As this report is issued, more than 33 million people worldwide have been infected with COVID-19 and one million have died. Some 11.8 million cases and 409 thousand deaths have been confirmed in the 63 countries covered in the COVID-19 Global Humanitarian Response Plan (GHRP). However, the raw data should be treated with caution. There are well-known limitations to testing and reporting from many countries, including those in the GHRP. Many places have likely not reached peak transmission yet. The enormity of the secondary consequences of the pandemic is also now coming into view. We are seeing increasing hunger and malnutrition. Famine is back on the agenda with warning lights flashing in South Sudan, Yemen, the Democratic Republic of the Congo, north-east Nigeria, and Africa's Sahel region to name a few.Health and education systems are collapsing in many countries, leading to a rise in preventable diseases and children dropping out of school. Women and girls face gender-based violence everywhere. The longer it takes before lockdowns and curfews can be lifted, the worse it will get. The contraction of economies is hurting everyone. But those at the bottom of the income pyramid and in the informal sector feel it most. Against a historic drop in poverty over the past three decades, the number of people in extreme poverty is set to rise again. The most vulnerable pay the biggest price - women, children, the disabled and the elderly.