The International Monetary Fund expects global economic growth in 2021 to fall slightly below its July forecast of 6%, IMF chief Kristalina Georgieva said on Tuesday, citing risks associated with debt, inflation and divergent economic trends in the wake of the COVID-19 pandemic.

Georgieva said the global economy was bouncing back, but the pandemic continued to limit the recovery, with the main obstacle posed by the “Great Vaccination Divide” that has seen too many countries with too little access to COVID vaccines.

In a virtual speech at Bocconi University in Italy, Georgieva said next week’s updated World Economic Outlook would forecast advanced economies’ returning to pre-pandemic levels of economic output by 2022, but most emerging and developing countries needing “many more years” to recover.

“We face a global recovery that remains ‘hobbled’ by the pandemic and its impact. We are unable to walk forward properly — it is like walking with stones in our shoes,” she said.

The United States and China remained vital engines of growth, and Italy and Europe were showing increased momentum, but growth was worsening elsewhere, Georgieva said.

Inflation pressures, a key risk factor, were expected to subside in most countries in 2022, but would continue to affect some emerging and developing economies, she said, warning that a sustained increase in inflation expectations could cause a rapid rise in interest rates and tighter financial conditions.

While central banks could generally avoid tightening for now, they should be prepared to act quickly if the recovery strengthened faster than expected, or risks of rising inflation materialized, she said.

She said it was also important to monitor financial risks, including stretched asset valuations.

Global debt levels, now at about 100% of world gross domestic product, meant many developing countries had very limited ability to issue new debt at favorable conditions, Georgieva said.

She urged richer nations to increase delivery of COVID-19 vaccines to developing countries, remove trade restrictions and close a $20 billion gap in grant funding needed for COVID-19 testing, tracing and therapeutics.

Failure to close the massive gap in vaccination rates between advanced economies and poorer nations could hold back a global recovery, driving cumulative global GDP losses to $5.3 trillion over the next five years, she said.

Georgieva said countries should also accelerate efforts to address climate change, ensure technological change and bolster inclusion – all of which could also boost economic growth.

A shift to renewable energy, new electricity networks, energy efficiency, and low carbon mobility could raise global GDP by about 2% this decade, creating 30 million new jobs, she said.