Humanitarian crises are among the defining global health challenges of our time, yet research from these environments remains underrepresented. Medical research has a universal purpose: to generate knowledge that improves health and wellbeing, particularly among the most vulnerable. In humanitarian settings, research also documents suffering, informs action, strengthens services, and supports recovery of health systems once crises subside.
Decisions in humanitarian operations involve allocating limited staff, medicines, vaccines, and finances under rapidly changing threats, population movements, and needs. These decisions are complicated by a lack of evidence and context‑specific guidance. Research provides the evidence base to improve operational choices, clinical care, and public health policy, and therefore can be more urgently needed in crisis settings than in stable environments.
Noncommunicable diseases were long overlooked in humanitarian responses despite substantial burdens. Research documenting the prevalence of diabetes and barriers to care in crisis-affected low‑ and middle‑income settings helped establish NCDs as essential components of humanitarian health responses.
Operational research has also addressed practical delivery challenges. Studies assessing the heat stability of different insulin formulations under tropical temperature conditions demonstrated that some formulations remain stable despite temperature fluctuations. That evidence supports safer insulin use where reliable refrigeration is unavailable and informed programmatic decisions in resource‑limited and emergency contexts.
UNRWA’s recent experience in Gaza illustrates how meaningful research can be embedded within humanitarian operations. Beginning in 2024, UNRWA integrated nutrition surveillance into routine primary care to identify and treat malnourished children. Across 16 health centers and 78 medical points, frontline workers measured mid‑upper arm circumference (MUAC) in over 220,000 children, producing more than 265,000 measurements during active conflict, repeated displacement, and widespread health system disruption.
This surveillance informed humanitarian responses in real time, improved operational decision‑making, and contributed to international understanding of the evolving nutritional crisis. The resulting analysis was subsequently published in a major medical journal, demonstrating that rigorous, useful evidence can be generated during conflict when systems and partnerships are arranged to support it.
Conducting research in armed conflict and other humanitarian crises is extraordinarily difficult. Conventional study designs may be infeasible or, in some cases, ethically inappropriate. Protecting frontline workers and participants must always be the highest priority. Data collection and quality are often compromised by insecurity, displacement, infrastructure collapse, and workforce pressures, making data cleaning and interpretation more complex.
These constraints do not diminish the value of research conducted in crisis settings, nor do they justify lowering expectations for scientific rigor or research integrity. Instead, they call for recognition that rigorous investigation may take different methodological forms depending on context. Thoughtful appraisal of study design, transparency about limitations, and clear description of operational constraints enable journals, reviewers, and readers to assess the validity and applicability of findings.
Mainstream medical journals should consider the realities of humanitarian contexts when evaluating submissions without compromising on integrity and quality. This requires:
The UNRWA example highlights three enabling factors that facilitated research during conflict: the commitment of frontline health staff, remote analytic capacity to clean and interpret complex data, and academic partnership for scientific guidance and oversight. Supporting these elements more broadly can expand the capacity for high‑quality research in emergencies.
Humanitarian settings should not be treated as the periphery of medical research. As crises become more frequent, complex, and prolonged, integrating evidence from these environments into mainstream medical literature is essential for improving responses and saving lives. A shift toward greater support, methodological flexibility grounded in rigor, and heightened visibility for humanitarian research is an investment in global health and the dignity and wellbeing of crisis‑affected populations.