NCDs in refugees and migrants – the hidden crisis

19 September 2016 | Policy

Esperanza Martinez is Head of Health at the International Committee of the Red Cross, Geneva

The World Health Organization estimates that 70% of deaths throughout the world are attributable to non-communicable diseases (NCDs), mainly in the form of cardiovascular diseases, diabetes, lung disease and cancer. Low and middle-income countries are particularly affected, with the risk of premature death – before the age of 70 – caused by NCDs .

Armed conflict and other situations of violence have driven millions of people from their homes. Refugees and migrants suffering from NCDs are more vulnerable to the stresses of migration and the harsh conditions on migration routes, and suffer from a lack of regular access to suitable health care. For people living in crisis or emergency situations, the risk of exacerbating pre-existing conditions or suffering acute complications, is two to three times higher than it was beforehand.

The humanitarian community has not on the whole sought to address the NCD issue. However, this is changing. Non-governmental organisations and humanitarian agencies are now placing NCDs in their programming as a matter of priority. Managing NCDs, which are chronic in nature, is a challenging task for people more accustomed to dealing with acute conditions during humanitarian emergencies. Migrants are extremely mobile and patterns of migration are unpredictable - these are further impediments to the provision of comprehensive and continuous care.

In non­humanitarian, stable settings, the management of NCDs has a strong focus on preventive activities. However, in conflict affected contexts and during humanitarian crises, it is not feasible to carry out traditional prevention programs. In addition, screening programmes are not appropriate, nor would it be responsible, as more often than not continuity of care cannot be ensured.

The International Committee of the Red Cross (ICRC) seeks to respond to the health needs of people affected by armed conflict and other situations of violence by means of a comprehensive public health approach. For individuals suffering from NCDs, the ICRC’s focus is on the first encounter to treat symptoms, provide essential medicines and give self-management training. We also support governments with NCD related initiatives where they exist.

Given the scale of the challenges, we clearly need new approaches to managing NCDs in humanitarian crises, particularly those resulting in large-scale movements of people. It is only with a coordinated and multi-stakeholder approach, including humanitarian agencies, government bodies, research and academic institutions, as well as relevant actors from the corporate sector that we can develop approaches that are fit to tackle the NCD challenge facing refugees and migrants today.

For more information on the ICRC’s activities, see

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Esperanza Martinez | 19 September 2016

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