What does ‘leave no one behind’ mean for humanitarian crises-affected populations in the COVID-19 pandemic?

Poorly resourced and fragmented health systems in humanitarian settings with limited resources, including health workforce, are likely to struggle to prevent the spread of COVID-19, and consequently be placed under immense strain with implications for patient care. Humanitarian actors and governments must step up measures to reduce strain from COVID-19 on the healthcare workforce and provide appropriate support at the front line in humanitarian settings, including strengthening WASH, reducing overcrowding where possible, protecting populations vulnerable to COVID-19 and providing additional resources to health services to be able to cope with the response. Health systems in humanitarian settings are often poorly resourced and suffer from workforce shortages.4 Controlling COVID-19 requires multidisciplinary input from doctors to cleaners, whose integral role in prevention of spread of disease is often disregarded.5 A 2015 survey on infection prevention and control (IPC) preparedness of institutions worldwide showed that preparedness levels were only partially adequate.6 Without appropriate personal protective equipment (PPE), the health workforce is put at risk of infection with COVID-19. Any loss to the health workforce will add pressure to an already under-resourced service, with implications for patient care and ability to control COVID-19.