GENEVA (AP) — The U.N. humanitarian office says needs for assistance have ballooned to unprecedented levels this year because of COVID-19, projecting that a staggering 235 million people will require help in 2021.

This comes as a result of the coronavirus pandemic and global challenges including conflicts, forced migration and the impact of global warming.

The U.N. Office for the Coordination of Humanitarian Affairs, or OCHA, expects a 40% increase in the number of people in need of such assistance in 2021 compared to this year — a sign that pain, suffering and torment brought by the coronavirus outbreak and other problems could get worse even if hopes of a vaccine are rising.

OCHA made the projections in its latest annual Global Humanitarian Overview on Tuesday, saying its hopes to reach 160 million of those people in need will cost $35 billion. That’s more than twice the record $17 billion that donors have provided for the international humanitarian response so far this year — and a target figure that is almost certain to go unmet.

“The picture we’re painting this year is the bleakest and darkest perspective on humanitarian needs we’ve ever set out, and that’s because the pandemic has reaped carnage across the most fragile and vulnerable countries on the planet,” said U.N. humanitarian chief Mark Lowcock, who heads OCHA.

“For the first time since the 1990s, extreme poverty is going to increase, life expectancy will fall, the annual death toll from HIV, tuberculosis and malaria is set to double,” he said. “We fear a near doubling in the number of people facing starvation.”

Lowcock told a U.N. briefing in New York on the overview that he thinks the U.N. appeal will probably raise a record $20 billion by the end of the year -- $2 billion more than last year. But he said the gap between needs and funding is growing and the U.N. is looking to “new players” coming on the scene in 2021, including U.S. President-elect Joe Biden’s new administration.

The U.N. aims to reach about two-thirds of those in need, with the Red Cross and other humanitarian organizations trying to meet the rest, Lowcock explained.

U.N. Secretary-General Antonio Guterres said humanitarian aid budgets are now facing dire shortfalls as the impact of the COVID-19 pandemic continues to worsen, and said extreme poverty has risen for the first time in more than a generation.

“The lives of people in every nation and corner of the world have been upended by the impact of the pandemic,” he said in a video statement. “Those already living on a knife’s edge are being hit disproportionately hard by rising food prices, falling incomes, interrupted vaccination programs and school closures.”

The overview, which is billed as one of the most comprehensive looks of the world’s humanitarian needs, has put together nearly three dozen individual response plans for a total of 56 “vulnerable” countries.

Lowcock said the biggest problem is in Yemen where there is danger of “a large-scale famine” now, saying a prime reason is lack of funding from Gulf countries that were major donors in the past which has led to cuts in aid and the closing of clinics.

He said the biggest financial request is for the Syrian crisis and its spillover to neighboring countries where millions of Syrians have fled to escape the more than nine-year conflict.

OCHA said other countries in need include Afghanistan, Congo, Haiti, Nigeria, South Sudan, Ukraine and Venezuela. Newcomers to this year’s list are Mozambique, where extremist activity has increased in the north, Pakistan and Zimbabwe.

Lowcock said it’s not the pandemic, but its economic impact that’s having the greatest effect on humanitarian needs.

“These all hit the poorest people in the poorest countries hardest of all,” he said. “For the poorest, the hangover from the pandemic will be long and hard.”

Lowcock told the launch of the overview, speaking virtually from New York, that the world faces a clear choice.

“We can let 2021 be the year of the grand reversal – the unravelling of 40 years of progress – or we can work together to make sure we all find a way out of this pandemic,” he said.

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Lederer reported from the United Nations