Never has the “leave no one behind” pledge felt more urgent. As nations around the world implement measures to control the spread of SARS-CoV-2, including lockdowns and restrictions on individuals’ movements, they must heed their global commitments. When member states adopted the UN 2030 Agenda for Sustainable Development, they promised to ensure no one will be left behind. Chief among the world's most vulnerable people are refugees and migrants. The COVID-19 crisis puts these groups at enormous risk. Yet global pandemic efforts have so far failed in their duty of care to refugees and migrants.
There are millions of refugees and migrants in camps and detention centres worldwide. Resettlement procedures have been suspended by the UN. UNHCR reports that 34 countries hosting substantial refugee populations have seen local transmission of SARS-CoV-2. The often appalling conditions of migrant camps are fertile for infectious disease outbreaks. With few latrines and water supplies, basic hygiene to prevent spread is difficult. With extreme overcrowding, physical distancing is impossible.
In Europe, tens of thousands of migrants live in densely packed camps along the Mediterranean, without adequate medical personnel and infrastructure to cope. With no emergency COVID-19 plan in place by governments, Médicins san Frontières has demanded evacuation of 42 000 asylum seekers on the Greek islands to suitable accommodation. In a Lancet Comment, WHO leaders appeal for more attention for refugees and migrants, including in humanitarian settings, which are facing disruption of essential supplies of food, medicines, and aid workers.
The worst might be yet to come. 80% of refugees live in low-income and middle-income countries, the sites of the expected fourth wave of COVID-19 behind China, Europe, and the USA. Already, these settings have weak health-care systems, scarce protective equipment, and poor testing and treatment capacity. They need enormous global support to prepare for an impending crisis. This virus disregards all borders. COVID-19 responses must not overlook refugees and migrants.
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