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The 2015–2017 global migratory crisis saw unprecedented numbers of people on the move and tremendous diversity in terms of age, gender and medical requirements. This article focuses on key emerging public health issues around migrant populations and their interactions with host populations. Basic needs and rights of migrants and refugees are not always respected in regard to article 25 of the Universal Declaration of Human Rights and article 23 of the Refugee Convention. These are populations with varying degrees of vulnerability and needs in terms of protection, security, rights, and access to healthcare. Their health status, initially conditioned by the situation at the point of origin, is often jeopardised by adverse conditions along migratory paths and in intermediate and final destination countries. Due to their condition, forcibly displaced migrants and refugees face a triple burden of non-communicable diseases, infectious diseases, and mental health issues. There are specific challenges regarding chronic infectious and neglected tropical diseases, for which awareness in host countries is imperative. Health risks in terms of susceptibility to, and dissemination of, infectious diseases are not unidirectional. The response, including the humanitarian effort, whose aim is to guarantee access to basic needs (food, water and sanitation, healthcare), is gripped with numerous challenges. Evaluation of current policy shows insufficiency regarding the provision of basic needs to migrant populations, even in the countries that do the most. Governments around the world need to rise to the occasion and adopt policies that guarantee universal health coverage, for migrants and refugees, as well as host populations, in accordance with the UN Sustainable Development Goals. An expert consultation was carried out in the form of a pre-conference workshop during the 4th International Conference on Prevention and Infection Control (ICPIC) in Geneva, Switzerland, on 20 June 2017, the United Nations World Refugee Day.

Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches1, while maintaining proven prevention measures using a vaccines-plus approach2 that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities3 in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.

Background Within the context of the growing burden of non-communicable diseases (NCDs) globally, there is limited evidence on how researchers have explored the response to chronic health needs in the context of health policy and systems in low- and middle-income countries. Continuity of care (CoC) is one concept that represents several elements of a long-term model of care. This scoping review aims to map and describe the state of knowledge regarding how researchers in resource-constrained settings have defined and used the concept of CoC for chronic conditions in primary healthcare. Methods This scoping review adopted the modified framework for interpretive scoping literature reviews. A systematic literature search in PubMed was performed, followed by a study selection process and data extraction, analysis and synthesis. Extracted data regarding the context of using CoC and the definition of CoC were analysed inductively to identify similar patterns; based on this, articles were divided into groups. MaxQDA was then used to re-code each article with themes according to the CoC definition to perform a cross-case synthesis under each identified group. Results A total of 55 peer-reviewed articles, comprising reviews or commentaries and qualitative or quantitative studies, were included. The number of articles has increased over the years. Five groups were identified as those (1) reflecting a change across stages or systems of care, (2) mentioning continuity or lack of continuity without a detailed definition, (3) researching CoC in HIV/AIDS programmes and its scaling up to support management of NCDs, (4) researching CoC in NCD management, and (5) measuring CoC with validated questionnaires. Conclusion Research or policy documents need to provide an explicit definition of CoC when this terminology is used. A framework for CoC is suggested, acknowledging three components for CoC (i.e. longitudinal care, the nature of the patient–provider relationship and coordinated care) while considering relevant contextual factors, particularly access and quality. Electronic supplementary material The online version of this article (10.1186/s12961-019-0426-1) contains supplementary material, which is available to authorized users.

Palliative care interventions have historically been neglected in the practice of humanitarian medicine. This may come as a surprise, since it is a sombre reality that medical practitioners are frequently witness to death and dying in their response to humanitarian crises. Making the case for palliative care in humanitarian crises At the World Health Assembly (WHA) in May 2014, the World Health Organization affirmed a commitment to develop and implement policies that integrate palliative care services across the continuum of care. Three days following the close of the WHA, the Centers for Disease Control and Prevention released cumulative data estimating that 187 people had died from Ebola in Liberia, Sierra Leone, and Guinea. 1 By the end of the summer, this number had increased tenfold. Rosa Crestani of Médecins Sans Frontières (MSF) would later describe the challenging conditions faced by staff working in Monrovia during this period: 'We could only offer very basic palliative care and there were so many patients and so few staff that the staff had on average only one minute per patient'. 2 The exceptionally high mortality rates associated with the West African Ebola outbreak have prompted further reflection on the role of palliative care in humanitarian crises. 3,4 A similar trend was seen during the height of the HIV/AIDS epidemic in the late 1990s, as health actors were faced with the need to focus on palliative care in the absence of affordable anti-retroviral treatment (ART). In addition to high mortality situations such as the Ebola and pre-ART HIV epidemics, a substantial proportion of medical humanitarian programmes still focus on the treatment of common diseases in protracted crises in settings with limited health infrastructure. Without the necessary capacity-or the required political commitment-in such circumstances, it is often not possible to deliver clinical care of the same breadth and standard as can be expected in higher resource settings.

The principles of humanitarianism explicitly require both saving lives and prevention and alleviation of human suffering as essential parts of a humanitarian healthcare response. The consequences of humanitarian crises vary greatly depending on the causes, location, and vulnerability of the population they affect, but the consequences often include extensive loss of life and physical, psychological, social, and spiritual suffering on a massive scale. The poor, the displaced (refugees and internally displaced persons), and those living in low-income settings generally are most vulnerable to unnecessary suffering and death. Palliative care must be provided for all dying patients and should be integrated with life-saving treatment for patients with acute life-threatening conditions. This chapter discusses a range of humanitarian crises, the needs of people affected by and living in such crises, and components of effective palliative care.

Decolonising humanitarian aid has imposed itself on the humanitarian debate over the past few years, both in academic and practitioner circles. Decolonisation, as a term, alludes to the imbalance of power and the potential to rebalance this power asymmetry. But the how, to what extent, and with what means is not yet clear.The use of decolonisation as a framework for action has thus far sidestepped the important -and more complex-act of understanding the monopoly, misuse, or abuse of power in the mainstream humanitarian sector. This lack of a collective consciousness has opened spaces for defensiveness, denial, and repudiation by those in the humanitarian sphere who see the call to decolonise as a threat to the power hierarchy. Likewise, decolonisation as an act is not seen equally by those who advocate it and ranges from reforming the system to calls for disposing of it all together.Whether decolonising humanitarianism means giving back agency and leadership to the people it serves, combatting its embedded structural racism, or decentralizing its power and resources to local humanitarian actors, there is a need to talk of existing power imbalances across the Global North and South, if humanitarianism is to live up to its own claims.

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