Cancer in refugees in Jordan and Syria between 2009 and 2012: challenges and the way forward in humanitarian emergencies - 27/05/14

Doi : 10.1016/S1470-2045(14)70067-1

Paul Spiegel, MD ^a,^⁎ , Adam Khalifa, MD ^b, Farrah J Mateen, MD ^c,^d

^a Office of the United Nations High Commissioner for Refugees, Geneva, Switzerland

^b Office of the United Nations High Commissioner for Refugees, Damascus, Syria

^c Department of Neurology, Massachusetts General Hospital, Boston, MA, USA

^d Harvard Medical School, Boston, MA, USA

^* Correspondence to: Dr Paul Spiegel, Office of the United Nations High Commissioner for Refugees 1211 Geneva, Switzerland

Summary

Treatment of non-communicable diseases such as cancer in refugees is neglected in low-income and middle-income countries, but is of increasing importance because the number of refugees is growing. The UNHCR, through exceptional care committees (ECCs), has developed standard operating procedures to address expensive medical treatment for refugees in host countries, to decide on eligibility and amount of payment. We present data from funding applications for cancer treatments for refugees in Jordan between 2010 and 2012, and in Syria between 2009 and 2011. Cancer in refugees causes a substantial burden on the health systems of the host countries. Recommendations to improve prevention and treatment include improvement of health systems through standard operating procedures and innovative financing schemes, balance of primary and emergency care with expensive referral care, development of electronic cancer registries, and securement of sustainable funding sources. Analysis of cancer care in low-income refugee settings, particularly in sub-Saharan Africa, is needed to inform future responses.

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