TORONTO -- As developed countries like Canada spend billions of dollars to flatten the curve, the world’s poorest and most conflict-ravaged countries could see millions of deaths and upwards of one billion COVID-19 infections if aid isn’t provided -- a dire situation that could prolong the global pandemic.

New analysis from the International Rescue Committee (IRC) suggests that 34 at-risk countries could be decimated by COVID-19 with anywhere from 500 million to 1 billion infections and 1.7 million to 3.2 million deaths.

IRC president David Miliband says it isn’t too late for the world to intervene, but that will require developed countries to look beyond their own domestic emergencies.

“There’s a focus on the home front, which is completely understandable. But there’s a neglect of the global nature of this disease,” Miliband, who also served as Britain’s Foreign Secretary under Gordon Brown, told CTV’s Power Play on Tuesday.

“This disease won’t be vanquished anywhere until it’s fully vanquished everywhere. There won’t be a return to normality until you’re sure that if you’re flying from one part of the world to another, you’re not going to contract the disease.”

According to global tracking, the virus has yet to take hold in many third-world countries. In Uganda, just 79 cases of COVID-19 have been reported. Miliband said estimates suggest the virus could reach those nations by mid to late May -- and once it does, those 34 countries will be ill prepared.

Take South Sudan, a country of nearly 11 million people that only has four ventilators and 24 intensive care units. In Uganda, there is only one ICU bed available for every one million people. In Bangladesh, one million Rohingya refugees are living in camp with a population density four to seven times higher than New York City.

“So you’ve got the conditions for this to run rampant unless you take the preventative steps,” Miliband said.

The IRC is calling on donations of money to help pay for things such as hand washing stations, medical equipment and frontline healthcare workers. Without that aid, Miliband says, millions will die and the virus will continue to spread.

“When I say to you that our international aid workers haven’t got the soap, haven’t got the hand-washing stations, haven’t got the fever testing kits in order to be able to do this basic prevention, we are really making a bad moral choice but also a bad strategic choice,” he said.

Millions of deaths in the world’s most vulnerable countries is a bleak outlook, but the IRC says those projections “may be conservative at best” due to a few major limitations in the data.

For instance, current modelling for the spread of the virus that uses mortality data from China assumes that all countries have comparable healthcare systems. That’s hardly the case, the IRC suggests, pointing out that in Venezuela, more than half of the country’s doctors have left and 90 per cent of hospitals face critical shortages.

Physical distancing measures, which have been enforced by police in Canada and have helped avoid a worst-case scenario, are impossible to practice in slums and refugee camps. Judicious hand-washing is also out of the question as most camps have extremely limited access to clean water.

And while wealthier nations have been able to use economic stimuli such as emergency cheques and relief packages to help workers and businesses stay afloat, developing nations simply don’t have the resources to survive strict lockdowns. The IRC says shutting down markets or enforcing strict measures could create a “double emergency” that worsens pre-existing problems such as hunger and domestic violence.

The IRC analysis was based off the latest epidemiological modelling and data from the WHO and Imperial College London.

Globally, more than 3.1 million people have been infected with the virus, with a third of all positive cases recorded in the U.S. Canada has confirmed 50,026 cases of COVID-19 and 2,859 deaths. ​