Progress has not only stopped, but has regressed in areas like getting people out of poverty and improving conditions for women and children around the world, the Bill and Melinda Gates Foundation finds in its 2020 Goalkeepers report published Monday.

Vaccination coverage, seen as a good indicator for how health systems are functioning, is dropping to levels last seen in the 1990s, it says.

“In other words, we’ve been set back about 25 years in about 25 weeks,” the report says. “What the world does in the next months matters a great deal.”

Global action to stop the pandemic would prevent illness and deaths caused by Covid-19, but there’s more at stake: The crisis sets back strides made in global poverty, HIV transmission, malnutrition, gender equality, education and many more areas. Even if the world manages to get the coronavirus under control soon, it could take years to claw back lost progress.