Canadian Journal of Public Health

, Volume 104, Issue 3, pp e267–e269 | Cite as

Global Health on the Edge - The Humanitarian Tipping Point

  • Jason W. NickersonEmail author


Major disasters pose significant threats to population health: rapid-onset crises can result in a massive loss of life, while protracted emergencies can result in both direct and indirect adverse effects to population health and livelihoods. In many cases, windows of opportunity present themselves to mitigate the effects of emergencies, but these opportunities must be seized and acted upon. Regrettably, current models of international development and global public health are frequently reactive, rather than preventive, with regard to major emergencies; major humanitarian responses frequently occur only once select indicators have reached or breached established emergency thresholds, which are late indicators of a population’s health. In order to avoid these predictable late responses, current models of international development and their relationship to emergency humanitarian responses need to be placed under the microscope. The public health community must serve as strong advocates for interventions to address worsening public health situations before they tip into crisis, and should be advocates for the reconceptualization and reform of priority setting in international development. The failure to do so quite clearly comes at the expense of some of the world’s most vulnerable populations.

Key Words

Disasters relief work international cooperation malnutrition public health emergencies 


Les grandes catastrophes constituent une menace importante pour la santé des populations: les crises soudaines peuvent entraîner de lourdes pertes en vies humaines, tandis que les urgences prolongées peuvent avoir des effets indésirables, directs et indirects, sur la santé et les moyens de subsistance des populations. Dans de nombreux cas, il se présente des occasions d’atténuer les effets des urgences, mais il faut les saisir et agir. Regrettablement, les modèles actuels du développement international et de la santé publique mondiale sont fréquemment réactifs plutôt que préventifs en ce qui concerne les urgences majeures; la riposte aux grandes crises humanitaires ne s’enclenche souvent que lorsque certains indicateurs atteignent ou dépassent les seuils d’urgence établis, mais ce sont des indicateurs tardifs de la santé d’une population. Pour éviter les délais prévisibles dans la riposte, il faut scruter au microscope les modèles actuels du développement international et leurs liens avec les interventions humanitaires d’urgence. La communauté de la santé publique doit promulguer vigoureusement les interventions qui empêchent les problèmes de santé publique de s’aggraver jusqu’à devenir des crises, et elle doit promulguer la reconceptualisation et la réforme de l’établissement des priorités en matière de développement international. L’inaction à ce chapitre pose clairement un risque pour certaines des populations les plus vulnérables du monde.

Mots Clés

catastrophes secours coopération internationale malnutrition santé publique urgences 


  1. 1.
    Office of the United Nations Resident & Humanitarian Coordinator for Somalia. The UN Declares Famine in Somalia, 2011. Available at: resources/Full%20Report_66.pdf (Accessed October 25, 2012).Google Scholar
  2. 2.
    Office of the United Nations Resident & Humanitarian Coordinator for Somalia. Famine Spreads to More Areas in Southern Somalia, 2011. Available at: 20Somalia.pdf (Accessed October 25, 2012).Google Scholar
  3. 3.
    Assefa F, Jabarkhil MZ, Salama P, Spiegel P. Malnutrition and mortality in Kohistan District, Afghanistan, April 2001. JAMA 2001;286(21):2723–28.CrossRefGoogle Scholar
  4. 4.
    Centers for Disease Control and Prevention. Notes from the field: Malnutrition and mortality - Southern Somalia, July 2011. MMWR 2011;60:1026–27.Google Scholar
  5. 5.
    The Sphere Project. Humanitarian Charter and Minimum Standards in Humanitarian Response. United Kingdom: Practical Action Publishing, 2011.CrossRefGoogle Scholar
  6. 6.
    Famine Early Warning Systems Network. East Africa Food Security Alert: Below-average March to May Rains Forecast in the Eastern Horn - Current Crisis Likely to Worsen. 2011. Available at: (Accessed October 25, 2012).Google Scholar
  7. 7.
    Editorial. Growth of aid and the decline of humanitarianism. The Lancet 2010;375:253.CrossRefGoogle Scholar
  8. 8.
    Famine Early Warning Systems Network. Somalia Food Security Alert: Extremely High Cereal Prices Across Southern Somalia Exacerbate Ongoing Emergency, 2011. Available at: (Accessed October 25, 2012).Google Scholar
  9. 9.
    ECB/ACAPS. Secondary Data Review: Horn of Africa. 2011. Available at: (Accessed January 30, 2013).Google Scholar
  10. 10.
    ALNAP. Humanitarian action in Drought-related Emergencies. 2011. Available at: (Accessed January 30, 2013).Google Scholar
  11. 11.
    Olsen GR, Carstensen N, Hoyen K. Humanitarian crises: What determines the level of emergency assistance? Media coverage, donor interests and the aid business. Disasters 2003;27(2):109–26.CrossRefGoogle Scholar
  12. 12.
    Canadian International Development Agency. Countries of Focus, 2011. Available at: (Accessed October 25, 2012).Google Scholar

Copyright information

© The Canadian Public Health Association 2013

Authors and Affiliations

  1. 1.Institute of Population HealthUniversity of OttawaOttawaCanada

Personalised recommendations