This World Refugee Day comes as the world approaches a milestone: the seventy-fifth anniversary of the 1951 Refugee Convention, the agreement that established the right of people fleeing persecution to seek safety and protection. It was one of the great achievements of the postwar order. Having seen what a world that abandoned the displaced could do, nations made a different commitment: displacement should not mean abandonment.
For seventy-five years, that promise has held. But it is beginning to fray.
Today, nearly 120 million people are forcibly displaced, and the average displacement now lasts close to two decades. For millions, displacement is no longer an interruption on the path back to normal life. It is the condition of their lives. Yet much of the architecture built to support them still operates as though these crises are short-lived.
Nowhere is that disconnect more visible than in health. The world’s greatest unmet need for primary care has migrated into a geography of compounding crisis: places where conflict, displacement, climate stress, and fragile institutions reinforce one another. Just twenty countries account for the vast majority of humanitarian need and are projected to host more than half of the world’s extreme poor within a few years. At the center of that convergence are displaced people — and the systems meant to serve them rest on assumptions that no longer hold.
Humanitarian financing is built for emergencies. Development financing is built for stability. Refugee populations increasingly live in neither condition.
The result is a health architecture perpetually struggling to serve people whose displacement lasts not months but decades. That is not merely a technical problem. It is a failure to align our institutions with the world we are actually trying to serve.
I lead Medical Teams International, which provides health care for displaced people across East Africa, including as UNHCR, the UN Refugee Agency’s sole health implementing partner across Uganda’s refugee settlements. From that vantage point, one fact is impossible to ignore: some of the most durable institutions serving displaced people have never been incorporated into the architecture designed to support them.
Earlier this year, just in the month of January, sixty-five people died in refugee settlements across northern Uganda from entirely treatable causes, including malaria and neonatal complications. Twenty were children under five. The health workers knew what to do. The treatments were available. What failed was the architecture around them: chronic funding volatility, short-cycle emergency financing, and repeated disruptions that made it impossible to sustain the staffing, supply chains, and community systems that keeping people alive requires. The tragedy was not a lack of medical knowledge. It was a lack of durable systems.
Yet durable systems have been hiding in plain sight. The Uganda Catholic Medical Bureau traces its origins to 1934; the Uganda Protestant Medical Bureau followed in 1957. Together they account for a substantial share of the country’s health services. They have operated through colonial transition, dictatorship, civil conflict, economic collapse, and mass displacement. In many places, they remained when others could not.
Their significance is not theological. It is institutional. They possess what refugee health increasingly demands: permanence, deep community trust, and the ability to keep operating across political, donor, and humanitarian cycles. They did not emerge as a supplement to the modern humanitarian system. In many places they predated it, training health workers and running hospitals in communities that remain underserved today, long before today’s development institutions existed.
Yet the deeper lesson is not about Uganda. It is about what kinds of institutions endure.
The Uganda bureaus are part of something larger that the policy world has been slow to name: an interconnected ecosystem of faith-based health networks, faith-based humanitarian organizations, and broader communities of faith whose presence and commitment often outlast the headlines.
Usually discussed separately, in practice, they perform a connective function that the formal system struggles to replicate. They connect emergency and development financing, national governments and local providers, global resources, and the communities that need them. Each dimension does work the others cannot, and the value lies in the combination. That connective function is not incidental to refugee health. It is precisely what the current architecture was never built to count.
Their reach extends beyond service delivery. The Refugee Convention was never merely a legal document; it was an expression of moral consensus, and consensus requires constituencies willing to sustain it. Across continents, these same institutions remain among the few capable of keeping public attention on displaced people long after emergencies fade from view. That, too, is a form of infrastructure the system depends upon and rarely recognizes.
None of this means faith-based institutions should replace governments or public health systems. Accountability matters. Quality assurance matters. Public institutions remain indispensable.
But a refugee health strategy that overlooks this ecosystem is working from an incomplete map.
Seventy-five years after the Convention, we should be honest about what the world has learned. Displacement is no longer primarily a short-term humanitarian emergency. It is a persistent and defining feature of the global landscape, and the institutions meant to support displaced people must be designed accordingly.
Refugees need more than recognition of their rights. They need a global health system capable of sustaining those rights over time.
Faith-based networks have spent generations building pieces of exactly that architecture: caring for displaced people, strengthening local health systems, connecting global resources to local realities, and sustaining public commitment long after crises leave the headlines.
The question on this World Refugee Day is not whether we still believe in the promise of the Refugee Convention.
It is whether we are finally prepared to recognize and build around the institutions whose connective role the global health system now needs to meet that promise.
This World Refugee Day
More than 41 million refugees around the world have been forced to flee their homes because of conflict, violence, and persecution.
Behind every statistic is a person — a parent, a teacher, a healthcare worker, a leader—with gifts to share and dreams for the future. Through life-saving healthcare, Medical Teams helps refugees and displaced families heal, recover, and rebuild their lives.
This World Refugee Day, you can help provide the care people need to move forward with hope.