Editorial:
Vikas Londhe, MPharm
At a time when wars, conflicts, climate change, and poverty are forcing millions of people to leave their homes and currently the world is facing record levels of migration and displacement. Migrating families often struggle not only with the loss of safety and stability but also with basic healthcare facility and human dignity. To address this, the global health community has put forward the Halifax Declaration, published in The Lancet Regional Health-Europe and endorsed by Lancet Migration. This declaration demands for protecting the health, dignity, and rights of displaced people as a mutual global responsibility.
What the Halifax Declaration Is
The Halifax Declaration was developed at the 2025 International Refugee and Migration Health Conference in Halifax, Canada, which brought together over 600 professionals, scholars, and people with lived experiences of displacement and migration. The declaration establishes 11 key principles and sets 11 recommendations (Panels 1 and 2).
Key Principles
Human mobility whether as refugees, asylum seekers, displaced people, migrant workers, or unaccompanied children has always been part of our collective humanity. It is driven by hope, necessity, and resilience.
Migrated people have always enriched the communities they join personally, culturally, socially, and economically helping to build united prosperity.
Displaced people often encounter many barriers that challenge their health, well-being, and dignity at every stage of migration.
Health systems should be inclusive, fair, and sensitive to trauma, built on the principle of Universal Health Coverage so that everyone, including migrating people, can get care without facing financial hardship.
Governments and institutions need to tackle the fundamental factors that harm health such as colonial legacies, climate change, conflict, economic inequality, racism, and restrictive migration policies.
Racism, xenophobia, and systemic discrimination damage health and must be actively dismantled through inclusive, community driven efforts that promote equity. Family unity is essential to safeguarding the health of displaced children.
Vulnerable groups such as unaccompanied children, survivors of torture or trafficking, detainees, and undocumented people need urgent protection and care grounded in human rights.
Providing care that recognizes both trauma and resilience in displaced populations builds clinical skills that ultimately benefit all patients
Displaced people, Indigenous Peoples, and racialized communities should be included in health research, service design, and policymaking with respect, reciprocity, and self-determination
Migration policies should protect and prioritize family unity, especially to safeguard the health of displaced children and minors
Investing in the health of displaced people supports Universal Health Coverage, prevents avoidable harm and costs, and strengthens communities, health systems, and societies.
Key Recommendations
Alongside its core principles, the Halifax Declaration sets out 11 concrete recommendations for governments, health systems, global organizations, and civil society. These recommendations are designed to turn values into action making sure that displaced people are not only recognized in policy but also given real access to health, dignity, and protection.
Guarantee healthcare for all displaced people regardless of legal status within Universal Health Coverage, and also ensure access to housing, education, income security, and legal protections.
Remove barriers to care including legal, language, financial, and cultural obstacles and make mental health and psychosocial support available.
Adopt inclusive, evidence-based, rights-focused policies and services for refugees and migrants.
Build secure and accountable health data systems to track progress, monitor equity, and ensure impact.
Address the root causes of forced migration such as climate change, conflict, and economic inequality through coordinated, multisector action.
Involve displaced people in decision-making across research, policy, education, and healthcare design, ensuring their voices are represented at every level.
Protect healthcare providers, facilities, and patients from violence, particularly in conflict and humanitarian settings, and safeguard academic freedom and advocacy.
Strengthen global solidarity by expanding partnerships among governments, NGOs, academia, and the private sector to share responsibility and resources for migrant health.
Fight xenophobia, stigma, and misinformation in public discussions about refugees and migrants.
Integrate refugee and migrant health into education and training for doctors, nurses, and public health professionals.
Ensure sustainable funding for migrant health, both domestically and through international agencies, especially in low-resource and crisis-affected settings.
Why This Declaration Matters
The Halifax Declaration developed on previous frameworks such as the Edinburgh Declaration (2018) and the UCL–Lancet Commission on Migration and Health (2018). Its timing is important as wars, climate change, and inequality drive more people from their homes, the declaration reminds us that protecting migrant health is not charity it is a basic human right.
International bodies like the WHO, UNHCR, and Lancet Migration are key to ensuring that the declaration’s principles are translated into global and national policy. If widely adopted, Halifax could play the same historic role for migrant health that the Declaration of Helsinki has played for clinical research ethics.
Real-World Reminder
The recent fatal attack on a young Ukrainian refugee girl Iryna Zarutska in the United States which is widely covered in the media is tragically showing the vulnerability of displaced populations. While the Halifax Declaration does not address individual cases but it underscores why protecting migrants’ dignity, safety, and health is a global responsibility.
Keynote Voices
The Halifax Declaration Conference witnessed some of the powerful words of those on the frontlines of refugee and migrant health.
Dr. Anisa Ibrahim from Harborview Pediatric Clinic, University of Washington School of Medicine (USA) reminded participants that advocacy requires bravery:
“This is the time for courage, not comfort. Speak up, even if your voice is shaking.”
Dr. Joanne Liu from School of Population & Global Health, McGill University, Canada emphasized the need for humility and openness: “We need to listen to someone who thinks differently than ourselves.”
These statements underscore the spirit of the Declaration calling on health professionals, policymakers, and communities to act with both courage and compassion.
Pharmacally Take
At Pharmacally, we believe that protecting health must extend to everyone including refugees, migrants, and displaced populations. The Halifax Declaration provides a framework for action that aligns with our commitment to patient safety, dignity, and human rights.
The Halifax Declaration offers a roadmap for governments, health systems, and global organizations to protect displaced people and migrants but it is also important that every declaration got meaning if it enacted in real world. Its adoption could become a defining moment in global health ethics just as Helsinki shaped clinical research, Halifax could shape the health and dignity of migrants in coming years.
References
Fabreau GE, Coakley A, Clarke SK, et al. The Halifax Declaration: protecting health, dignity, and human rights in an era of forced displacement. Lancet Reg Health Eur. 2025;56:101406. doi:10.1016/j.lanepe.2025.101406.
Lancet Migration. Halifax Declaration. 2025. Available at: https://migrationhealth.org/halifax-declaration/
Footnote: “Several other documents bear the name ‘Halifax Declaration’ (for example on sustainable development and racial justice, published in earlier years). These are distinct from the 2025 Halifax Declaration on migrant and refugee health.”