Share & more
The international humanitarian system must be inverted and revamped – armed with new principles, independent financing, a far smaller footprint, and oversight mechanisms with the teeth to enforce, a global commission says.
Two years in the works, the Lancet Commission on Health, Conflict, and Forced Displacement is launching what it says is a blueprint for transforming an international humanitarian system stuck in a crisis of funding and legitimacy.
It includes calling for independent financing detached from institutions, three new core principles and a double-take on “neutrality”, a single United Nations agency during humanitarian operations, and levers to hold all parts of the system accountable. The recommendations are built on central themes: flipping power, ending impunity, fixing financial dependency, and prioritising health access.
“There needs to be a significant change – a transformation,” Paul Spiegel, the commission’s chair and director of the Johns Hopkins Center for Humanitarian Health, said in an interview before the 20 May launch. “The most important part would be [to] invert the power, which really means to ensure that the affected populations, the local and national authorities, and the local and national NGOs really are running the show. Right now, it's a massive, frankly, business that is really, really internationally dominated.”
Many of the individual recommendations aren’t new. The Lancet commission’s work comes a decade after 2016’s World Humanitarian Summit birthed the Grand Bargain reform promises. This produced reams of commitments on shifting power and forefronting communities in crisis, but only incremental progress in the face of economic incentives that tie donor funding to political whims and push big aid groups to prioritise growth and self-preservation while the system shrinks.
However, the commission’s members see this moment – soaring needs, deep cuts that have gutted aid responses, the flouting of international law – as an opportunity.
“This is a once in a generational chance for change because of the really difficult and horrible situation that we find ourselves in globally right now. But that does allow for change,” Spiegel said. “That change will only come if we can put aside some of our differences and our prejudices.”
The commission started in 2024 with a pledge to “shake the tree”, promising to deconstruct colonial legacies and examine how to transition power. Core members include humanitarians and academics from around the globe, including experts in famine, infectious diseases, international humanitarian law, and forced displacement. Some advisers are senior staff at major aid agencies, Global South civil society networks, or foundations.
Amid widespread cuts in traditional donor aid funding capped by the Trump-led US aid implosion, the commission is one of several organised pushes to rethink the emergency aid system or international cooperation more broadly. Some are more vigorously challenging the premise behind aid itself, instead pushing to rebalance historically plunderous financial systems.
Here are some top-line takeaways from the Lancet commission report:
Upending power: a global pooled fund, a single UN humanitarian agency
The report’s central premise is to invert power: shift governance, funding, and decision-making to affected communities and “locally legitimate actors”.
Behind it is a blueprint to flip the focus onto community priorities when decision-makers debate what aid interventions (if any) are warranted, rethink legitimacy when it comes to governance, better distinguish between new emergencies and the protracted crises that dominate forced displacement, and recast the international aid system in a supporting role.
One element calls for a single operational UN agency in crisis response. It’s not a call for mergers, but for big agencies to shrink and step back from the massive operational roles they’ve grown to occupy.
“There are just too many – especially in an acute phase – UN agencies and international NGOs,” Spiegel said. “Almost from a business model, you need to be there in the acute phase because that's where you're going to get your donors and you're going to get your publicity. And so there are just too many actors, number one.”
A core proposal aims to build financial independence through a global pooled fund (or funds) not controlled by a single agency or donor.
As part of the so-called humanitarian reset, UN relief chief Tom Fletcher has called on donor governments to shift their money through funds run by the UN’s humanitarian coordination arm, OCHA. Spiegel sees this as a conflict of interest that concentrates money among the usual players.
New humanitarian principles: focus on accountability, rethink neutrality
The commission is proposing a set of five core humanitarian principles, which would mean adding three and – controversially in some corners – down-shifting two seen as fundamental to conventional interpretations of humanitarianism.
In addition to the “non-negotiable” principles of humanity and impartiality, the commission is proposing adding: do no harm, solidarity, and accountability.
“Do no harm”, borrowed from the medical realm, is recognition of the collateral damage aid interventions can cause. Solidarity is essentially a nod to the sectors’ failure to shift power and localise aid. Accountability speaks to being accountable to affected populations.
The principles of neutrality and independence would be based on context and mandate – still important, but used as a tool to gain access, rather than a cudgel to exclude those who aren’t, or a doctrine that justifies silence in the face of atrocities.
Enforce change: Tie money to performance
Previous reform plans like the Grand Bargain have stumbled over voluntary commitments that have few consequences for failure. The current system’s nominal top strategic body, the Inter-Agency Standing Committee, has no particular power even when it does agree on policy.
“The humanitarian sector is the only industry where if your performance is very bad, we keep funding you,” said Karl Blanchet, a commission co-chair and director of the Geneva Centre of Humanitarian Studies.
The Lancet commission proposes explicitly tying money to performance and accountability, with consequences for harm or failure. It suggests independent oversight bodies that publish metrics for coordination platforms and agencies.
“Enforcement mechanisms should extend beyond funding conditionality to include public reporting, loss of coordination leadership roles, and reputational consequences for persistent non-compliance,” the commission report says. ”These measures re-anchor authority with affected populations, legitimate local leadership, and accountable institutions.”
Next steps: Follow the money and influence
The Lancet commission’s recommendations are splashed across 76 pages of small-print type. Now begins the push to convince people they’re worth following.
Those involved with the commission say they’re taking the pitch to donors, diplomats, decision-makers and others with the power to change minds and policies – and the funding to make it happen. Blanchet says some donors he has spoken with are receptive to proposals for independent pooled funds, unhappy with today’s options.
Leaders and civil society in countries that host humanitarian responses are crucial.
“I don’t think the system wants to change at all, internally,” he said. “The pressure has to come from the outside.”
Edited by Andrew Gully.
