Amidst insecurity, insufficient funding, mobility restrictions and uncertainty around how best to respond to this novel threat, displaced populations, humanitarian actors and governments are mounting responses to COVID-19 across sites of forced migration in the Middle East and East Africa. Importantly, many of these responses have built on existing local social and aid delivery structures particular to the displacement context (see Box 1). These have included: drawing on communication channels that displaced people actively maintain to politicians and humanitarian agencies to obtain COVID-19 information; leveraging the legitimacy of and relationships between medical providers to coordinate responses across fragmented systems; and building on long-term relationships between providers and patients to maintain remote services for people with chronic conditions. Refugee-led organisations have also functioned as important actors in solidarity networks to address the gaps and limitations of existing international aid and host government support systems in providing food relief for self-settled groups. Box 1. Examples of local initiatives to respond to COVID-19, highlighting the social relations that responses built on Obtaining information for COVID-19 education & Coordinating advocacy: In August 2018, violent clashes broke systems: In both Syria and Lebanon, healthcare out in a UN POC for IDPs among ethnic Nuer people governance is highly fragmented but frontline aligned to different vice-presidents in South medical workers have been key to ensuring Sudan, leading to one group leaving the camp en responses to COVID-19 are coordinated. In Syria’s masse for Mangateen settlement, a government- opposition-held province of Idlib, the civil society- managed site for IDPs on unused land outside of led health directorate has taken the lead in the city.72 Among several popular explanations for coordinating a COVID-19 task force through which the move was the idea that this minority group was NGOs, international agencies, volunteer rescue supported and workers and opposition groups are implementing patronage networks by one of the wealthiest COVID-19 preparedness activities for its besieged politicians in the country, and so should not be population, half of whom are displaced.77 In a receiving UN aid.73 When rumours of the cluster of context where so many actors are in dispute over COVID-19 cases in the POC reached Mangateen, territory, the local and international legitimacy of residents used different channels that they had the medical doctors leading the directorate has developed during their move to find out more been information on behalf of the settlement. One was fundraising.77 Grounded coordination is also key a channel to the politicians linked to the earlier within and around Ein-El-Helwe Palestinian clash who had direct experience of the disease. So refugee camp in Lebanon. Staff from the Ministry many of the country’s leadership had become of Public Health, UN agencies, international and infected with the virus that the entire COVID-19 local NGOs and first aid responders have financially taskforce was through self-isolating.74 charity Another channel key collaborated KEY CONSIDERATIONS: COVID-19 AND FORCED DISPLACEMENT IN THE MIDDLE EAST AND EAST AFRICA Contact: a.wilkinson@ids.ac.uk responses to to enabling reach across fragmented coordination communities and with 15