COVID-19 will drive 70–100 million people into poverty and 80–130 million into chronic hunger. These impacts will persist beyond 2021, the number of malnourished children will increase, and access to water and sanitation services will decrease. Priorities for mitigating impacts include averting the need for additional humanitarian assistance and preventing food crises that may contribute to political unrest. Country-specific case studies focus on operational and programmatic pivots.