Making the case for health research in humanitarian crises: A call for case examples
Photo credit: @UNICEF/UN029108/Phelps
Authors: Amit Mistry & Blythe Beecroft
Humanitarian crises are affecting hundreds of millions of lives around the world right now, with one in six children living in or near a conflict zone[i] and more people forced to flee their homes than at any time in recent history.[ii] These crises, such as armed conflict, forced displacement, disasters arising from natural hazards, and major disease outbreaks, take a staggering toll on human health, especially in low-resource settings. For example, children in fragile or conflict-affected countries are twice as likely to die before the age of five compared to children in other low- and middle-income countries.[iii] In addition to the immediate health issues caused by a humanitarian crisis, affected people often also suffer from higher rates of mental health disorders and other chronic diseases, and are more likely to die early.
To better meet the health needs of people affected by humanitarian crises, organizations responding to these crises need to act on reliable evidence. However, conducting the research needed to generate this evidence base is particularly challenging. Researchers must, among other challenges, ensure that research does not impede effective responses to the urgent needs of the distressed population, manage security and logistical concerns, consider ethical questions such as informed consent for extremely vulnerable populations, and adapt research methodologies for unstable and dynamic settings. This list may seem daunting, but the challenges can be addressed and researchers from academic institutions and NGOs have conducted high-quality, ethical, and actionable research in humanitarian settings.
For example, academic institutions in Texas used a pre-reviewed and approved research protocol, developed based on guidance from the National Institute on Environmental Health Sciences, to begin data collection rapidly in the immediate aftermath of Hurricane Harvey in 2017. The International Rescue Committee has employed flexible research methodologies to study violence against adolescent girls in conflict-affected communities in DRC, Ethiopia, Pakistan, and Liberia.[iv] Several clinical trials were conducted during the Ebola epidemic of 2014-2015 in West Africa and while some of the trials did not produce actionable findings, important vaccine trials were fruitful. Additionally, the experience of conducting research in Ebola-stricken countries yielded important lessons around the importance of building local capacity for research, engaging communities, and partnering with key stakeholders. [v]
The Fogarty International Center at the U.S. National Institutes of Health is eager to collect more experiences like these and share them with both the research and humanitarian communities. As such, we are excited to launch this call for case examples, specifically of health research that was conducted in the context of a humanitarian crisis. We anticipate that this collection of case examples will help research and humanitarian communities identify important high priority scientific questions that can be best addressed through health research in humanitarian settings, describe the challenges faced by this research, and share strategies for overcoming these challenges. We also hope that making these case examples publicly available will help systematic reviewers to summarize, compare and contrast their findings, thereby helping to build a solid evidence base for future researchers. More broadly, we hope to raise awareness around the need for reliable and robust research in humanitarian crises and to encourage more researchers to engage in the humanitarian context to address this gap.
Details on the call for case examples are available at the link below. To learn more about the broader project on this topic at the Fogarty International Center, please visit our website or contact us directly.
About the authors:
Amit Mistry Ph.D is a Senior Scientist in the Fogarty International Center at the U.S. National Institutes of Health (NIH) where he advises on science policy issues and leads multi-disciplinary projects on critical global health challenges. Previously, Amit served as a program manager in the U.S. Agency for International Development (USAID) within the Global Development Lab and USAID’s Bureau for Food Security. Amit has also served as a Congressional Fellow for health, education, and science policy and worked as a high school science teacher with Teach for America. Amit earned a bachelor’s degree in chemical engineering in 2000 and a doctorate in bioengineering in 2007, both from Rice University.
Blythe Beecroft M.S. is a Global Health Research & Policy Analyst at the Fogarty International Center at the National Institutes of Health. Within the Center for Global Health Studies her portfolio includes projects covering health research in humanitarian crises, emergency care research in low-and middle-income countries, the integration of HIV/NCD platforms and care, and implementation science in the global context. Blythe received a Master’s in Global Health with an emphasis in development and Sub-Saharan Africa from Georgetown University and a Bachelor’s in International Relations from Brigham Young University. She has conducted and supported research in Burkina Faso and Ghana relating to childhood vaccinations and inequalities in urban settings.
[i] Bahgat K, Dupuy K, Østby G, Rustad SA, Strand H, Wig T. Children and Armed Conflict: What Existing Data Can Tell Us. Oslo: Peace Research Institute Oslo (PRIO); 2018.
[iii] World Bank. World Development Report 2011: Conflict, Security, and Development. Washington, DC: World Bank; 2011.
[iv] Falb K. Learning from adolescent girls in emergencies. Medium. https://medium.com/@FalbKL/learning-from-adolescent-girls-in-emergencies-9be9acbe3306.
[v] National Academies of Sciences, Engineering, and Medicine. Integrating Clinical Research into Epidemic Response: The Ebola Experience. Washington, DC: The National Academies Press. 2017. https://doi.org/10.17226/24739.