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Direct Relief: 2021 Impact Report

From pandemic response to chronic disease support, a look back at this year's activity.


Giving Back

Healthcare Provider Ines Mendoza in the pharmacy of the Santa Barbara Neighborhood Clinics, in Goleta, California, on Friday, October 23, 2020. The Santa Barbara Neighborhood Clinics are among the hundreds of community health centers across the U.S. that received Bayer-donated IUDs to bolster reproductive health services for uninsured women. (Photo by Erin Feinblatt for Direct Relief)

Direct Relief improves the health and lives of people worldwide affected by poverty or emergencies. This year, the organization supported local healthcare facilities, public health authorities, and logistical partners in 99 countries, including all 50 U.S. states and U.S. territories, to maintain heightened operations for a global health landscape that has irrevocably changed.

In 2021 and the years ahead, Direct Relief must continue to expand capabilities, engage new partners, and strengthen health systems worldwide to ensure that it can meet growing requests and increasing demand for humanitarian aid in medically vulnerable communities.

This report provides an overview of how Direct Relief has leveraged support from generous individuals, companies, and foundations in 2021. Thank you for being part of Direct Relief.

By the Numbers

(Unaudited totals from January 1, 2021 – December 7, 2021)

  • $1,802,260,603 in medical assistance
  • 252.9 million Defined Daily Doses of medicine
  • 8.4 million pounds of medicine and supplies
  • 21,300 deliveries
  • 2,359 healthcare providers supported
  • 100 countries


Shipments of PPE and Covid-19 aid arrived via charter aircraft in Kathmandu, Nepal, in May 2021. (Photo by Pranjal Sharma for Direct Relief)

The disparate effects of the ongoing COVID-19 pandemic have brought attention to significant needs for health systems in medically vulnerable communities worldwide. Local healthcare facilities operating in these environments face difficulties, including the existing chronic lack of medical grade oxygen and cold storage capacity. Over the past two years, Direct Relief has ramped up efforts to work with healthcare facilities and nonprofits to address these needs.

In 2021 alone, Direct Relief has delivered:

  • 33,458 oxygen concentrators to healthcare facilities in 52 countries
  • 45 medical-grade vaccine fridges to facilities throughout the Caribbean
  • 11.6 million doses of COVID-19 vaccines
  • 128 million units of PPE to 70 countries


Storm activity in the Caribbean continues to grow in frequency and intensity, with widely distributed humanitarian consequences. Health centers in the region have limited capacity to store medicines that are needed immediately after disasters and through long-term recovery, including insulin, vaccines, and other temperature-sensitive therapies.

These critically needed medicines require specialized cold storage and handling, often lacking throughout the region and relies on backup power that may not exist or a power grid that may be devastated in an increasingly common and powerful event like a hurricane.

Temperature-sensitive therapies are stored in the organization’s cold storage facility in Santa Barbara, which doubled in capacity this year. (Lara Cooper/Direct Relief)

Direct Relief has drastically expanded its medical material and cold chain support to health centers worldwide in 2021, including the launch of the Caribbean Cold Chain Initiative to scale up reliable energy and cold chain capacity in the region.

Cold chain products require precise handling while in transit and at rest and are sensitive to variations in temperature (typically kept between 2 and 8 degrees Celsius), humidity, and light. Direct Relief provided insulin in partnership with nonprofit organization Life for a Child along with delivery devices, monitoring equipment, and testing supplies to meet the needs of 20,000 children in 32 countries in 2021.


Direct Relief supports healthcare facilities across the U.S. and around the world to improve access to maternal care for women who are low-income or uninsured and who otherwise would not have access to care.

In the U.S., Direct Relief has launched several initiatives to reduce barriers for women accessing family planning services, including access to long-acting reversible contraception.

Internationally, supporting healthcare providers who are working to reduce the burden of maternal and newborn mortality has long been a focus of Direct Relief.

A midwife with her patients in La Libertad, Peru. (Photo by Larry Rodolfo Campos Valeriano for the International Confederation of Midwives)

In 2021, Direct Relief delivered:

  • 479 midwife kits and consumable re-supply deliveries to 10 countries to equip midwives for safe labor and birth
  • 774,890 bottles of prenatal vitamins to support healthy early childhood development in 37 countries


Marginalized communities in the U.S. have long experienced worse health outcomes and are less likely to receive the medical care they need. That’s true of people of color, LGBTQ+ individuals, people experiencing homelessness, and other vulnerable populations.

Health provider and patient at the Henry J. Austin Health Center in Trenton, New Jersey. (Photo courtesy of Henry J. Austin Health Center)

These injustices are modern-day effects of a long history of discriminatory practices, policies, and traditions. Direct Relief is helping close the gap in health equity by delivering more medicine, medical equipment, and operational funding to support health facilities that serve marginalized communities.


Direct Relief operates the largest charitable medicines program in the U.S., providing medicines and supplies to nonprofit community health centers and free/charitable clinics that anchor medically underserved communities on an ongoing basis and through a range of emergencies in all 50 U.S. states.

Since their inception over 55 years ago as part of the Civil Rights movement with the express purpose of providing access to health services for people of color who had none, these health centers and clinics have grown to reach 32 million people – more than 60 percent of whom are from racial and ethnic minority communities.

  • Hispanic adults are 70% more likely to be diagnosed with diabetes
  • Direct Relief delivered $50.6 million (wholesale) in medicines and supplies to treat Type 1 and Type 2 diabetes to nearly 700 facilities in 550 cities in 2021
  • African American adults are 40% more likely to have high blood pressure and less likely to have their blood pressure under control
  • Direct Relief delivered more than $11.1 million (wholesale) in medicines to treat cardiovascular diseases to 550 facilities in 460 cities in 2021


Community health centers, free/charitable clinics, educational institutions, and other community-based organizations in medically underserved areas efficiently respond to the health disparities in their communities, but they are chronically underfunded. To help close the funding gap, Direct Relief launched its Fund for Health Equity in 2021 to provide these organizations with financial support.



Many of Zufall Health Center’s patients, who are 70% Hispanic and 7% Black, are forced to choose between paying for utilities and groceries, let alone paying for medications. Direct Relief has supported Zufall – and hundreds of similar health facilities – for more than a decade.

  • More than $110,000 (wholesale) of insulin, related supplies, and other essential items in 2021
  • A $150,000 grant through Helping Build Healthy Communities, a multi-year grant program in partnership with BD and the National Association of Community Health Centers, to expand the availability of monitoring and diagnostic supplies and equipment while formalizing approaches to developing individualized care plans with each patient


Direct Relief is a leader in using technology for humanitarian purposes – from its adoption of commercial-grade product management software to sophisticated cold chain logistics. The organization’s health mapping and research capabilities are a primary example of its expertise in these areas. They have become a critical driver of decision-making as Direct Relief continued to grow in 2021.


  • 2013: Mapping technology using geographic information systems (GIS) software is introduced, powering Direct Relief’s Global Aid Map to pinpoint distributions of aid for the organization and public use.
  • 2018: Access to data for real-time spatial analysis following emergencies is greatly enhanced through a newly-established partnership with Facebook in the aftermath of Hurricane Harvey, the first of many corporate partnerships that would allow Direct Relief to quickly test hypotheses about the causes and consequences of humanitarian aid distributions.
  • 2020: Direct Relief collaborates with research institutions, infectious disease experts, epidemiologists, technology companies, and public agencies to become a crucial source of actionable information products and analyses to guide operations and inform policymakers and public health authorities at the height of the COVID-19 pandemic.
  • 2021: Mapping, information, products, and analyses guide Direct Relief’s programs from pre-positioning materials for hurricane preparedness to distributions of medical oxygen and PPE to the areas of India most affected by a sudden surge in COVID cases in May.


Without power, critical health services can’t be provided – life-saving medicines go bad, electronic health records can’t be accessed, essential medical equipment can’t be powered, and vital community health facilities serving the most vulnerable shutdown.

In 2021, Direct Relief engaged with the California Primary Care Association to understand health facility and health safety network readiness for managing COVID-19 vaccinations, insulins, and other temperature-sensitive medications for the communities they serve.

Before the project’s launch, the status of refrigeration capacity and backup power availability across the California health safety net was known in only 8% of facilities. Within six weeks, visibility was provided into some level of capacity for 100% of primary care facilities in California.

The project revealed that 61% of facilities lacked backup power, 10% operated without refrigeration, and only 35% had both refrigeration and some form of backup power. Equipped with this knowledge, Direct Relief is launching a new initiative to bring resilient power to community health centers throughout California, to prepare these safety net providers better when the power goes out.

[Click here to download a PDF version of the report.]

Giving is Good Medicine

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