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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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Mental health in humanitarian settings

Mental health in humanitarian settings
Complex humanitarian emergencies and other low-resource settings can be exceedingly difficult places to provide quality mental health (MH) care. Yet these environments also often have a high burden of mental health care needs. This collection presents a set of articles describing how MSF teams have adapted and evaluated ways of bringing clinically impactful MH care to neglected communities and patients—from forcibly displaced populations in northern Nigeria to Syrian refugees in Lebanon and typhoon survivors in the Philippines. It also highlights work on developing new tools for providing clinical supervision and for identifying those patients most in need of care in fragile settings, and on new approaches to delivering MH services during the Covid-19 pandemic.
New tools and approaches to drug-resistant TB

New tools and approaches to drug-resistant TB
World Malaria Day 2023

World Malaria Day 2023
View All Collections
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).
World Malaria Day is April 25th. The theme for 2023 is "Zero malaria: invest, innovate, implement" and the importance of reaching marginalized populations with the tools and strategies that are currently available. This collection highlights research on this theme, especially the latter two "i's": From research on Seasonal Chemoprophylaxis (SMC) and mass drug administration (MDA), to analyzing the reach of gene mutations (HRP2) in new environments, to other interventional research topics, these articles show how innovative approaches can be successfully implemented even in the most challenging settings to fight this global public health threat.
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