The CHH-Lancet Commission reveals accountability issues in humanitarian aid, suggesting governance reforms for displaced populations.
WKS 10: Transforming the Humanitarian System to respond to the needs of forcibly displaced populations: early findings from The CHH-Lancet Commission on Health, Conflict and Forced Displacement, B309 (FCSH), September 3, 2025, 17:00 - 18:00 Humanitarian crises are becoming more complex, protracted, and difficult to respond to in an equitable and effective manner. The Johns Hopkins Center for Humanitarian Health (CHH)-Lancet Commission on Health, Conflict and Forced Displacement was established in 2023 to rethink and reimagine the strategies, governance, and delivery modes of humanitarian aid by proposing systemic changes and bold recommendations that influence global humanitarian and health agendas, and to encourage collective action. The group includes expert commissioners, NextGen young scholars, and an advisory board of senior humanitarians. The Commission has collected evidence from literature and policy analysis, as well as qualitative interviews with affected populations and humanitarian workers in 12 countries. This roundtable aims to explore the Commission’s findings and recommendations from this work, relating to the health needs of forcibly displaced populations. One of the key findings is that power asymmetries distort humanitarian governance. Donors tend to control funding and decisions, while UN agencies and large NGOs dominate operations, often sidelining national actors and affected communities. Local actors play a central role in implementation, but their influence is shaped by contextual dynamics and power relations. Governments are often absent due to limited capacity or authority. This top-down model reduces accountability, misaligns aid with local needs, and undermines long-term sustainability. Key Messages Include 1) the humanitarian system should localize and decentralize governance structures and expertise wherever possible, to provide transparent and real-time decision-making authority to the local actors responsible for the affected populations and 2) that priority humanitarian health packages should include conditions experienced by forcibly displaced populations, while prioritising equity and people-centred approaches.
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Spiegel et al. (2025) studied this question.
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