Refugee intake: reflections on inequality

Abstract

Abstract Background: Refugees represent one of the most marginalised populations with generally poor health outcomes and requirements often very different from, and in excess of, the populations in the countries of asylum. It stands to reason that countries that accept refugees should have the resources to support them. Although governments in industrialised countries are often vociferous about the generosity of their support for refugees, the appearance is that it is the poorest nations that bear the greatest burden. This has important implications for the allocation of resources to support the health and welfare needs of refugees. The distribution of refugees globally and the wealth of the countries of asylum are examined in this paper. Method: Data on the numbers of refugees accepted in each country were obtained from the United Nations High Commissioner for Refugees. These were used to analyse the ‘fairness’ of the distribution of refugees according to the economic capacity of the host countries. Findings: A similar distribution of refugees prevails in the poorest quintile of countries and in the richest. Although there is considerable between‐country variation, when account is taken of economic capacity, the poorest countries bear the greatest burden. Interpretation: The distribution of refugees is in stark contrast to the humanitarian rhetoric of the industrialised countries. The implications of the inequitable distribution on health cannot be overemphasised.