World's humanitarian system buckling, 'no longer fit for purpose,' US-based researchers say

In a stark examination of the current global humanitarian landscape, a recent report published in the Lancet medical journal sheds light on the dire situations unfolding from Sudan to Gaza. Civilians are caught in crossfires, hospitals face relentless attacks, and the aid system, overwhelmed by the magnitude of these crises, struggles to respond effectively.

“The humanitarian system is no longer fit for purpose, given the types of emergencies that we have and their magnitude,” remarked Dr. Paul Spiegel, a co-author of the report, in an interview with Fox News. Spiegel, a seasoned expert with over three decades of experience in refugee camps and conflict zones, paints a grim picture of the current state of humanitarian affairs.

The report, titled ‘Health in a World of Crises and Impunity,’ underscores the severity of Sudan’s ongoing civil war, one of the planet’s most catastrophic humanitarian disasters. As hospitals shut down and famine looms, the plight of tens of millions remains dire. Spiegel and his fellow experts argue that while the knowledge to save lives exists, the implementation suffers due to excessive bureaucracy and sluggish responses, necessitating a complete overhaul of the aid system.

Spiegel’s insights are informed by his role as a professor at Johns Hopkins University and co-chair of its Center for Humanitarian Health. His extensive background amplifies the report’s call for urgent improvements. “We’re in a very dark time,” he notes with concern, reflecting the urgency and necessity for swift action to address these escalating global emergencies.

A professor at Johns Hopkins University and co-chair of its Center for Humanitarian Health, Spiegel has decades of experience working in refugee camps and war zones around the world. “I’ve been doing this for well over 30 years,” he said. “We’re in a very dark time.”

Highlighting one of the world’s largest disasters, Sudan’s brutal civil war — where tens of millions of people are in need as hospitals close and famine spreads — the panel of experts behind the report says the world knows how to save lives, but that the system is failing to deliver. The experts’ report, titled ‘Health in a World of Crises and Impunity,’ argues that some agencies are too bureaucratic, and others too slow. The whole system, they say, needs revamping.

Dr. Paul Spiegel, is a professor at Johns Hopkins University and co-chair of its Center for Humanitarian Health. (Paul Spiegel)

The report argues the United Nations is in need of reform, while in the U.S. it highlights the Trump Administration’s shuttering of the United States Agency for International Development (USAID) over suspected fraud and abuse. 

During that restructuring, many of USAID’s most vital programs were folded into the State Department, but the report calls USAID’s closure a “shock” and “sudden,” and part of a chain of decisions in the U.S. and elsewhere which it condemns as “a political and moral failure.”

ANALYSTS SAY GAZA ‘CIVILIAN’ DEATHS INCLUDE HAMAS, OTHER TERROR MEMBERS WORKING AS MEDICS, MEDIA WORKERS

A truck loaded with humanitarian aid for the Gaza Strip travels to the Kerem Shalom crossing at the Israel-Gaza border on May 20, 2025. (Maya Alleruzzo/AP)

“USAID needed to be restructured,” Spiegel told Fox News. “The U.N. needs to be restructured in a very significant way. But it’s how you do that.

“It is the strategy to make sure that you do it in such a way that vulnerable populations across the globe are not going to be hurt, and that it wasn’t done like that.”

Paul Spiegel

Dr. Paul Spiegel has decades of experience working in refugee camps and war zones around the world. (Paul Spiegel)

The authors are pushing for major global reforms, including overhauling funding, sending aid directly to local communities, greater accountability if governments or armed groups block aid, and upholding healthcare as a basic human right.

“It’s really a complete rebalancing,” Spiegel said, “to make sure that the system actually works for the people it’s intended to help.”

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