-pandemic spending. In contrast, Sweden focused on social infrastructure and services (36%). Saudi Arabia's assistance also rose during the pandemic, with “other sectors” expanding significantly from 2021 onward, primarily due to substantial budget support provided to Egypt (Figure C.12 in Annex C).
The use of budget support was instrumental in responding to the crisis, particularly in certain recipient countries that received large emergency funding packages (e.g. Burkina Faso, Cabo Verde, Cambodia and Kenya). In Figure 2.6 the increase in budget support becomes visible in 2022, with “Other sectors” rising to USD 41 billion due to support provided countries in their economic recovery from the crisis (e.g. Egypt).
Importantly, for the period under evaluation, the increases in funding for health (especially in 2020 and 2021) and social infrastructure do not seem to have significantly displaced funding for other priorities, though this is difficult to determine at the aggregate and there is evidence of broader trade-offs in the aftermath of the pandemic (Penn et al., 2025[12]).
All official providers and philanthropic foundations, USD billion commitments, constant 2023 prices
Note: Includes flows on a gross basis from DAC countries, non-DAC bilateral providers, the core budgets of multilateral organisations, and philanthropic foundations.
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52.
Funding patterns by recipient region, country and income group
There are some key differences in sector allocations between regions (see Annex C). In Africa, commitments to the health sector more than doubled; in the Americas they increased by 25% from 2020-2021, as vaccines were deployed. Conversely, in Asia, commitments to health decreased by about USD 100 million in 2021, while humanitarian assistance increased 2.5 times from 2020-2021 (from USD 331 million to USD 818 million). Humanitarian assistance also became the second largest sector in 2021 in the Americas, reaching USD 658 million in commitments, with slight declines in the economic sectors.
In terms of countries receiving assistance, there was also great variation in the types of support. In Georgia, for example, health sector commitments increased by 146% from 2019 to 2020 (though still represented a small percent of total support – see Annex C); humanitarian assistance also increased from USD 85.6 million to USD 211.6 million (147%) and then again in 2021 reaching USD 356 million, with support to vulnerable groups. Kenya also experienced a sharp and sustained increase in health sector funding during the pandemic, rising from USD 386 million in commitments in 2019 to USD 945 million in 2020 and USD 1 billion in 2021, making it the largest sector in terms of assistance that year, overtaking economic infrastructure, which had declined significantly from pre-pandemic levels. In Lebanon, assistance continued to be dominated by the humanitarian and social infrastructure sectors during the pandemic, though health sector commitments roughly doubled. Bangladesh, meanwhile, saw a marked rise in commitments to health and social infrastructure in 2021, displacing all other sectors except economic infrastructure, which remained the largest throughout. But by 2022, these sectors had largely returned to their pre-pandemic levels. Interestingly, commitments to “other sectors” saw a temporary spike across in 2020 potentially reflecting the need and desire to rapidly disburse large amounts of funding flexibly.
In terms of income groups, while social infrastructure remained the largest sector, health sector commitments increased across all income groups (see Annex C). The increase in health funding is most visible for least developed countries (LDCs) saw their commitments to health increasing significantly from all providers, from USD 10.5 billion in 2019 to USD 12.3 billion in 2020 (+18%) and to USD 17.3 billion in 2021 (an additional 40%, making health the second sector by commitments) as vaccines and other support to address the impact of the pandemic were deployed (Figure 2.7). Humanitarian assistance also increased significantly in 2022, reaching nearly USD 19.9 billion and becoming the second most funded sector. Lower-middle-income countries (LMICs) also saw an increase in health in 2020 and 2021, however social and economic infrastructure remained the main sectors; “other sectors” largely increased in 2022, becoming the third sector at USD 22.4 billion.
In 2020, per capita assistance rose across all income groups, with the largest percentage increase in the wealthiest group of recipient countries (UMICs) (Figure 2.8). However, after the first two years of the pandemic, per capita assistance to UMICs and LICs declined from 2021 to 2022, while support to LMICs continued to rise, reflecting the increase in ODA to Ukraine.
USD million commitments, constant 2023 prices
Notes: Includes flows on a gross basis from DAC countries, official non-DAC bilateral providers, multilateral organisations, and philanthropic foundations. “Social infrastructure and services” includes education, population policies, governance, and water and sanitation. “Economic infrastructure” includes transport, energy, communications, banking and financial services, and business. “Other sectors” includes general budget support as well as debt rescheduling.
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52.
All official providers, bilateral net disbursements, USD per capita
Notes: Income groups are based on the World Bank income group that aligns with the calendar year being analysed. Countries classified as high-income or not classified by the World Bank are excluded from the analysis to adjust for the effect of outliers.
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flow) (Database), http://data-explorer.oecd.org/s/52.
To reach those in need, international assistance was disbursed by bilateral and multilateral development agencies, as well as through multi-bi support (bilateral support disbursed at country level to multilateral agencies) via different channels (e.g., governments, NGOs and private sector). International development and humanitarian assistance used a range of funding instruments (concessional and non-concessional, grants and loans, and debt-related action). This section looks at how financial flows changed during the crisis (2020-2022) setting the stage for analysis of relevance, effectiveness and efficiency.
Multilateral organisations
Multilateral agencies played a crucial role in supporting the global response to the COVID-19 pandemic, including receiving a higher share of COVID-19-tagged assistance, compared to overall assistance. Assistance via multilateral organisations was viewed as a way to ensure international support remained relevant, scalable and coherent – especially in early 2020, when countries’ specific needs were still unclear. Total multilateral assistance, and its share of all assistance provided, had been slowly increasing since 2016, reaching USD 51.9 billion in 2022, before a slight decline in 2023, as shown in (Figure 2.9).
Multilaterals were crucial in co‑ordinating responses, leveraging expertise, and ensuring distribution at speed and scale. Bilateral providers recognised the advantages multilaterals have in terms of their expertise (such as vaccine distribution, supply chains and procurement) and in their ability to mobilise resources and distribute assistance quickly and at scale.
The largest DAC contributors to multilateral funding in 2020 were the United States (USD 6.6 billion), Germany (USD 7.2 billion) and the United Kingdom (USD 3.3 billion). Significant contributors to multilaterals, as a percentage of overall assistance, were Sweden (76%) and Denmark (52%). France rapidly increased its provision of bilateral assistance through multilaterals from USD 323 million in 2019 to USD 1.1 billion in 2020, a 245% increase in one year.
From 2020-2022, 14% of bilateral assistance was channelled through multilaterals (“Multi-bi” in Figure 2.9), slightly above the 12% recorded from 2016-2019. The share of core contributions to multilateral organisations (“Multilateral”) also increased in 2020 and 2021 reaching 26%, compared to 13.0% for overall assistance during the same period. This is part of a general trend that saw bilateral providers leaning on the multilateral system to scale up co‑ordination mechanisms across development actors, to address the health, socio-economic and humanitarian impacts of the crisis, as well as provide flexible and timely responses depending on needs.
DAC and non-DAC donors, USD billion disbursements, constant 2023 prices
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52.
The World Bank Group disbursed over USD 157 billion between April 2020 and June 2021, aiding over 100 developing countries (World Bank, 2021[13]). Similarly, by March 2022, the IMF had made USD 250 billion – a quarter of its USD 1 trillion lending capacity – available to member countries (IMF, 2022[14]). In addition, key UN agencies contributed significant resources to the pandemic response, including WHO (co‑ordinating vaccine distribution and the COVID-19 Solidarity Response Fund), UNICEF (distributing billions of COVAX vaccines) and the World Food Programme (delivering emergency food and cash transfers to vulnerable populations, air logistics service, support to national social protection expansions, and continuity of national school feeding programmes).
Multilateral assistance followed a stable growth trend before the pandemic but saw notable shifts during COVID-19. Prior to 2020, multilateral assistance increased by 6-7% annually, with most funding directed to UN agencies (70%), followed by the World Bank (10%) and regional development banks (6%). However, in 2020 and 2021, growth accelerated to 13% and 11%, respectively, while the distribution among multilateral institutions remained largely unchanged. By 2022, UN agencies' share declined slightly to 65%, with increased allocations to the IMF and other institutions. In 2023, total multilateral assistance returned to 2021 levels, but funding to UN agencies increased, offsetting reductions to the IMF, World Bank and other multilateral entities (OECD, 2025[1]).
Amid concerns that earmarked funding was limiting the flexibility of multilateral agencies, there was an initial reduction in such restrictions at the outset of the pandemic, enabling a more responsive approach and a rapid scale-up of operations. However, over the course of the pandemic, earmarking gradually returned to pre-pandemic levels as the need for accountability on the use of funds increased (IAHE, 2022[15]).
In 2019, 78% of the UN Development Programme’s (UNDP) resources were earmarked, meaning additional resources for pandemic response had to be through the reallocation of resources or the mobilisation of new donor funding. In the first two quarters of 2020, only four countries (Australia, Belgium, France and the Netherlands) supported WHO with additional flexible voluntary funding (Gulrajani, 2020[16]). WHO, the UN agency tasked with directing and co‑ordinating authority on international health, had one of the highest rates of earmarked funding at 80% (Woskie and Wenham, 2024[17]). This was true of the broader UN system, with around 58% of funding earmarked in 2019 (UNDP IEO, 2022[18]).
The Netherlands’ pandemic funding comprised 64.4% unearmarked funds, enabling it to respond quickly and flexibly (OECD/IOB, 2025[19]). An evaluation of the UK’s Foreign, Commonwealth and Development Office’s (FCDO’s) response found that unearmarked contributions promoted coherence and co‑ordination, boosted efficiency, and enabled emerging needs and gaps to be rapidly filled (ICAI, 2022[20]). Norway concluded that significant core funding for some key multilaterals provided greater flexibility and allowed for a quick response and adjustment of priorities due to COVID-19 (NORAD, 2020[21]).
In the context of the COVID crisis, bilateral providers directed support via the multilateral system out of principle and as a way of ensuring global needs could be met even amid uncertainty. In total, donors provided USD 188.7 billion to the multilateral system between 2020-2022 (OECD, 2025[1]). Many governments placed trust in multilateral institutions, providing flexible funding to enhance coherence between bilateral and multilateral efforts. Among bilateral providers, however, there is considerable variation across providers in terms of the proportion of funding directed through multilateral channels and the extent to which their response to the pandemic marked a shift in funding strategies or continuity. Some smaller donors relied heavily on multilaterals, while others barely engaged with them. For example, the largest users of the multilateral system in percentage of overall assistance were Kazakhstan (71%), Cyprus (67%) and Ireland (41%), whereas Türkiye (0%), Poland (1.1%) and Bulgaria (1.2%) provided almost no funding through these channels (OECD, 2025[1]).
The Independent Commission for Aid Impact’s (ICAI’s) evaluation of the United Kingdom’s humanitarian response found that its early prioritisation of supporting multilateral delivery generally worked well, with its flexible contributions proving an efficient way of targeting relevant needs and disbursing funding, as well as supporting coherence (see Chapter 4) (ICAI, 2022[20]).
Norway also preferred using multilateral channels, channelling 77% of its total ODA for COVID-19 into 12 projects with seven multilateral organisations (NORAD, 2020[21]). Similarly, Spain explicitly recognised the importance of a multilateral co‑ordinated response and channelled 61.2% of its ODA through international organisations, funding projects directly and indirectly related to COVID-19 (Government of Spain, 2024[22]). The Netherlands also delivered the bulk of its COVID-19 response through the multilateral channel, with its decisions and funding allocations being both principle-driven and informed by needs assessments conducted by key multilateral organisations (OECD/IOB, 2025[19]). Japan contributed to the establishment of a framework for providing additional funding through the Global Fund, as well as allowing the use of Grant Flexibility (Ministry of Foreign Affairs of Japan, 2025[23]).
Drawing on their experience in large-scale humanitarian operations in response to pandemics, UN organisations were quickly able to prepare a response to the humanitarian and socio-economic impacts of the crisis (UNSDG, 2022[24]). For example, an independent evaluation found that the WFP was very timely in this regard, declaring its Level 3 emergency response before the end of March 2020. By December 2020 they had recast their medium-term programme framework to become the “Socio-economic response and recovery programme framework” and in early 2021 integrated COVID-19 into global operational planning, rather than a standalone emergency (WFP, 2022[25]).
The United Nations Population Fund (UNFPA) also moved quickly to make existing emergency core funding streams available and put COVID-19-specific funding mechanisms in place. It prioritised programme countries with the highest needs and least ability to finance their own development, notably those in fragile and humanitarian situations (UNFPA, 2024[26]). Similarly, UNICEF declared a Level 3 emergency in April 2020 and invested considerably in analysing needs. The broad range of evidence generated contributed to the global evidence base and supported countries’ knowledge of their populations’ needs (UNICEF, 2022[27]).
Other funding channels
Governments in recipient countries were another preferred channel for disbursing assistance, both before and during COVID-19, receiving an average of 40% of total flows from 2016-2023 (see Figure 2.10) and showing a slight increase in 2020 linked to budget support. Other major channels included donor governments (16%), UN entities (8%) and donor-country based non-governmental organisations (5%).
The distribution of assistance shifted following the onset of the COVID-19 pandemic. In the four years prior to the pandemic (2016-2019), recipient governments accounted for 37.1% of assistance, increasing to 41.5% during the pandemic period (2020-2023). In contrast, donor-country-based non-governmental organisations (NGOs) saw a decline in their share, from 5.8% pre-pandemic to 4.6% post-pandemic.
All official providers, USD billion disbursements, constant 2023 prices
Notes: Includes official development assistance and other official flows. From 2023 onwards, PSI is no longer included in the analysis of ODA cash flows.
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52.
Financing instruments
As the pandemic unfolded in early 2020, international development and humanitarian institutions had several options of financing instrument, each with its own risks and benefits. There was significant variation across bilateral providers in terms of the types of finance used – though most remained consistent with pre-pandemic trends (see Annex C for examples from select providers).
Resource constraints favoured the use of loan instruments. Concerns about debt sustainability in a context of a steep increase in public debt, particularly in developing economies (World Bank, 2025[28]) affected decisions about the types of loans and often led to actions such as freezing of repayments.
Use of loan instruments
In 2020, all funding types saw an uptick in use – except mobilised private finance – with increases in grants, concessional loans and other official flows. The largest increase in 2019-2020 came in the form of concessional loans. From 2020-2021, grants increased, while both concessional loans and other official flows dropped, resulting in a net decrease year on year.
Figure 2.11 displays the volume of ODA loan disbursements from 2016-2023, covering all donors and flow types. The percentage of assistance provided via ODA loans increased from 13% of the total development finance mix in 2019 to 18% in 2020 (corresponding to a 42% increase in total amounts). From 2021-2022, as the intensity of the pandemic diminished and global economic conditions began to stabilise, the pattern shifted slightly again. ODA grants as a percentage of total assistance increased slightly, while ODA loans initially fell in 2021 but then rebounded in 2022. This reflected strategic adjustments to the easing of the immediate crisis as well as support to vaccine rollouts in 2021.
All official providers, USD billion disbursements, constant 2023 prices
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52.
Pre-pandemic, multilaterals accounted for around half of all ODA loans, with bilateral providers, including EU institutions, providing the other half. However, in the first year of the pandemic, this pattern significantly changed as the total loan disbursements soared from USD 52 billion in 2019 to USD 77 billion in 2020, with multilaterals providing 83% of loans. ODA loans from multilateral providers increased by 55% in 2020, adding an additional USD 15 billion. ODA loans from national governments and the European Union also increased by 42%, but in 2021 they decreased by 8%, before picking up again in 2022.
In 2022, the overall volume of ODA loans increased markedly, in part due to the exceptional increase in loans committed in 2020 and 2021 to respond to the COVID-19 pandemic, as well as new loans to Ukraine (Kiernan, Turroques and Ahmad, 2024[29]). The largest individual providers of ODA loan disbursements (aggregated across 2020-2022) were the World Bank (USD 50 billion), Japan (USD 32 billion), and the European Union (USD 28 billion). The European Union more than doubled its ODA loan disbursements from USD 3.5 billion in 2019 to USD 7.2 billion in 2020, and then almost doubled again in 2022.
The largest recipients of ODA loan disbursements (aggregated across 2020-2022) were Ukraine (USD 16.4 billion), Bangladesh (USD 16.1 billion) and India (USD 15.3 billion). While Bangladesh and India are regularly in the top ten countries by volume of assistance, and both received significant COVID-19-related support, the jump in assistance to Ukraine in 2022 was in response to Russia’s full-scale war of aggression.
In total, 54 countries were provided with total loan disbursements worth USD 1 billion or more. From 2020-2021, Kenya received approximately USD 1.2 billion in COVID-19-related assistance, accounting for 8% of its total aid during this period. Of this, 61% was in grants and 8% was in concessional loans. The remaining 31% consisted of non-concessional loans (OECD, 2025[30]). In contrast, COVID-19-related assistance commitments to Bangladesh amounted to USD 5.9 billion, equivalent to around one-fifth of the total development finance committed to this country over this period. Concessional loans represented a third of COVID-19 related finance to Bangladesh (OECD, 2025[31]).
Navigating fiscal vulnerability and debt distress with concessional lending
With the pandemic testing the fiscal resilience of development institutions, the increase in loan use may reflect the sudden pressure that donor countries and financial institutions faced to balance providing support with their own economic challenges (UN, 2020[32]). Within the first three months of the pandemic, two-thirds of the 62 countries receiving IMF support did so via concessional loans (IEO, 2023[33]). The IMF doubled its emergency lending capacity by increasing concessional support via its Poverty Reduction and Growth Trust and its Catastrophe Containment and Relief Fund (UNDP IEO, 2022[18]). In Kuwait, assistance was provided via the Kuwait Fund for Arab Economic Development, which provides concessional loans using a demand-driven approach (OECD, 2020[34]). Qatar and France also predominantly utilised concessional loans.
However, due to the high risk of debt distress and rising interest rates, driven in part by increased borrowing from provider countries for their own domestic pandemic responses, there was a strong push to use concessional finance and grants. Approximately half of LMICs had high public debt levels prior to COVID-19, a trend that worsened due to the pandemic. Even prior to the pandemic, over 30 African countries spent more on debt service than on healthcare. According to the World Bank’s 2024 International Debt Report, LMICs accumulated significant debt during the pandemic years, driven by the need to scale-up health services and provide economic relief amid sharp declines in economic activity and government revenues. This trend persisted in 2023, as countries continued to navigate the post-pandemic recovery and address mounting development challenges.
The external debt of LMICs reached a record USD 8.8 trillion in 2023, while debt servicing costs for LMICs also reached an all-time high (Gill and Schellekens, 2021[35]). By early 2023, 54 ODA-eligible countries were at moderate or high risk of debt distress and nine were already in distress – the majority of which were African nations (OECD, 2023[36]). Generally, fragile and conflict-affected states, commodity-dependent countries, and small states were more likely to be at moderate or high risk of debt distress (World Bank, 2022[37]). Countries such as Burkina Faso, Burundi, the Republic of the Congo, Côte d’Ivoire, Ghana, Liberia, Senegal and Sierra Leone saw significant rises in their debt burden between 2018 and 2023, reaching at least 15% of GDP (UNAIDS, 2025[38]).The terms of the loans countries could access, combined with large falls in exports, foreign direct investment (FDI) and recessions, undermined the fiscal space of governments in many LMICs, resulting in some countries being required to make debt payments at the expense of health and other social services, hampering their ability to respond with the health and stimulus packages that were commonplace in HICs (U.S. Global Leadership Coalition, 2021[39]).
In contrast, some governments sought to avoid new debt by reallocating existing budgetary resources to fund their pandemic response. While this strategy provided immediate relief without worsening debt levels, it came at the cost of diverting funds from other critical sectors, potentially stalling long-term development objectives. The opportunity costs of these reallocations were high: for every dollar shifted, countries lost an estimated USD 1.20 to USD 1.60 in potential returns from postponed or cancelled public investments. Sectors such as education, infrastructure and social services bore the brunt of these cuts, which could have long-term consequences for economic growth and social development (Allan and Bayley, 2023[40]).
To support vulnerable countries in debt management during the pandemic, the G20 set up the Debt Stress Suspension Initiative. G20 countries agreed in March 2020 to defer debt payments until the end of 2021. The World Bank and the IMF supported the implementation of the initiative by monitoring spending, enhancing public debt transparency and ensuring prudent borrowing. Established in May 2020, the initiative helped countries concentrate their resources on fighting the pandemic and safeguarding the lives and livelihoods of millions of the most vulnerable people. Forty-eight out of 73 eligible countries participated in the initiative before it expired at the end of December 2021. From May 2020 to December 2021, the initiative suspended USD 12.9 billion in debt-service payments owed by participating countries to their creditors (World Bank, 2022[41]). However, that relief did not apply to private lenders or payments to the World Bank itself which means only 41% of debt payments qualitied for relief (COVID Collective, 2022[42]).
Grants
Grants are transfers of cash, goods or services for which no repayment is required. Grants provided immediate financial relief without adding to the debt burden of recipient countries, which was particularly important and relevant for low-income countries with limited fiscal space. The overall amount of ODA grants disbursed has increased steadily from USD 178 billion in 2016 to USD 233 billion in 2022. Annual percentage increases in ODA grants were below 2% in the years preceding the pandemic (2016-2019). However, total ODA grants then increased by 5% in 2020 and reached 18% in 2022.
Bilateral providers increased their ODA grants by nearly USD 3 billion from 2019-2020, while also increasing loans. Grant disbursements increased again in 2022 with bilateral providers increasing their share of ODA grants by 21%, the highest share in the reporting period. Multilaterals, conversely, had the largest increase (18%) in 2020, and maintained the same level – above USD 40 billion – throughout the pandemic.
Between 2020-2022, the largest providers of ODA grants were the United States (USD 133 billion), Germany (USD 73 billion), and the European Union (USD 54 billion). The World Bank was the largest multilateral donor, disbursing USD 19.1 billion, followed by the Global Fund with USD 15.4 billion.
Some providers, including Austria, Hungary and Finland, increased their grant disbursements by more than 20% from 2020-2022 (32%, 24% and 21%, respectively). Others, such as Greece, New Zealand, Türkiye and the United Arab Emirates, reduced their ODA grant disbursements during the same period.
All official providers, USD billion disbursements, constant 2023 prices
Notes: Bilaterals include DAC and non-DAC countries, as well as EU institutions. Multilaterals refer to concessional outflows from the core budgets of multilateral organisations that voluntarily report their data to the OECD.
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52.
In November 2020, Saudi Arabia chaired and hosted the G20 in Riyadh and played an active role in its presidency, succeeding in mobilising G20 members to commit sizeable funding to respond to the COVID-19 pandemic.
Saudi Arabia has committed and disbursed a significant amount of funding to assist various countries worldwide in responding to the pandemic, often working in challenging contexts of high need and fragility. From 2020-2022, the average annual assistance to developing countries provided by Saudi Arabia more than doubled compared to 2016-2019 levels. In 2020-2021, Saudi Arabia’s external assistance reached USD 3.8 billion on average per year, compared with USD 1.8 billion in 2018-2019, (average per year, commitment basis). The composition of Saudi Arabia’s assistance also changed: in 2020-2021 it was 100% grant based, while in previous years most of the aid was provided as concessional loans.
Saudi Arabia’s COVID-19 international response of more than USD 825 million was managed by King Salman Humanitarian Relief. This included funding to 33 countries for the purchase of COVID-19 vaccines, medical supplies and equipment, as well as USD 10 million in financial support to the Solidarity Response Fund managed by the World Health Organization (WHO) and about USD 300 million to international research institutions working to develop COVID-19 vaccines. WHO received grants equivalent to USD 109 million commitments, Gavi received USD 108 million (of which USD 106 million to COVAX) and CEPI, USD 150 million. Local and central governments of partner countries received USD 64 million. Concerning vaccine doses, in addition to the Gavi donation, Saudi Arabia provided 1 499 270 vaccine doses (valued at some USD 6.4 million) to Bangladesh. As part of the broader crisis response, Saudi Arabia provided significant budget support to Egypt in 2021.
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52; Interview with King Salman Humanitarian Aid and Relief Center (KSRelief), May 2024.
The World Bank Group announced “broad, fast action” to help developing countries strengthen their pandemic response. It focused on supporting public health interventions, working to ensure the flow of critical supplies and equipment, and helping the private sector continue to operate and sustain jobs. The aim was to deploy USD 160 billion in financial support over 15 months to help more than 100 countries. This included USD 50 billion of new IDA resources through grants and highly concessional loans. These global amounts translated into significant funds in many countries. For example, in Kenya, in 2020, USD 1 billion in financing was approved to support the COVID response.
Source: World Bank (2020[43]), ‘’World Bank Approves $1 Billion Financing for Kenya, to Address COVID-19 Financing Gap and Support Kenya’s Economy’’, https://www.worldbank.org/en/news/press-release/2020/05/20/world-bank-approves-1-billion-financing-for-kenya-to-address-covid-19-financing-gap-and-support-kenyas-economy.
The COVID-19 vaccine development and rollout were unprecedented in terms of their scale, speed and reach, and formed a key component of the crisis funding for nearly all providers of assistance in line with the November 2020 DAC high-level meeting call to make “affordable vaccines, tests and treatments available to all” (OECD, 2020, p. 3[44]).
Providers channelled vaccine donations both multilaterally and bilaterally. Key channels included Gavi (USD 6.2 billion), central governments (USD 559 million), and CEPI (USD 541 million) (OECD, 2025[1]). Most vaccines were channelled globally (unallocated by income). Least-developed countries were the largest recipient group of vaccines by total disbursements at USD 754 million, followed by lower-middle-income countries at USD 744 million (see Figure 2.14).5 The largest recipient region was Africa at USD 882 million, followed by Asia at USD 725 million and the Americas at USD 355 million (Figure 2.15).
According to OECD figures, from 2021-2022, disbursements for vaccines totalled USD 8.6 billion, with the large majority being disbursed during the first year. In 2021, the donations totalled USD 6.8 billion (or 3% of the total ODA), amounting to more than 932 million doses.6 Within the 2021 figure, about one-third (USD 2.4 billion) were donations of excess doses from domestic supplies (amounting to nearly 353 million doses); USD 3.9 billion was for donations of doses specifically purchased for developing countries; and USD 0.5 billion went towards ancillary costs (OECD, 2025[1]).
Almost 1.7 billion vaccine donations were pledged throughout the course of the pandemic (Launch and Scale Speedometer, 2023[45]). The vaccines donated by DAC members accounted for more than 80% of the overall number of shipped donated vaccines. The largest DAC donors in terms of shipping volume were the United States (around 578 million doses), Germany (136 million), and France (91 million) (OECD, 2025[1]).
From 2021-2022, the largest contributors in terms of funding disbursements for vaccines were the United States (USD 4.5 billion), Germany (USD 909 million) and France (USD 606 million). Some countries, however, did not report vaccine donations to the CRS as ODA. This includes China, which is estimated to have sold 1.85 billion vaccines and donated a further 328 million (Bridge Beijing, 2022[46]).
As for other providers, Japan combined vaccine provision and support to cold chains. For example, Japan provided approximately 7.35 million doses directly to Viet Nam. The provision of cold chains and the introduction of digital vaccination records were promoted via a grant to UNICEF, which contributed to the promotion of vaccination among children aged 5 and over and their mothers, which was being promoted by the Government of Viet Nam (JICA, 2024[47]).
All official bilateral providers, USD billion disbursements, constant 2023 prices
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52.
Note: 2021 is used as the base year as COVID-19 vaccines were not widely available before January 2021. The data in these graphs includes direct procurement and delivery of vaccines, as well as donations of funding and excess supply to vaccine facilities such as Gavi COVAX. However, a large number of vaccine disbursements (around USD 6.5 billion) from DAC members to these facilities are unspecified by region or income group.
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52.
Note: 2021 is used as the base year as COVID-19 vaccines were not widely available before January 2021. The data in these graphs includes direct procurement and delivery of vaccines, as well as donations of funding and excess supply to vaccine facilities such as Gavi COVAX. However, a large number of vaccine disbursements (around USD 6.5 billion) from DAC members to these facilities are unspecified by region or income group.
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52.
Ireland provides an illustrative example of how many EU members supported the vaccine effort as part of a broader, multilateral approach to the crisis. In addition to funding WHO and bilateral support, the Department of Foreign Affairs provided early support for the establishment of the COVAX mechanism set up by the WHO, Gavi, the Vaccine Alliance, UNICEF and CEPI in 2021 to accelerate the production and equitable distribution of COVID-19 vaccines. Ireland provided a total of EUR 13.5 million to this facility including prompt release of funding for country readiness measures such as the provision of equipment and technical support to low-income countries to boost their ability to roll out large, safe, and rapid vaccination campaigns delivery of vaccination campaigns. In addition to funding for the COVAX facility, Ireland donated over 4 million COVID-19 doses, the majority of which were distributed to countries in Africa via the COVAX facility (Department of Foreign Affairs and Trade, Ireland, 2025[48]).
The United States provided cross-government support to vaccine supply and rollout, with an initial goal of contributing to achieving 70% coverage in the countries it supported by 2022. As of July 2023, international providers, partner governments, multilateral organisations and implementing partners had contributed to fully vaccinating an average of 45% of the population across the 123 countries that received support, falling well short of the 70% goal (GAO, 2023[49]). The United States, and other countries, scaled back this goal to focus more on vulnerable populations.
South-South and South-North co‑operation played an important role in vaccine access. Countries in Latin America, Africa and Asia engaged in knowledge exchanges and direct assistance to supply vaccine components and equipment and to bolster vaccine rollouts. A survey conducted by the United Nations Office for South-South Co-operation’s (UNOSSC’s) division for Asia and the Pacific found that all 17 countries surveyed had received support and that most had also provided support to neighbouring countries and others.
In August 2020, Mexico and Argentina agreed to produce 250 million COVID-19 vaccines, to be distributed in those countries as well as other Latin American countries “on an equal basis” (OECD, 2025, p. 15[50]). An Argentine laboratory produced the active substance, while a Mexican company led packaging. Mexico’s Fundación Carlos Slim was the financier, reaching an agreement with AstraZeneca to produce vaccines “without economic benefit” (OECD, 2025, p. 15[50]). Among the countries that received the first donations of vaccines from Mexico were Belize, Bolivia and Paraguay. By October 2021, Mexico had donated more than 1.1 million vaccines within the region (OECD, 2025[50]).
OECD figures show that nearly two-thirds of disbursements for vaccines were routed multilaterally to the COVID-19 Vaccine Global Access (COVAX). COVAX was funded by governments, philanthropic organisations, multilateral institutions and the private sector. Importantly, COVAX's Advance Market Commitment (AMC) targeted funding from wealthier nations to subsidise vaccines for 92 low- and middle-income countries. As of April 2022, the vast majority (96.1%) of COVAX funding came from donor governments and the European Commission; with the remainder donated by foundations, corporations and organisations (Gavi, 2022[51]).
International development and humanitarian actors made substantial contributions to supporting vaccine access by employing a range of strategies, including funding, partnerships with multilateral organisations, bilateral donations, and the continuation of existing programmes. COVAX was the most important delivery vehicle for vaccine equity, supplying, as of December 2022, almost 75% of all doses to low-income countries.
As of April 2022, the vast majority (96.1%) of COVAX funding came from donor governments and the European Commission, with the remainder donated by foundations, corporations and organisations (OECD, 2024[52]). COVAX's Advance Market Commitment (AMC) targeted funding from wealthier nations to subsidise vaccines for 92 LMICs. However, limited supply, delayed funding and competing procurement strategies limited potential success (Box 5.11 in Chapter 5).
Several examples from providers illustrate the significant contributions bilateral providers made to COVAX:
In 2020, China provided USD 20 million to support Gavi’s work for the 2021-2025 strategic period. In 2021, China further pledged USD 100 million to the COVAX Advance Market Commitment (AMC), marking its largest voluntary pledge to an international organisation to date (Gavi, 2025[53]).
Japan contributed about USD 1.5 billion to COVAX and provided 19 million vaccine doses to 25 countries through the facility (Gavi, 2024[54]). In addition, over 24 million vaccine doses were provided bilaterally to seven countries (Ministry of Foreign Affairs of Japan, 2023[55]).
The Netherlands donated 16.1 million vaccine doses through COVAX, representing over 70% of the country’s total donated doses (OECD/IOB, 2025[19]).
New Zealand donated USD 18.2 million to COVAX to provide safe access to COVID-19 vaccinations for developing states in Polynesia (Samoa, Tonga and Tuvalu); the Western Pacific (Fiji, Papua New Guinea, the Solomon Islands and Vanuatu); Southeast Asia (Indonesia and Timor-Leste); and Africa (Cameroon, Malawi, Mauritania, Niger and South Sudan) (CBi, 2021[56]).
The Kingdom of Saudi Arabia responded to the global pandemic with a contribution of USD 150 million and USD 41 million in donated doses through COVAX (Gavi, 2025[57]).
Spain, channelling the majority of their vaccine donations through COVAX, invested close to EUR 300 million (Ministerio de Asuntos Exteriores, Unión Europea and Cooperación, 2024[58]).
The United States, as the largest donor to COVAX, provided USD 4 billion in funding for the 2021 financial year (Gavi, 2025[59]).
Other major donors to COVAX included Brazil (USD 86.7 million) and Kuwait (USD 50 million). Smaller contributions (under USD 1.2 million) came from Moldova, Malaysia, Mauritius, the Philippines and Viet Nam (Gavi, 2022[51]), further underscoring the role of South-South co-operation in the pandemic response.
COVAX achieved significant goals, including delivering almost two billion doses to more than 110 countries (Gavi, 2022[60]), though many challenges to achieving equitable access remained (see Chapter 5).
Private philanthropy for development was on a gradual upward trend prior to the pandemic, increasing from USD 8.6 billion in 2018 to USD 8.9 billion in 2019 (Figure 2.16). With the onset of the pandemic, total philanthropic flows increased significantly, rising to USD 10.9 billion in 2020 and peaking at USD 12 billion in 2021. As the pandemic waned, total philanthropic flows also decreased in 2022. The latest data for 2023 show an increase back to USD 12 billion.
The USD 3.5 billion in international philanthropy for the COVID-19 response from 2020 to 2022 was highly concentrated among a limited number of donors, with the top five donors representing 86% of the total contribution. These were the Mastercard Foundation (USD 1.3 billion), the Gates Foundation (USD 1.2 billion), the Wellcome Trust (USD 208 million), the Rockefeller Foundation (USD 159 million), and the LEGO Foundation (USD 98 million). Philanthropic spending for all purposes across 2020-2022 totalled USD 34.0 billion, with COVID-19-related spending representing 10.3%.
The pandemic crisis catalysed innovative financial approaches, such as the issuance of social bonds. The Ford Foundation led this effort with a USD 1 billion bond to stabilise non-profit organisations that sought to address inequity during and after the pandemic (OECD, 2021[61]). This novel funding mechanism, which was later adopted by the Rockefeller Foundation and others, raised USD 2.9 billion collectively, supplementing traditional grant making without reallocating existing resources. Low interest rates in 2020 made these bonds financially feasible, allowing foundations to amplify their impact through expanded grant making and targeted recovery efforts.
All philanthropic providers, USD billion disbursements, constant 2023 prices
Source: OECD (2025[1]), OECD Data Explorer, Creditor Reporting System (flows) (Database), http://data-explorer.oecd.org/s/52.
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← 1. Official development finance (ODF) comprises official development assistance (ODA) (including humanitarian assistance) provided by governments, and other official flows (OOF). In addition, the study includes non-official flows from philanthropic organisations and where possible analysed official flows not reported to the OECD as ODF – such as assistance provided by China and Mexico – for which comparable quantitative data are not available. As such, the expression “international development assistance” used encompasses this broader scope of financing, referring to all international assistance provided in 2020-2022 to eligible countries, unless otherwise specified.
← 2. There are United Nations Country Team (UNCT) in 130 countries, covering all 162 countries where there are UN programmes. The UNCT includes all the UN entities working on sustainable development, emergency, recovery and transition in programme countries. The UNCT is led by the UN Resident Coordinator, who is the representative of the UN Secretary-General in a given country. See https://unsdg.un.org/about/how-we-work.
← 3. The humanitarian cluster system is a co‑ordination mechanism used by the United Nations and other humanitarian organisations to respond to crises. It is designed to organise humanitarian actors into core sectors, such as water, health and food security. The aim is to improve the efficiency and effectiveness of the response, avoid duplication and ensure that affected people’s needs are met in a timely and appropriate manner. More info at: https://www.unocha.org/we-coordinate.
← 4. The gender marker in the CRS is reported and tracked on a two-year basis. Reporting on the gender marker is mandatory, while reporting on disability is voluntary.
← 5. A large number of vaccine disbursements (around USD 6.5 billion) from DAC members are unspecified by region or income group. These unspecified allocations were mostly provided to global vaccine efforts, i.e. Gavi and COVAX AMC.
← 6. Calculated using total disbursements for excess supply donations and donations for developing countries reported in CRS, divided by the average price per dose (USD 6.72 in 2021 and USD 6.66 in 2022). Excludes ancillary costs.