Dear HIFA colleagues,
CITATION: The Lancet Commissions Volume 407, Issue 10543 p2065-2140 May 23, 2026
Johns Hopkins Center for Humanitarian Health–Lancet Commission on health, conflict, and forced displacement: health in a world of crises and impunity
Prof Paul Spiegel et al
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00564-7/fulltext
The recommendations of the Commission are summarised in the Lancet editorial:
'The Commission provides a coherent and actionable strategy centred on four interdependent recommendations targeted at states; non-state actors; donors; multilateral institutions; and humanitarian, health, and local leaders. First, invert power by shifting resources and decision making to affected populations, making external leadership exceptional, and strengthening nationally led health and social protection systems. Second, end impunity by enforcing accountability to affected populations across governance, financing, coordination, and implementation, with health outcomes and continuity of care serving as measures of compliance. Third, fix the money by aligning humanitarian financing with needs rather than donor priorities, and by transferring decision-making authority to local and national actors through independently governed global and multilevel pooled funding mechanisms. Fourth, uphold health for all as a non-negotiable right by ensuring that decisions at all levels advance equitable care and health protection, with service delivery embedded within national health and social protection systems wherever feasible. The Commission provides detailed guidance on how to operationalise these recommendations.'
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01017-2/fulltext
COMMENT (NPW): For me, one of the major strengths of this Commission is that it draws on no fewer than 18 systematic reviews and a systematic analysis. Whereas 45 years ago, when I was a medical student, such an article would have been written from a position of 'expertise', now it demands to be grounded in the cumulative available evidence. Here are the 19 papers that it references:
Noble, E ∙ Moinul, D ∙ Khairy Djim Sylla, O ∙ et al.
Downward accountability mechanism effectiveness by non-governmental organizations in low-and middle-income countries: a qualitative systematic review
PLoS One. 2025; 20, e0324098
Bwirire, D ∙ Crutzen, R ∙ Ntabe Namegabe, E ∙ et al.
Health inequalities in post-conflict settings: A systematic review
PLoS One. 2022; 17, e0265038
Bogale, B ∙ Scambler, S ∙ Mohd Khairuddin, AN ∙ et al.
Health system strengthening in fragile and conflict-affected states: a review of systematic reviews
PLoS One. 2024; 19, e0305234
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Khorram-Manesh, A ∙ Burkle, FM ∙ Goniewicz, K ∙ et al.
Estimating the number of civilian casualties in modern armed conflicts-a systematic review
Front Public Health. 2021; 9, 765261
Kadir, A ∙ Shenoda, S ∙ Goldhagen, J
Effects of armed conflict on child health and development: A systematic review
PLoS One. 2019; 14, e0210071
Vu, A ∙ Adam, A ∙ Wirtz, A ∙ et al.
The prevalence of sexual violence among female refugees in complex humanitarian emergencies: a systematic review and meta-analysis
PLoS Curr. 2014; 6:6
Charlson, F ∙ van Ommeren, M ∙ Flaxman, A ∙ et al.
New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis
Lancet. 2019; 394:240-248
Morina, N ∙ Akhtar, A ∙ Barth, J ∙ et al.
Psychiatric disorders in refugees and internally displaced persons after forced displacement: a systematic review
Front Psychiatry. 2018; 9:433
Horyniak, D ∙ Melo, JS ∙ Farrell, RM ∙ et al.
Epidemiology of substance use among forced migrants: a global systematic review
PLoS One. 2016; 11, e0159134
El-Khalil, C ∙ Tudor, DC ∙ Nedelcea, C
Impact of intergenerational trauma on second-generation descendants: a systematic review
BMC Psychol. 2025; 13:668
Bellos, A ∙ Mulholland, K ∙ O'Brien, KL ∙ et al.
The burden of acute respiratory infections in crisis-affected populations: a systematic review
Confl Health. 2010; 4:3
Haeuser, E ∙ Byrne, S ∙ Nguyen, J ∙ et al., the GBD 2023 Vaccine Coverage Collaborators
Global, regional, and national trends in routine childhood vaccination coverage from 1980 to 2023 with forecasts to 2030: a systematic analysis for the Global Burden of Disease Study 2023
Granata, G ∙ Petersen, E ∙ Capone, A ∙ et al.
The impact of armed conflict on the development and global spread of antibiotic resistance: a systematic review
Clin Microbiol Infect. 2024; 30:858-865
Jawad, M ∙ Vamos, EP ∙ Najim, M ∙ et al.
Impact of armed conflict on cardiovascular disease risk: a systematic review
Heart. 2019; 105:1388-1394
Kampalath, V ∙ MacLean, S ∙ AlAbdulhadi, A ∙ et al.
The delivery of essential newborn care in conflict settings: A systematic review
Front Pediatr. 2022; 10, 937751
Rabbani, A ∙ Padhani, ZAA ∙ Siddiqui, F ∙ et al.
Systematic review of infant and young child feeding practices in conflict areas: what the evidence advocates
BMJ Open. 2020; 10, e036757
Marou, V ∙ Vardavas, CI ∙ Aslanoglou, K ∙ et al.
The impact of conflict on infectious disease: a systematic literature review
Confl Health. 2024; 18:27
Ramesh, A ∙ Blanchet, K ∙ Ensink, JH ∙ et al.
Evidence on the effectiveness of water, sanitation, and hygiene (WASH) interventions on health outcomes in humanitarian crises: a systematic review
PLoS One. 2015; 10, e0124688
Gesesew, H ∙ Kebede, H ∙ Berhe, K ∙ et al.
Perilous medicine in Tigray: a systematic review
Confl Health. 2023; 17:26
Doocy, S ∙ Tappis, H
Cash-based approaches in humanitarian emergencies: a systematic review
Campbell Syst Rev. 2017; 13:1-200
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org