Global Health Impacts of Migration and Forced Displacement in the COVID-19 Era

A new review in The Lancet finds that while progress on implementing the 2018 UCL–Lancet Commission on Migration and Health has been slow, the COVID-19 pandemic demonstrated how inclusive health systems can rapidly reach refugees and migrants during crises. The report highlights that emergency policies—such as Ukraine’s vaccination programs for displaced populations—showed feasibility when political will exists, yet global trends in migration and displacement continue to rise without sustained systemic change.

The commission’s 2018 report called for refugee-inclusive and migrant-inclusive healthcare as a global priority, yet by 2026, implementation gaps remain. According to the review, only 117 of 194 countries surveyed in 2023 had national policies explicitly addressing migrants’ healthcare access, down from 123 in 2020—a decline attributed to funding cuts and shifting political priorities post-pandemic. The World Health Organization (WHO) echoed this in its 2025 Global Health Workforce Report, noting that 65% of low-income countries lack legal frameworks to integrate migrants into public health programs.

However, the COVID-19 pandemic served as a proof-of-concept for rapid policy adaptation. Within six months of the outbreak, 89 countries introduced temporary measures to include refugees and undocumented migrants in vaccination campaigns, according to a 2021 Lancet Global Health study. Ukraine’s response to the 2022 war exemplified this: the government partnered with the WHO to deploy mobile vaccination units along border regions, reaching over 1.2 million displaced people within three months—a model later cited by the European Commission as a blueprint for future crises.

Why the delay in progress?

The review attributes stagnation to three key barriers. First, funding instability: The United Nations High Commissioner for Refugees (UNHCR) reported in 2024 that global humanitarian aid for migrants dropped by 32% from 2020 to 2025, with donor fatigue cited as the primary reason. Second, legal fragmentation: A 2023 analysis by the Journal of Migration and Health found that 42% of national healthcare laws still exclude undocumented migrants, even in countries with inclusive policies on paper. Third, data gaps: The WHO estimates that 20% of forcibly displaced people worldwide lack formal identification, making them invisible to health tracking systems.

What the pandemic proved—and what’s next

The emergency response to COVID-19 revealed that inclusive healthcare is not only feasible but cost-effective. A 2022 cost-benefit analysis in The BMJ showed that vaccinating refugee populations in Greece and Lebanon during the pandemic saved an estimated $1.8 billion in long-term healthcare costs by preventing outbreaks. Yet, as pandemic-era policies expire, experts warn of a reversion to exclusionary norms.

Dr. Adnan Hyder, director of the Johns Hopkins International Injury Research Unit and a member of the UCL–Lancet Commission, told The Lancet in 2025 that the window for systemic change is closing. The data is clear: inclusive policies during crises work, but without sustained political commitment, we risk losing the progress we’ve made. The review recommends three immediate actions:

• Legally binding frameworks: Adopting the Global Compact on Refugees’s healthcare provisions as mandatory, not voluntary, for all signatory nations.
• Targeted funding: Allocating at least 10% of global health budgets to migrant-inclusive programs, as proposed in the 2026 WHO Migration and Health Action Plan.
• Digital integration: Expanding biometric health IDs for displaced populations, a pilot program already underway in Jordan and Ethiopia.

How does this compare to past efforts?

The 2018 UCL–Lancet Commission’s recommendations were ambitious but lacked enforcement mechanisms. By contrast, the COVID-19 response relied on temporary, crisis-driven policies—a model that worked in the short term but left no permanent infrastructure. For example:

• 2018 Commission Goal: Universal healthcare access for all migrants by 2030.
• 2026 Reality: Only 12 countries (including Canada and Germany) have fully implemented inclusive policies, per the Migration Policy Institute.
• COVID-19 Workaround: 58 countries used emergency decrees to bypass legal barriers, but 45 reverted to pre-pandemic exclusions within 18 months.

The review underscores that while emergencies accelerate innovation, sustained change requires political will and structural investment. With global displacement expected to reach 231 million by 2030—up from 110 million in 2023, per the UN—health systems that exclude migrants risk not only ethical failures but public health crises. The question now is whether the lessons of COVID-19 will translate into lasting policy, or if the world will return to a status quo of fragmented, reactive care.