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Healthcare needs of older people in humanitarian settings | Collections | MSF Science Portal
Healthcare needs of older people in humanitarian settings

Healthcare needs of older people in humanitarian settings

Globally, the number of older people is rapidly increasing, with those aged 60+ expected to more than double by 2050—yet in humanitarian crises, they remain one of the most neglected groups. Older adults often face higher risks due to chronic illnesses, mobility issues, and limited access to appropriate care, especially in low-resource or emergency settings. Despite these needs, humanitarian responses rarely prioritize them, and data on their health and mortality are often lacking.


This collection reflects MSF’s ongoing examination of its own data and practices to identify pathways toward more age-inclusive services in humanitarian crises. It includes analysis of data from MSF-supported mental health services, inpatient departments, and sexual violence services, and further offers several calls to action and reflections on why older people remain overlooked in humanitarian crises. However, MSF also acknowledges major challenges remain, including inadequate age-inclusive services, data gaps, and the need for more geriatric expertise.


Watch this space for more publications from a Lancet Healthy Longevity series on healthcare rights and needs of older people.


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TB-PRACTECAL Trial—Evidence for a shorter, safer, more effective treatment for drug-resistant tuberculosis

TB-PRACTECAL Trial—Evidence for a shorter, safer, more effect...
Drug-resistant tuberculosis (DR-TB) remains an especially deadly form of the ancient scourge of TB, while current treatments are long, toxic, and ineffective for half of all patients. Aiming to change this unacceptable status quo, in the mid-2010’s MSF and partners launched three clinical trials to test novel regimens containing the first new TB drugs in decades. On 22 December 2022 the New England Journal of Medicine published findings from TB-PRACTECAL, a three-country randomized controlled trial, showing that a shorter regimen is safer and cured 89% of DR-TB patients, compared with 52% on the standard of care. These findings have already been incorporated into the World Health Organization’s new TB treatment guidelines. A separate study shows that the new regimen is also more cost-effective. Alongside these results the content collection linked below highlights other aspects of the trial, from community engagement strategies that helped shape TB-PRACTECAL to setbacks arising from the Covid-19 pandemic. It also examines urgent challenges in scaling up access to these life-saving drugs, including affordability and patent barriers.
MSF Scientific Days Latin America 2024

MSF Scientific Days Latin America 2024
New tools and approaches to drug-resistant TB

New tools and approaches to drug-resistant TB
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MSF Scientific Days in Latin America 2024 focused on two thematic areas:

Climate Emergency in the Americas: What Are We Seeing as a Medical Humanitarian Organization and How Are We Responding?

  • MSF has long responded to health crises aggravated by the climate emergency —such as disease outbreaks, food insecurity, and displacement—and these events are intensifying in severity and frequency. This session presented examples of how MSF is adapting to address climate-related emergencies in the region, and explored strategies for future humanitarian action.

Mental Health and Psychosocial Support Interventions in Violence, Migration, and Indigenous Health Projects

  • This session explored the complexities of providing mental health and psychosocial support (MHPSS) in some of the region’s most challenging settings. It focused on interventions in areas affected by violence, the mental health impact on migrants, and the unique needs of indigenous populations. The discussion highlighted innovative strategies, culturally sensitive approaches, and the importance of integrating MHPSS into healthcare projects in these complex settings.
The World Health Organization estimates that 410,000 people developed a drug-resistant tuberculosis infection (DR-TB) in 2022, only 40% of whom were diagnosed and started on treatment—and only 63% then cured. Given all these points of failure, innovation in preventing, diagnosing and treating DR-TB cannot come fast enough. To mark World TB Day (24 March 2024) the content collection linked below highlights recent work by MSF and collaborators to help change this grim picture. The TB-PRACTECAL and endTB studies delivered robust evidence for shorter, safer, more effective drug regimens that are already saving lives worldwide. Other studies explore new approaches to preventive treatment and simpler, quicker, accurate detection of TB and drug resistance—especially among difficult-to-diagnose populations such as children and people living with HIV. But to impact DR-TB globally these innovations must become widely accessible. This requires changes on many fronts, as described in an accompanying Collection (Expanding Access to Lifesaving New TB Tools).
Journal Article
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Research

Health conditions of older adults in complex humanitarian settings in low- and middle-income countries: a retrospective analysis of 2019–2025 data from Médecins Sans Frontières-supported inpatient departments

van Boetzelaer E, Keating P, Caleo G, Oluyide B, Masum RR,  et al.
2025-11-01 • BMJ Global Health
2025-11-01 • BMJ Global Health

BACKGROUND

Inpatient admissions of older adults in humanitarian settings in low-income and middle-income countries remain poorly documented, likely leading to g...

Journal Blog
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Perspective

Symposium on ageing in crisis: Advancing the overlooked healthcare rights and needs of older people in humanitarian crises

van Boetzelaer E
2025-10-29
2025-10-29
Journal Article
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Research

Differences in sexual violence against younger and older adults in complex humanitarian settings: a retrospective analysis from Médecins Sans Frontières in 2019–24

Van Boetzelaer E, Biru T, Idris A, Keating P, Staunton M,  et al.
2025-10-16 • Lancet Global Health
2025-10-16 • Lancet Global Health

BACKGROUND

Sexual violence against older adults in humanitarian settings is poorly documented, leading to gaps in prevention and delivery of support services. T...

Journal Article
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Research

Differences in mental health between younger and older adults in complex humanitarian settings in low-income and middle-income countries: retrospective analysis from Médecins Sans Frontières-supported mental health services, 2019–2024

van Boetzelaer E, Sleit R, Rodriguez E, Kagomba Barathi G, Escobio F,  et al.
2025-09-26 • BMJ Global Health
2025-09-26 • BMJ Global Health

BACKGROUND

Humanitarian emergencies increase the risk of development or exacerbation of mental health conditions. This study documents how mental health differs...

Journal Article
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Research

Mental health of older adults in humanitarian settings in low- and middle-income countries: a retrospective analysis from Médecins sans Frontières-supported mental health services, 2019–2024

van Boetzelaer E, Keating P, Wasara N, Rodriguez E, Escobio F,  et al.
2025-07-05 • BMJ Global Health
2025-07-05 • BMJ Global Health

BACKGROUND

More complex humanitarian emergencies have a profound impact on a rapidly growing ageing population. There are few data available on the mental healt...

Journal Article
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Review

Health needs of older people and age-inclusive health care in humanitarian emergencies in low-income and middle-income countries: a systematic review

van Boetzelaer E, Rathod L, Keating P, Pellecchia U, Sharma S,  et al.
2024-12-30 • The Lancet Healthy Longevity
2024-12-30 • The Lancet Healthy Longevity
Journal Article
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Commentary

Involving older people in the preparedness, response, and recovery phases in humanitarian emergencies: a theoretical framework on ageism, epistemic injustice, and participation

van Boetzelaer E, van de Kamp J, Keating P, Sharma SK, Pellecchia U,  et al.
2024-01-01 • The Lancet Healthy Longevity
2024-01-01 • The Lancet Healthy Longevity
Journal Article
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Letter

The disproportionate vulnerability of older people in humanitarian emergencies

van Boetzelaer E, Franco OH, Moussally K, Khammash U, Escobio F
2023-10-20 • Lancet
2023-10-20 • Lancet
Journal Article
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Commentary

Elderly people in humanitarian crises, a forgotten population: A call for action

van Boetzelaer E, Browne JL, Vaid S, Pellecchia U, van de Kamp J,  et al.
2023-07-17 • PLOS Global Public Health
2023-07-17 • PLOS Global Public Health
Journal Blog
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Perspective

Conflict in eastern Ukraine is a reminder that older people are especially vulnerable in emergencies

Simonyan G
2019-06-04 • BMJ Opinion (blog)
2019-06-04 • BMJ Opinion (blog)
Journal Article
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Research

Risk factors for mortality during antiretroviral therapy in older populations in resource-limited settings

O'Brien DP, Spelman T, Greig J, McMahon J, Ssonko C,  et al.
2016-01-01 • Journal of the International AIDS Society
2016-01-01 • Journal of the International AIDS Society
INTRODUCTION
An increasing proportion of adult patients initiating antiretroviral therapy (ART) in resource-limited settings are aged >50 years. Older populations on ART appear to ha...
Journal Article
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Commentary

Should mortality data for the elderly be collected routinely in emergencies? The practical challenges of age-disaggregated surveillance systems

du Cros PAK, Venis S, Karunakara U
2013-10-10 • Transactions of the Royal Society of Tropical Medicine and Hygiene
2013-10-10 • Transactions of the Royal Society of Tropical Medicine and Hygiene
Data on the elderly are rarely collected in humanitarian emergencies. During a refugee crisis in South Sudan, Médecins Sans Frontières developed a prospective mortality surveillance syst...
Journal Article
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Commentary

Ending neglect of older people in the response to humanitarian emergencies

Karunakara U, Stevenson F
2012-12-18 • PLOS Medicine
2012-12-18 • PLOS Medicine