The Bill & Melinda Gates Foundation launched its fifth annual Goalkeepers Report, featuring an updated global dataset illustrating the pandemic’s adverse impact on progress toward the United Nations Sustainable Development Goals (Global Goals).

This year’s report, co-authored by Bill Gates and Melinda French Gates, co-chairs of the Bill & Melinda Gates Foundation, shows that disparities caused by COVID-19 remain stark, and those who have been hardest hit by the pandemic will be the slowest to recover. Because of COVID-19, an additional 31 million people were pushed into extreme poverty in 2020 compared to 2019. And while 90% of advanced economies will regain pre-pandemic per capita income levels by next year, only a third of low- and middle-income economies are expected to do so.

Fortunately, amidst this devastation, the world stepped up to avert some of the worst-case scenarios. In last year’s Goalkeepers Report, the Institute for Health Metrics and Evaluation (IHME) predicted a drop of 14 percentage points in global vaccine coverage—effectively erasing 25 years of progress in 25 weeks. New analysis from IHME demonstrates that the decline, while still unacceptable, was only half of what was anticipated.

The report highlights the disproportionate economic impact that the pandemic has had on women globally. In high- and low-income countries alike, women have been harder hit than men by the global recession that was triggered by the pandemic.

More than 80% of all COVID-19 vaccines have been administered in high- and upper-middle-income countries to date, with some securing two to three times the number needed so they can cover boosters; less than 1% of doses have been administered in low-income countries. Further, COVID-19 vaccine access has been strongly correlated with the locations where there is vaccine R&D and manufacturing capability. Though Africa is home to 17% of the world’s population, for example, it has less than 1% of the world’s vaccine manufacturing capabilities.

Ultimately, the report calls for the world to invest in R&D, infrastructure, and innovation in places closer to the people who stand to benefit.