The CHH–Lancet Commission on Health, Conflict, and Forced Displacement: reimagining the humanitarian system

• Published in: The Lancet (British edition) 2024-03, Vol.403 (10433), p.1215-1217
• Main Authors: Spiegel, Paul B, Karadag, Ozge, Blanchet, Karl, Undie, Chi-Chi, Mateus, Ana, Horton, Richard
• Format: Article
• Language: English
• Subjects: Ambulances; Artificial intelligence; Asymmetric warfare; Climate change; Climate effects; Displaced persons; Emergency management; Emergency preparedness; Emergency response; Funding; Gender; Health planning; Humanitarian aid; Humanitarianism; Humans; International law; Migration; Populism; Refugees; Relief Work; Sustainable practices; Warfare
• ISSN: 0140-6736; 1474-547X; 1474-547X
• DOI: 10.1016/S0140-6736(24)00426-4

Populism tinged with anti-refugee discourse has led to a weakening of asylum and refugee law in many countries.1 While special protection of hospitals and ambulances was previously largely respected by warring parties under the Geneva Conventions, attacks on health care have become the norm.2 With conflict-related deaths at a 26-year record high3 and more than 110 million people forcibly displaced worldwide at the end of June, 2023,4 the humanitarian system is overwhelmed, despite increases in humanitarian support from public and private donors.5 As one of us (PBS) wrote in The Lancet in 2017: “An unprecedented number of humanitarian emergencies of large magnitude and duration is causing the largest number of people in a generation to be forcibly displaced. At the forefront of the Commission's agenda will be a critical re-evaluation of humanitarian principles (ie, humanity, independence, impartiality, and neutrality) in light of asymmetric warfare, the increasing presence of non-state armed groups, and complex conflict environments that include sanctions and restrictions on how humanitarian agencies can respond.7 The Commission will examine global configurations of refugees and internally displaced persons, acknowledging the complex dynamics of global migration flows1 and climate change,8 and will promote an inclusive and flexible protection system. In an era defined by technological advancement, artificial intelligence has the potential to revolutionise humanitarian health strategies and interventions, but might also be detrimental depending on how the technology is developed and used in complex and life-saving settings.11 We are equally committed to addressing the effects of the climate emergency in humanitarian health and will advocate for sustainable practices in health planning, emergency preparedness, and humanitarian response.8 In the financial realm, we will explore financing models that align with humanitarian objectives, supporting a shift towards more proactive and sustainable funding strategies that address components of the humanitarian–development–peace nexus and promote national responders having access to humanitarian funding.