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Rapid urbanisation is a key characteristic of the modern world, interacting with and reinforcing other global mega trends, including armed conflict, climate change, crime, environmental degradation, financial and economic instability, food shortages, underemployment, volatile commodity prices, and weak governance. Displaced people also are affected by and engaged in the process of urbanisation. Increasingly, refugees, returnees, and internally displaced persons (IDPs) are to be found not in camps or among host communities in rural areas, but in the towns and cities of developing and middle-income countries. The arrival and long-term settlement of displaced populations in urban areas needs to be better anticipated, understood, and planned for, with a particular emphasis on the establishment of new partnerships. Humanitarian actors can no longer liaise only with national governments; they must also develop urgently closer working relationships with mayors and municipal authorities, service providers, urban police forces, and, most importantly, the representatives of both displaced and resident communities. This requires linking up with those development actors that have established such partnerships already.

Forced displacement has become a defining characteristic of sub-Saharan Africa, obliging people to abandon their homes and seek refuge elsewhere, often at the price of serious threats to their welfare and rights. Focusing on mass displacements, this article examines the changing scope, scale, and dynamics of the problem of human displacement in Africa. The article then goes on to analyse a number of policy challenges related to this issue: the principle and practice of asylum; insecurity in refugee-populated areas; protracted refugee situations; the return and reintegration of displaced people; and the protection of people who have been displaced within their own country.

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Addressing increasing concerns about public health equity in the context of violent conflict and the consequent forced displacement of populations is complex. Important operational questions now faced by humanitarian agencies can to some extent be clarified by reference to relevant ethical theory. Priorities of service delivery, the allocation choices, and the processes by which they are arrived at are now coming under renewed scrutiny in the light of the estimated two million refugees who fled from Iraq since 2003.Operational questions that need to be addressed include health as a relative priority, allocations between and within different populations, and transition and exit strategies. Public health equity issues faced by the humanitarian community can be framed as issues of resource allocation and issues of decision-making. The ethical approach to resource allocation in health requires taking adequate steps to reduce suffering and promote wellbeing, with the upper bound being to avoid harming those at the lower end of the welfare continuum. Deliberations in the realm of international justice have not provided a legal or implementation platform for reducing health disparities across the world, although norms and expectations, including within the humanitarian community, may be moving in that direction.Despite the limitations of applying ethical theory in the fluid, complex and highly political environment of refugee settings, this article explores how this theory could be used in these contexts and provides practical examples. The intent is to encourage professionals in the field, such as aid workers, health care providers, policy makers, and academics, to consider these ethical principles when making decisions.