This blog is co-authored by Ariane McCabe, PhD, Director of Global Health and Public Affairs, GSK Vaccines and by Claire Leonie Ward, PhD, Health Advocacy Advisor at Save the Children UK.

As the world's attention and resources focus on fighting the global pandemic, what does it mean for those most at risk of other life-threatening diseases, especially vaccine-preventable diseases? This question poses major challenges for countries where health systems and economies are already weak.

To date, reports of transmission of COVID-19 to developing countries and fragile environments such as war zones and refugee camps appear to be relatively limited, but rates of transmission in these locations are beginning to worryingly increase. In the Cox’s Bazar refugee camp - where Save the Children has been working since August 2017 - based on the available evidence, no COVID-19 infection has been reported among the refugee population in Bangladesh; although the country has reported cases of COVID-19 elsewhere.

However, with 914,998 Rohingya refugees residing in 34 refugee camps in Cox's Bazar, often with up to five people living in temporary shelter, it may be only a matter of time before an outbreak of COVID -19 does happen. The low numbers reported may also be symptomatic of weak health care and surveillance systems, limited testing, reports and available data on the pandemic. Environmental, political and social factors in these countries pose unique challenges for the prevention and control of infectious diseases. Limited access to clean water, soap and primary health care services, such as routine immunization, means that families often already exposed to malnutrition and other underlying health problems - cholera , measles and whooping cough - are the most vulnerable.

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