New surges of COVID-19 infection rates and patients requiring specialised care, more infectious variants of the SARS-CoV-2 virus, as well as the limited supply of vaccines and complex global rollout of vaccination campaigns continued to challenge pandemic response efforts and put strain on health systems in low- and high-resource settings alike.

Likely linked to the rapid spread of the Delta variant of the virus, April and May saw several regional hotspots in Asia, South America and Africa. Among the countries reporting the highest infection rates were India, Nepal, and Sri Lanka in Asia in April, and Colombia, the Dominican Republic and Venezuela in May.

Several African countries also reported increasing trends in infection rates in the second quarter of the year, including Algeria, Cameroon, Egypt, Uganda and Zambia. By the end of July, some 68 countries on all continents again showed increasing infection rates, with global numbers slowly stabilising in August and September.

In the second and third quarters of the year, the global number of confirmed COVID-19 infections increased from 151 million at the end of April to nearly 234 million by the end of September 2021. Close to 1.5 million patients died from COVID-19 related complications during the same period, adding to more than 4.7 million confirmed deaths since the beginning of the pandemic.

By late September, 6.5 billion COVID-19 vaccine doses had been administered worldwide, with 23 million doses being administered every day amid persistent supply and demand challenges.

From May to September, we maintained dedicated COVID-19 activities in some 138 projects in 49 countries, working alongside local health workers and supporting hospitals and treatment facilities to deliver medical care and improve infection prevention and control measures.

In many countries, our pandemic response continued to focus on providing protection and care for vulnerable populations in remote communities, people on the move or homeless people, as well as the elderly, including with vaccination campaigns and dedicated support activities. In all MSF projects around the world, our teams worked to maintain other essential healthcare services amid implementing COVID-19 prevention and control measures.

While some additional COVID-19 projects could be closed or reintegrated into regular operations over the second and third quarter, we again launched or reactivated several new COVID-19 interventions.

For the first time since the beginning of the pandemic, we responded with dedicated medical and vaccination activities in Burundi, Lesotho, Tunisia and Uganda. Compared to the first four months of 2021, the number of MSF projects reporting dedicated COVID-19 activities from May to September decreased by around 10 per cent.

Since the beginning of the pandemic, our teams responded to COVID-19 in 368 projects in 76 countries.