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

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International humanitarian law is routinely being broken with impunity in conflicts globally. Populism tinged with anti-refugee discourse has led to a weakening of asylum and refugee law in many countries. 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. With conflict-related deaths at a 26-year record high and more than 110 million people forcibly displaced worldwide at the end of June, 2023, the humanitarian system is overwhelmed, despite increases in humanitarian support from public and private donors. 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. Yet the existing humanitarian system was created for a different time and is no longer fit for purpose.” Since then, the situation has become worse. The creeping normalisation of violations of international humanitarian law and refugee law and insufficient accountability of humanitarian organisations to affected persons must be rejected. The humanitarian system needs to be reimagined with the priorities of the affected communities at its centre.