A Scientific Report calls for the Urgent Transformation of the Humanitarian System

A Scientific Report calls for the Urgent Transformation of the Humanitarian System

Published on 20 May 2026

Launched in 2024, the CHH-Lancet Commission on Health, Conflict and Forced Displacement is a collaboration between the Johns Hopkins Center for Humanitarian Health and the medical journal The Lancet. It brings together 21 commissioners and 21 early-career researchers - many from low- and middle-income countries - with the mission of analysing the growing impact of armed conflict and the unprecedented scale of forced displacement on global health.

In a report presented on May 20 in Geneva, the Commission reveals that the Global Humanitarian Overview 2025 - the United Nations' official estimate of global humanitarian needs and funding requirements for 2025 - was revised during the year from USD 44 billion to USD 29 billion, highlighting an alarming collapse in resources at a time when humanitarian needs have reached unprecedented levels.

In conflict zones, most deaths are not caused directly by violence, but by the collapse of essential health systems.

152 Million People Left Without Aid

Of the 239 million people expected to require humanitarian assistance in 2026, only 87 million are projected to receive life-saving support. "In conflict zones, most deaths are not caused directly by violence, but by the collapse of essential health systems. The disruption of vaccination campaigns, maternal care and treatment for chronic diseases turns otherwise preventable conditions into major causes of mortality," explains Karl Blanchet, Director of the Centre for Humanitarian Studies and Full Professor at the Faculty of Medicine of UNIGE, who co-chairs the Commission.

At the same time, attacks on and obstruction of healthcare have reached record levels: 3,663 incidents were documented in 2024, continuing a steady increase observed over recent years. Medical personnel are increasingly being targeted, while access to humanitarian aid is being instrumentalised for political purposes.

Finally, funding for humanitarian aid and global health is now being shaped largely by national security and foreign policy considerations, rather than by the actual needs of affected populations. This shift is making the system more selective, unpredictable and deeply politicised.

"Behind every statistic in this report is a person who has been abandoned by a system meant to protect them. Today, the world spends roughly 100 times more on the military sector than what would be required to meet the most urgent humanitarian needs. This is not a resource problem - it is a political choice that we have the power to change," says Paul Spiegel, Chair of the Commission and Director of the Johns Hopkins Center for Humanitarian Health.

Four Urgent Recommendations

In response to these alarming findings, the panel of experts calls for four urgent actions:

Rebalance power dynamics: place affected communities - rather than donors or geopolitical interests - at the centre of decision-making and resource allocation. International actors must justify their presence on the ground and progressively transfer authority to local leaders, according to a clear and binding timeline. The United Nations humanitarian system should be consolidated into a single, fully accountable structure.

End impunity: attacks on civilians, health workers and medical infrastructure must carry concrete consequences. A global alliance for the protection of health is needed to bring together states, UN agencies and non-governmental organisations, and to take action when health protections are violated.

Reform financing: funding must be guided by humanitarian needs, not political or strategic priorities. This requires the establishment of an independent global fund, separate from UN agencies and bilateral donors, with allocations based on equity. Expanding cash-based assistance programmes should help strengthen the autonomy of affected populations and support local economies. Finally, humanitarian financing must be better integrated into national social protection systems to include displaced populations, rather than managing them through parallel mechanisms.

Ensure health for all: War does not suspend the right to health - it makes it more urgent. Every decision must be grounded in this fundamental right, ensuring equitable access, particularly for the most vulnerable populations. Continuity of care must become the norm: the interruption of essential services - whether for trauma care, maternal health, chronic diseases or mental health - should be regarded as a systemic failure. Health systems must also integrate climate resilience and ensure that technological innovation primarily serves the needs of communities.

Following the global launch of the report in Geneva, the Commission will organise five events between June and July 2026 in Washington, Dakar, Nairobi, Amman and Bogotá. These meetings will bring together commissioners, partners, policymakers, practitioners, and affected communities, with the aim of grounding the report's findings in regional realities and defining actions for the years ahead.