Can Armenia’s refugee crisis catalyse health-system reform?

Editor’s note: This article is co-authored by AAHPO Board Member Kim Hekimian, PhD and AAHPO Member and MD/PhD student Christopher Marskosian, as well as Shant Shekherdimian, MD, Kent Garber, MD, MPH, and Ara Darzi, KBE, MD. The article was recently published in The Lancet, a prestigious British medical journal.

The immediate health needs of the refugees are immense. Before the exodus, people of Nagorno-Karabakh had been living under a punitive 9-month blockade, resulting in malnutrition and worsening health conditions due to scarcity of food, medicine, and vaccines. During their exile, a fuel depot explosion led to hundreds of casualties among refugees. Other factors contributing to medical needs include the suddenness of displacement, forfeiture of medical records, and loss of established longitudinal health-care providers.

But as headlines fade and humanitarian priorities shift elsewhere, Nagorno-Karabakh refugees will continue to face challenges in accessing high-quality health care. The Armenian Government intends to integrate displaced people into the health-care system, providing them with the same care as their host communities. However, Armenia has a health-care infrastructure with scarce resources and of inadequate quality. Given this reality, it would be wise for the global health response—typically focused on the acute needs of the refugees, and sometimes guilty of setting up health programming in parallel to government efforts—to simultaneously strengthen local health services towards universal health coverage, improved primary care, and optimized outcomes.


Leave a Reply

Your email address will not be published. Required fields are marked *