PurposeThe coronavirus disease (COVID-19) pandemic has emerged as an unprecedented health crisis worldwide and heavily disrupted the healthcare supply chain. This study focuses on analysing the different types of disruptions occurring in personal protective equipment (PPE) supply chains during the COVID-19 pandemic and on proposing mitigation strategies that are fit to the global scale and many interdependencies that are characteristic for this pandemic. The authors construct a conceptual system dynamics model (SD) based on the literature and adjusted with the use of empirical data (interviews) to capture the complexity of a global supply chain and identify leverage points (mitigation strategies).Design/methodology/approachThis research follows a mix-methods approach. First, the authors developed a conceptual framework based on four types of disruptions that usually occur during health emergencies (direct effect, policy, supply chain strategy, and behaviourally induced disruptions). Second, the authors collected and analysed data from interviews with experts in the PPE supply chain. Based on the interviews data, the authors developed a conceptual system dynamics (SD) model that allows to capture the complex and dynamic interplay between the elements of the global supply chain system, by highlighting key feedback loops, delays, and the way the mitigation strategies can impact on them. From this analysis, the authors developed four propositions for supply chain risk management (SCRM) in global health emergencies and four recommendations for the policy and decision makers.FindingsThe SD model highlights that without a combination of mitigation measures, it is impossible to overcome all disruptions. As such, a co-ordinated effort across the different countries and sectors that experience the disruptions is needed. The SD model also shows that there are important feedback loops, by which initial disruptions create delays and shortages that propagate through the supply chain network. If the co-ordinated mitigation measures are not implemented early at the onset of the pandemic, these disruptions will be persistent, creating potential shortages of PPE and other critical equipment at the onset of a pandemic – when they are most urgently needed.Originality/valueThis research enriches the understanding of the disruptions of PPE supply chains on the systems level and proposes mitigation strategies based on empirical data and the existing literature.

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Involuntary displacement from conflict and other causes leads to clustering of refugees and internally displaced people, often in long-term settlements. Within refugee-hosting countries, refugee settlements are frequently located in isolated and remote areas, characterized by poor-quality land and harsh climatic conditions. Yet, the exposure of refugee settlements to climatic events is underresearched. In this article, we study the exposure of the 20 largest refugee settlements worldwide to extreme variations in climatic conditions. The analysis integrates exposure of camp locations compared to the national trends for both slow- and rapid-onset events and includes descriptive statistics, signal-to-noise analyses, and trend analyses. Our findings show that most refugee settlements included face relatively high exposure to slow-onset events, including high temperatures (for settlements in Kenya, Ethiopia, Rwanda, Sudan, and Uganda), low temperatures (in the case of Jordan and Pakistan), and low levels of rainfall (in Ethiopia, Rwanda, Kenya, and Uganda) compared to national averages. Our findings for rapid-onset events—heatwaves, coldwaves, and extreme rainfall—are less conclusive compared to country trends, although we find relatively high exposure to extreme rainfall in Cox’s Bazar, Bangladesh. Our analyses confirm that refugee populations are exposed to extreme weather conditions postdisplacement, which, in combination with their sociopolitical exclusion, poses a threat to well-being and increased marginalization. Our findings call for an inclusive and integrated approach, including refugees and their host communities, in designing climate adaptation and sustainable development policies, in order to promote equitable sustainable development pathways in refugee-hosting countries.