Health and Healthcare Systems

No refuge: the impact of coronavirus on the world's most vulnerable

Migrants line up to receive sanitisers outside a hotel used as a refugee shelter, after authorities found several cases of the novel coronavirus and put the area under quarantine, following the outbreak of the coronavirus disease (COVID-19), in Kranidi, Greece April 21, 2020. REUTERS/Costas Baltas - RC259G9ZPYG0

How do you manage a pandemic with no running water or electricity? Image: REUTERS/Costas Baltas

Johnny Wood
Writer, Forum Agenda
Our Impact
What's the World Economic Forum doing to accelerate action on Health and Healthcare Systems?
The Big Picture
Explore and monitor how COVID-19 is affecting economies, industries and global issues
A hand holding a looking glass by a lake
Crowdsource Innovation
Get involved with our crowdsourced digital platform to deliver impact at scale
Stay up to date:


  • COVID-19 poses a devastating threat to many of the world’s poorer countries.
  • Many developing nations have crowded living conditions and inadequate healthcare capacity.
  • Urgent action is needed to prevent the disease spreading unchecked.

The health and economic impact of the COVID-19 pandemic has been felt around the world, but the virus could have a devastating effect on developing nations that are home to some of the planet’s most vulnerable communities.

As a guest on the World Economic Forum’s World vs Virus podcast, David Miliband, former British foreign secretary and current head of the International Rescue Committee – a global aid organization for people displaced by conflict, persecution and natural disasters – lays bare his fears for the world’s poorest people as the virus approaches.

“If you think it is really terrifying to face the prospect of COVID-19 in an advanced industrialized country, if you're worried about ventilators in New York City, if you're concerned about the health system in Italy, just imagine what it's like to face the prospect of a virus where there isn't running water, where there isn't a proper health system,” says Miliband.


Subscribe to the podcast:
Apple Podcasts

That’s the situation facing people living in Cox’s Bazar, Bangladesh. It’s the world’s biggest refugee camp, with around 1 million refugees from Myanmar living in severely cramped conditions with little more than 10 square metres per person.

There will be death on “an appalling scale” unless urgent action is taken to limit the impact of the virus in such places, Miliband warns.

Rohingya refugees gather to mark the second anniversary of the exodus at the Kutupalong camp in Cox’s Bazar, Bangladesh, August 25, 2019. REUTERS/Rafiqur Rahman     TPX IMAGES OF THE DAY - RC1E6F0E33F0
Cox’s Bazar in Bangladesh is the world’s biggest refugee camp. Image: REUTERS/Rafiqur Rahman
Have you read?

No refuge for refugees

Asif Saleh, the head of development organization BRAC in Bangladesh and one of the World Economic Forum’s Young Global Leaders, knows only too well the difficulties refugees and other vulnerable people face. While for many countries the imposition of lockdown restrictions can help slow the spread of COVID-19, in poorer nations such measures may have less of an impact.

In the capital, Dhaka, millions of people are slum dwellers, many living a hand-to-mouth existence working in the country’s informal economy. Like its refugee camps, the slums are densely packed, leaving occupants exposed to rapid spread of disease.

Around 90% of workers, such as rickshaw drivers or van drivers, depend on the local economy to survive. If they don’t work they don’t receive any income, leaving them little choice but to go out to seek a living and ignore the national lockdown.

With no health insurance or social protection available, vulnerable people have no safety net to fall back on. Working from home or applying for unemployment wages, like in some developed economies, are not realities for people in Bangladesh.

“So oftentimes in countries like ours, because you don't have these kinds of social protections in place, if you don't pair up economic support or assistance with the lockdown, it's not gonna work,” explains Saleh.

“We need to think of something which actually works locally,” he continues, “to figure out what is the best solution beyond shutting down the economy completely.”

coronavirus fears epidemic pandemic disease infection contamination sanitation spread virus health care
Men carry bags of food aid at the Kakuma refugee camp in northern Kenya. Image: REUTERS/Baz Ratner

Distancing is impossible

Far from Bangladesh, Mohammed Mahmoud is also concerned about the threat posed by the coronavirus pandemic. In search of work, he left the Kakuma Refugee Camp in Kenya for the country’s capital city, Nairobi. Despite spending his entire life in Kenya his refugee status leaves him legally unsettled.

For Mohammed and his neighbours, staying safe in the crowded building they live in is a challenge. With access to water only once a week, it is difficult to follow healthcare advice to wash your hands in order to slow the spread of the coronavirus pandemic.

“People are using one toilet. For a whole floor, you have 100 people using this one toilet. How do you stay clean? People don't have gloves. People don't have soap,” he says.

The search for work involves avoiding the authorities. Mohammed has no access to healthcare workers, so getting sick and reporting his illness could result in being deported or put in prison. Living in such cramped conditions also makes quarantine or social distancing virtually impossible, exacerbating the dangers of COVID-19 for the wider community.


What is the World Economic Forum doing about the coronavirus outbreak?

Time is running out

The message is clear, according to David Miliband: time is running out to prevent a humanitarian crisis. Cases of the disease have been recorded in some of the world’s poorest countries, including conflict hotspots, such as Syria and Afghanistan, which mostly have healthcare systems that could be quickly overwhelmed.

“So we're talking a matter of weeks before this disease, if unchecked, becomes really rampant,” says Miliband.

At a time when governments around the world are making available huge stimulus packages to support flailing economies, money is being spent, he says, but not in the countries where the disease could spread unchecked.

Don't miss any update on this topic

Create a free account and access your personalized content collection with our latest publications and analyses.

Sign up for free

License and Republishing

World Economic Forum articles may be republished in accordance with the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Public License, and in accordance with our Terms of Use.

The views expressed in this article are those of the author alone and not the World Economic Forum.

Related topics:
Health and Healthcare SystemsGlobal Risks
World Economic Forum logo
Global Agenda

The Agenda Weekly

A weekly update of the most important issues driving the global agenda

Subscribe today

You can unsubscribe at any time using the link in our emails. For more details, review our privacy policy.

Scientists make pancreatic cancer discovery, and other top health stories to read

Shyam Bishen

July 17, 2024

About Us



Partners & Members

  • Sign in
  • Join Us

Language Editions

Privacy Policy & Terms of Service

© 2024 World Economic Forum