War and displacement have pushed 65.3 million people from their homes worldwide, and health systems in the Middle East and North Africa are now struggling to treat the rising burden of cancer and mental illness among refugee populations. This matters because humanitarian and health agencies have long focused on infectious diseases in conflict zones, but these populations have aged and now face non-communicable diseases—conditions that require long-term, expensive care. Without local research capacity, governments and aid providers lack the evidence to plan affordable health systems or allocate resources effectively. If this partnership succeeds, it will train researchers in four areas—conflict and health, political economy, cancer, and mental health—and produce published studies that directly inform policy. Ministries, academic centres, and international partners will be linked together, allowing evidence to shape clinical care pathways and health budgets. The approach could also be adapted for other conflict-affected regions, helping to sustain universal health coverage commitments where they are most fragile.
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Two billion people currently live in areas of conflict and fragility, reflecting a rapid increase in wars, ethnic strife and other man-made disasters since 2010. The world is also experiencing the greatest forced migration crisis since the Second World War with 65.3 million forcibly displaced persons, 40.8 million internally displaced persons (IDPs), 21.3 million refugees and a further 10 million stateless people. Across the Middle East and North Africa (MENA) region protracted conflicts in countries such as Syria and Libya, as well as Afghanistan, Iraq and Yemen, have led to dramatic increases of refugee populations in Turkey, Lebanon, the Occupied Palestinian Territories and Jordan. War affected populations from these countries have undergone the epidemiological transition and therefore present new health challenges. In particular, the diagnosis, management and treatment of non-communicable diseases (NCDs) present new challenges for domestic health systems, as well as for humanitarian and development aid providers. These challenges also threaten domestic health commitments to Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs). This new humanitarian-development-health nexus demands a unique research agenda radically different from traditional approaches that address health challenges in low-income countries with weak governments, institutions and a mainly communicable disease burden. Without proper research capacity to generate crucial evidence to inform health policy and care, it will be impossible for countries in the MENA region to plan for rational and affordable health systems, sound economic policy and more effective aid effectiveness. The vision for our R4HC (Research for Health in Conflict)-MENA partnership is to build sustainable research capacity in this region to address major health challenges arising from conflict, specifically cancer and mental health as key NCDs. R4HC-MENA will build research capacity in four distinct areas: (1) conflict and health; (2) the political economy of health in conflict; (3) cancer; and (4) mental health research in regions of conflict. This research capacity will focus on training staff in a variety of theoretical and practical methods for studying these areas, as well as conducting and publishing research projects to build further capability and disseminate findings. R4HC-MENA will enable lead countries in this region to grow and sustain research capacity that can critically inform aspects of health development that relate to armed conflict in the region. This will inform not only regional and international policy-makers, but also the development of affordable and equitable clinical models of care and pathways in complex NCDs such as cancer and mental health. R4HC-MENA will also link together regional ministries and academic centres, and key international partners, to widen the research to policy translation, and critically inform the health development agenda in other regions affected by conflict.
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