By Allen Gidraf Kahindo Maina, Chief of Public Health Section, Division of Resilience and Solutions, UNHCR
A silent emergency is brewing. Without immediate and sustained investment, an estimated 12.8 million refugees—among them 6.3 million children—face the terrifying prospect of being stripped of life-saving health services in 2025. This unfolding crisis stems from a precipitous decline in humanitarian aid, compounded by diminishing health expenditures in host countries.
The reverberations are profound. It is not only the refugees whose lives hang in the balance, but also the host communities—many of whom are living on the margins of survival themselves.
On World Health Day (2025), the urgency of this crisis was underscored through the launch of a global campaign to end preventable maternal and newborn deaths. The risks are especially high in contexts of forced displacement, where women and girls face barriers to even the most basic healthcare.
UNHCR’s response: progress amid precarity
Despite relentless challenges, UNHCR’s 2024 Annual Public Health Global Review highlights resilience and progress. Crude mortality rates declined, and over 15 million health consultations were facilitated across 63 countries, with nearly 8.7 million tracked through the integrated Refugee Health Information System (iRHIS).
Yet, beneath these encouraging figures lie deeply concerning realities:
- Acute malnutrition continues to afflict 1 in 10 refugee children.
- Children under five accounted for nearly a third of all reported deaths, many of which could have been averted through low-cost interventions.
- Mental, neurological, and substance use conditions now account for 3% of all consultations—a sharp rise, underscoring the psychological toll of displacement.
Maternal health remains a concern. While skilled birth attendance held steady at 93%, there was also a relative increase in maternal mortality reported, a stark reminder that progress is fragile and uneven.
The report also underscores the resilience shown in addressing the needs of Sudanese refugees, such as the provision of multi-layered mental health support—including initiatives led by refugee-led organizations—in a situation where only 30% of the required funding for the Sudanese refugee response in Chad was secured in 2024.
Importantly, UNHCR has worked in lockstep with governments, development actors, private sector and partners to uphold universal health coverage principles by supporting refugee inclusion in national health systems, guided by its Global Public Health Strategy (2021-2025). Key achievements highlighted in the 2024 overview include the handover of camp-based health services to national authorities in Iraq, the integration of refugee health professionals into Kenya’s national nursing training programme, and the enrolment of over 93,000 refugees into Cameroon’s national health insurance scheme.
Notably, a joint report by World Bank and UNHCR demonstrated the low financial cost of refugee inclusion in national health systems, particularly in low-income countries. Investments to build national health system capacity would benefit host communities as well, enhancing healthcare access and supporting better care for everyone.
But this vision is under threat.
2025: the year of uncertainty
The current funding crisis is severely affecting public health and nutrition programs for refugees and host communities. Vital services are being disrupted or dismantled entirely. The fallout is swift and unforgiving:
- Disease outbreaks are rising.
- Maternal and newborn care is deteriorating.
- Mental health support is eroding.
- Treatment for chronic illnesses will be interrupted.
This systemic unraveling burdens already overstretched local health systems, pushing clinics and hospitals to the brink.
Country snapshots: health on the brink
Bangladesh: Home to nearly a million Rohingya refugees, the stakes are critical. More than 40,000 pregnant women are at risk of losing antenatal care, while 19,000 acutely malnourished children may be denied life-saving treatment. Up to 200,000 people may lose access to mental health services.
Democratic Republic of the Congo: A staggering 87% cut to the 2025 health budget has pushed the healthcare system toward collapse. Clinics are overwhelmed, medicine stocks are depleting, and referrals for urgent care are no longer guaranteed.
Egypt: All non-emergency medical services for refugees have been suspended. Treatment for chronic diseases, planned surgeries, and essential medications—now out of reach for at least 20,000 patients.
Jordan: 43,000 refugees risk losing access to primary health care and health-related financial support in urban areas.
Mozambique: Last year, a UNHCR-supported clinic delivered over 80,000 consultations. This year, with a 50% funding cut, that support is evaporating—threatening both refugee and host populations.
South Sudan: A major funding cut has crippled refugee health services in South Sudan, closing health facilities, reducing the remaining health workforce by 50%, and leaving 40,000 people with limited health care even as more refugees arrive.
A crisis beyond numbers, and a call to action
The funding crisis is not just a financial issue; it is a matter of life and death for millions of displaced individuals and their host communities. Every day that this financial uncertainty persists, the health and well-being of countless men, women, and children are increasingly jeopardized. The ripple effects of inadequate funding go beyond individual suffering, threatening the stability and resilience of entire communities.
Immediate financial support is crucial to prevent the collapse of health-care systems in refugee settings and to ensure that displaced people and host communities receive the life-saving health interventions they desperately need.
What’s needed now is diversified, sustained, and coordinated funding
These are needed to:
- Restore essential health and nutrition services.
- Support the transition to national-led health service provision.
- Reinforce host country health systems to support inclusive care.
- Prevent a full-scale health catastrophe.
Lives are not numbers. They are our shared responsibility.
