The number of protracted conflicts, recurrent emergencies and health crises across the globe today has resulted in an unprecedented level of humanitarian need. This assistance must be impartial, based upon need and guided by humanitarian principles, while ensuring a focus on the most vulnerable.
Countries experiencing humanitarian crises struggle with decimated or fragile health delivery systems, resulting in limited access to health care and poor health outcomes.
The burden of infectious disease and mortality levels in countries affected by humanitarian crises are tragically high. In Yemen, 2.3 million cases of cholera were reported from October 2016 to January 2020, while the recent reemergence of Ebola in the Democratic Republic of Congo  accounts for the second largest Ebola outbreak in history. 2019 also marked the highest number of measles cases recorded worldwide since 2006. 
Many fragile states and low- and middle-income countries, or LMICs, are now dealing with a double burden of disease. The burden of noncommunicable disease (NCD) is disproportionately rising in LMICs, with close to 32 million deaths occurring in these countries out of 41 million NCD deaths globally, over one year. 
Meeting mental health and psychosocial needs and preventing and responding to gender-based violence are critical components of humanitarian assistance. Recent research has shown that one in five people in areas affected by conflict are living with some form of mental disorder and one in 10 are living with a moderate or severe mental disorder. Additionally, 70% of women experience gender-based violence in humanitarian contexts compared to 35% worldwide. 
Maintain strong support for the International Disaster Assistance and Migration and Refugee Assistance accounts, and continue robust funding levels for humanitarian emergencies through the U.S. Agency for International Development Bureau for Humanitarian Assistance, the Department of State Bureau of Population, Refugees, and Migration, and the Centers for Disease Control and Prevention.
U.S. government agencies should continue to implement timely and flexible funding mechanisms to allow for rapid and appropriate response to the COVID-19 pandemic and encourage other donors and U.N. agencies to do the same. This will facilitate the ability for organizations to adapt field operations to changing contexts and increase speed and effectiveness.
Remain a global leader in humanitarian health response by enhancing coordination with key domestic donors, engaging and supporting influential donors from other countries, and contributing substantively to global humanitarian policy discussions.
Advocate for the protection of humanitarian workers who provide lifesaving care by ensuring that frontline health workers are protected against infectious diseases and that hospitals and health centers in conflict-affected areas are not military targets.
Lay the groundwork for transitioning from emergency response to longer-term development initiatives through interventions that increase access to health care, support the detection and prevention of infectious diseases and strengthen fragile health systems.
Photo Credits: Patrick Meinhardt ALIMA
Humanitarian programs funded by the United States are essential to saving lives, preventing further degradation of fragile states and contributing to global safety and security. Addressing the health needs of the most vulnerable can lay the groundwork for improving access to healthcare and strengthening and rebuilding fragile health systems.
In the last 50 years the U.S. government has been the leading contributor of global humanitarian assistance. Strategic, timely and effective action by the U.S. humanitarian and health funding agencies allows the humanitarian community to reach millions of people throughout the world each year. This generous support enabled the humanitarian health community to respond to multiple disasters and crises of displacement in 2019.
As part of a coordinated humanitarian response during and after a natural disaster or in times of conflict, investments in health care and services are the key to saving millions of lives. U.S. funding provides emergency medical interventions, nutritional support and access to clean water and sanitation. Detection and prevention of infectious diseases through surveillance and immunizations can be lifesaving interventions for millions. The support of the U.S. government to combat the COVID-19 pandemic globally is especially critical to contain the spread and reduce mortality in countries experiencing conflict and recurrent shocks.
While many emergencies can never be perfectly predicted or entirely prevented, the resulting loss of life can be reduced through appropriate mitigation and preparedness. The U.S. should remain steadfast in its leadership role by helping to build resilient health systems in low-income countries, responding quickly and efficiently when emergencies occur, and coordinating efforts in post-emergency recovery. Since many issues arising from large-scale emergencies require long-term solutions, the United States should continue supporting countries after the initial disaster period to help address the most critical health needs and shorten the recovery phase.
COVID-19 has spread unevenly throughout the world; however, in the face of community transmission, COVID-19 will aggravate existing vulnerabilities and create or exacerbate humanitarian needs far into 2021.
The pandemic has revealed inequities in health in terms of vulnerability to diseases, lack of adequate water and sanitation, and access to care. Critical vaccination efforts are affected in more than 70 countries and in many places, health services for chronic diseases, sexual and reproductive health services or non-COVID-19 infectious diseases have been interrupted or are being neglected. The destruction of hospitals and other health infrastructure in northwest Syria and in Yemen, for example, has put even greater strains on these countries’ ability to cope with COVID-19.
 USAID Democratic Republic of the Congo – Ebola Outbreaks https://www.usaid.gov/sites/default/files/documents/DRC_Ebola_Outbreak_Fact_Sheet_9_09.18.20.pdf
 CDC Global Measles Outbreak https://www.cdc.gov/globalhealth/measles/globalmeaslesoutbreaks.htm
 World Health Organization. Noncommunicable diseases: mortality. www.who.int/gho/ncd/mortality_morbidity/en/
 Global Humanitarian Overview 2021 gho.unocha.org
 The Lancet, Will the COVID-19 pandemic threaten the SDGs? https://www.thelancet.com/action/showPdf?pii=S2468-2667%2820%2930189-4
HEADER PHOTO CREDIT: Seth Doyle