GCRF RESEARCH FOR HEALTH IN CONFLICT (R4HC-MENA): developing capability, partnerships and research in the Middle and Near East (MENA)

目前有20亿人生活在冲突和脆弱地区，反映出自2010年以来战争、族裔冲突和其他人为灾难迅速增加。世界也正在经历第二次世界大战以来最严重的被迫移徙危机，6530万被迫流离失所者、4080万境内流离失所者、2130万难民和另外1000万无国籍人。在整个中东和北非地区，叙利亚和利比亚等国以及阿富汗、伊拉克和也门的旷日持久的冲突导致土耳其、黎巴嫩、巴勒斯坦被占领土和约旦的难民人数急剧增加。这些国家受战争影响的人口经历了流行病的转变，因此提出了新的健康挑战。特别是，非传染性疾病的诊断、管理和治疗给国内卫生系统以及人道主义和发展援助提供者带来了新的挑战。这些挑战还威胁到国内对全民健康覆盖(UHC)和可持续发展目标(SDGs)的卫生承诺。这种新的人道主义-发展-卫生三者之间的关系需要一种独特的研究议程，与传统的方法截然不同，这些传统方法在低收入国家应对卫生挑战，这些国家的政府和机构薄弱，主要是传染病负担严重。如果没有适当的研究能力来产生关键证据，为卫生政策和护理提供信息，中东和北非地区的国家将不可能规划合理和负担得起的卫生系统、健全的经济政策和更有效的援助效力。我们的R4HC(冲突中的健康研究)-中东和北非国家合作伙伴关系的愿景是在该地区建立可持续的研究能力，以应对冲突带来的重大健康挑战，特别是癌症和精神健康作为关键的非传染性疾病。R4HC-MENA将在四个不同的领域建设研究能力：(1)冲突与健康；(2)冲突中健康的政治经济学；(3)癌症；(4)冲突地区的心理健康研究。这一研究能力将侧重于为研究这些领域的各种理论和实践方法培训工作人员，以及开展和出版研究项目，以建设进一步的能力和传播研究成果。R4HC-MENA将使该区域的主要国家能够增强和维持研究能力，这些能力可以为与该区域武装冲突有关的卫生发展方面提供重要信息。这不仅将为区域和国际政策制定者提供信息，也将为癌症和精神健康等复杂非传染性疾病制定负担得起和公平的临床护理模式和途径提供信息。R4HC-MENA还将把区域部委和学术中心以及主要的国际合作伙伴联系起来，将研究扩大到政策翻译，并为受冲突影响的其他区域的卫生发展议程提供重要信息。

Two billion people currently live in areas of conflict and fragility, reflecting a rapid increase in wars, ethnic strife and other man-made disasters since 2010. The world is also experiencing the greatest forced migration crisis since the Second World War with 65.3 million forcibly displaced persons, 40.8 million internally displaced persons (IDPs), 21.3 million refugees and a further 10 million stateless people. Across the Middle East and North Africa (MENA) region protracted conflicts in countries such as Syria and Libya, as well as Afghanistan, Iraq and Yemen, have led to dramatic increases of refugee populations in Turkey, Lebanon, the Occupied Palestinian Territories and Jordan. War affected populations from these countries have undergone the epidemiological transition and therefore present new health challenges. In particular, the diagnosis, management and treatment of non-communicable diseases (NCDs) present new challenges for domestic health systems, as well as for humanitarian and development aid providers. These challenges also threaten domestic health commitments to Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs). This new humanitarian-development-health nexus demands a unique research agenda radically different from traditional approaches that address health challenges in low-income countries with weak governments, institutions and a mainly communicable disease burden.Without proper research capacity to generate crucial evidence to inform health policy and care, it will be impossible for countries in the MENA region to plan for rational and affordable health systems, sound economic policy and more effective aid effectiveness. The vision for our R4HC (Research for Health in Conflict)-MENA partnership is to build sustainable research capacity in this region to address major health challenges arising from conflict, specifically cancer and mental health as key NCDs. R4HC-MENA will build research capacity in four distinct areas: (1) conflict and health; (2) the political economy of health in conflict; (3) cancer; and (4) mental health research in regions of conflict. This research capacity will focus on training staff in a variety of theoretical and practical methods for studying these areas, as well as conducting and publishing research projects to build further capability and disseminate findings. R4HC-MENA will enable lead countries in this region to grow and sustain research capacity that can critically inform aspects of health development that relate to armed conflict in the region. This will inform not only regional and international policy-makers, but also the development of affordable and equitable clinical models of care and pathways in complex NCDs such as cancer and mental health. R4HC-MENA will also link together regional ministries and academic centres, and key international partners, to widen the research to policy translation, and critically inform the health development agenda in other regions affected by conflict.