The arrival of COVID-19 in Nigeria sparked a cascade of crises, but the pandemic poses its greatest threat in the impoverished, fragile northeast of Africa’s largest country, according to a new assessment by the UNDP .

There, Borno, Adamawa, and Yobe states comprise “one of the most pronounced, multi-faceted, and complex humanitarian and development crises known to the international community today,” UNDP’s 2018 Nigeria Human Development report found—more than two years before the zoonotic pathogen we now know as a novel coronavirus brought economies, livelihoods, and lives to a sudden, painful halt.

As all of Nigeria reels from a 55 percent drop in the price of its leading export, oil, experts say the country’s northeast stands to suffer most as a result of the pandemic—particularly its 1.8 million internally displaced people, living in overcrowded camps and already struggling to survive. The health care system in all three states is fractured, with 35 percent of health facilities damaged by conflict and routine vaccination campaigns and other essential health services already disrupted.

UNDP’s rapid COVID-19 socioeconomic assessment, which will inform policies and programs to help the country recover, envisages three possible scenarios in the northeast:

– Violent extremist groups such as Boko Haram could step up recruitment by exploiting vulnerable people or take advantage of security vacuums as the government pivots to contain the outbreak or as outbreaks occur within the military or police.

– A complete lockdown without protection for vulnerable populations in a conflict setting—where social bonds are weak—could trigger further unrest, which would make containing the virus even more difficult.

– Lockdown could also threaten peacebuilding work by humanitarian and security actors, who play a vital role in rebuilding social bonds, reintegrating ex-combatants, and restoring livelihoods.

Possible responses include halting the rotation of security personnel, setting up testing, quarantine, and isolation centers within military barracks and camps, and raising awareness of key hygiene practices and COVID-19 symptoms. Keeping supply chains intact and expanding the land area of extremely crowded IDP camps in the Northeast will be essential, the assessment finds.

UNDP and other agencies respond

Across the country, Nigeria—with more than 200 million people—has extremely limited health care resources, with only 330 intensive care facilities, five COVID-19 testing and treatment centers, and just 100 beds in a designated isolation facility in the capital, Lagos—with graver shortfalls in the northeast.

To help meet emerging needs, UNDP and other agencies have shipped in ventilators and other essential medical supplies. An initial shipment included 50 A30 ventilators and personal protective equipment procured with funds from the COVID-19 Basket Fund, launched in April.

UNDP is helping to create emergency employment opportunities—restoring trade flows and supporting the smooth functioning of markets shoring up food security in the hardest-hit communities—and supported the creation of public service announcements with celebrities aimed at tackling gender-based and domestic violence, which spike globally during crises.

It’s also helped launch a National COVID-19 Response Plan around 10 pillars that include scaling up surveillance, testing, isolation, contact-tracing, infection prevention and control; case management of COVID-19 patients; risk communication and community engagement; emergency preparedness, security, and logistics for mass care; and resource mobilization.