Table 2.

Some effects of the COVID-19 response that put sustainable development goals out of reach (78–93).

Sustainable development goal	Effect of COVID-19 response: some details
Childhood vaccination	Programs stalled in 70 countries (Measles, Diphtheria, Cholera, Polio)
Education	School closures: 90% of students (1.57 Billion) kept out of school -Early primary grades are most vulnerable, with effects into adulthood: effects on outcomes of intelligence, teen pregnancy, illicit drug use, graduation rates, employment rates and earnings, arrest rates, hypertension, diabetes mellites, depression -Not just education affected: school closures have effects on food insecurity, loss of a place of safety, less physical activity, lost social interactions, lost support services for developmental difficulties, economic effects on families
Sexual and reproductive health services	Lack of access: estimated ~2.7 Million extra unsafe abortions For every 3 months of lockdown: estimated 2 Million more lack access to contraception, and over 6 months, 7 Million additional unintended pregnancies
Food security	Hunger pandemic: undernourished estimated to increase 83–132 Million (>225,000/day; an 82% increase) -from disrupted food supply chains (labor mobility, food transport, planting seasons) and access to food (loss of jobs and incomes, price increases)
End poverty	Extreme poverty (living on < US$1.90/day): estimated to increase >70 Million -Lost “ladders of opportunity” and social determinants of health
Reduce maternal and U5M	Estimated increase of 1.16 Million children (U5M) and 56,700 maternal deaths, if essential RMNCH services are disrupted (coverage reduction 39–52%) for 6 months in 118 LMIC mostly (~60%) due to affected childhood interventions (wasting, antibiotics, ORS for diarrhea); and childbirth interventions (uterotonics, antibiotics, anticonvulsants, clean birth)
Infectious Disease Mortality	Tuberculosis: in moderate and severe scenario, projected excess deaths (mostly from reduced timely diagnosis and treatment) 342,000–1.36 Million over 5 years (an increase of 4–16%) Malaria: in moderate and severe scenario, projected excess deaths (mostly from delayed net campaigns and treatment) 203,000 to 415,000 over 1 year (an increase of 52–107%, with most deaths in children <5 yo). HIV: in moderate projected excess deaths (mostly due to access to antiretrovirals) 296,000 (range 229,000–420,000) in Sub-Saharan Africa over 1 year (an increase of 63%). Also would increase mother to child transmission by 1.6 times.

LMIC, low- and middle-income countries; ORS, oral rehydration solution; RMNCH, Reproductive Maternal Newborn and Child Health; U5M, under 5 mortality.