The fallout from the coronavirus outbreak has hurt the income of 77% of Africans surveyed in a report by the Partnership for Evidence-Based Response to Covid-19.

The impact of the pandemic also left many hungry, with four out of five respondents saying they struggled to get food over the past week, an 8% increase from the last survey in August, according to PERC, a public-private group affiliated to the African Union. Even when they had access to food, nearly half of all respondents reduced the number or size of meals, according to a survey of 24,000 adults in 19 AU member-countries.

“The world doesn’t fully recognize the burden that the African continent is facing from Covid,” Tom Frieden, who led the survey, said at a live-streamed report launch Wednesday.

Delays in vaccinating the continent’s more than 1.3 billion people will likely lead to additional resurgences of the virus. They may also result in mutations that will potentially be more transmissible and cause further economic damage associated with lockdowns. Less than 20 million people have been inoculated in Africa, with almost half of those living in Morocco, according to Bloomberg’s Covid-19 Vaccine Tracker.

PERC called on governments to implement public health measures while minimizing socio-economic disruption. It also urged the global community to scale up vaccine supply.

“We have essentially a tale of two worlds going on,” said Frieden, a former director of the U.S. Centers for Disease Control and Prevention. “A world where a vaccine is crushing the curve,” he said, “and a world where a vaccine remains many months, if not even years away.”