Forecasting Humanitarian Risk in 2026: A Conversation With David Miliband

David Miliband, president and chief executive officer of the International Rescue Committee (IRC), presents the new IRC Emergency Watchlist report, highlighting the countries at highest risk of humanitarian crises in 2026 and examining where the international community has made progress or fallen short.

MITCHELL: Thank you so much, everyone. It’s great to be here. Good afternoon. Great to be here at CFR and seeing so many friends, old and new friends here gathered and gathered for such an important talk. So thank you. Welcome to the community, to the Council on Foreign Relations meeting “Forecasting Humanitarian Risk in 2026” with International Rescue Committee President and CEO David Miliband.

I am Andrea Mitchell, chief Washington correspondent and chief foreign affairs correspondent for NBC News, and I will be presiding over today’s discussion. We’re joined today by CFR members and IRC guests attending both virtually and in person here in Washington.

I’d like to invite David to the podium now to give us some brief introductory remarks framing the IRC 2026 Watchlist Report.

MILIBAND: Thank you very much, Andrea. Good evening. Good afternoon, everyone. Very nice. Good evening when I finish my remarks. (Laughter.) It’s really nice to see you all here. Thank you very much for taking the time to come and discuss some of the issues that are raised by our report. Really, thanks to you, Andrea, for agreeing to be my interrogator for part of the program, and then we’ll open up for questions and comments from the audience.

As we close the first quarter of the twenty-first century, a humanitarian organization like the IRC is presented with a series of contradictions. The world’s able to feed 9 billion people, but 43 million children are acutely malnourished today. It’s never been easier to travel, but 120 million refugees and displaced people can’t go home. Clean energy has never been cheaper, yet the poorest countries in the world are falling behind on every measure of mitigation and adaptation to climate change, and poverty has been dramatically slashed over the last thirty years, global poverty, but inequalities are growing fast. And the biggest inequality of all is between people who are born in stable states and those unfortunate enough to be born in fragile or conflict-affected states.

And the analysis that’s presented in our Emergency Watch List—a summary of which you have here, but which is online if you scan the QR code on the back—the analysis in our Emergency Watch List, this is a data-driven exercise. We use about seventy-four, seventy-five different quantitative and qualitative indicators to generate the twenty countries at greatest risk of humanitarian crisis in the year ahead. We have a 85 to 95 percent success rate in our—in the predictive power of the work. The analysis in the 2026 Emergency Watch List is that we’re living through a quote-unquote “new world disorder.” The map of poverty has been redrawn around conflict, just as the map of geopolitics has been scrambled by shifts in economic and political power. Civil wars that once had two sides now have more than ten. And the red lines that once protected children, hospitals, and aid workers are being erased.

And the purpose of my remarks over the next ten or twelve minutes or so is to try and give a summary of the argument underlying the watch list, but I hope you do get the chance to read the full document.

The starting point is the number of people in humanitarian need around the world. Those of you who follow the data will notice that the figure of 239 million in humanitarian need is 70 million lower than the number at this time last year, when it was around 305 million. I wish that was because the needs had been addressed or mitigated, but sadly, that’s not the case. The difference between 305 million and the 239 million is the method of counting, not the amount of suffering.

Funding constraints have led the U.N. Office for the Coordination of Humanitarian Affairs, which generates that figure, to narrow the scope of their assessment. The fact that they now report only on people under the most severe humanitarian needs is itself a manifestation of the new world disorder. We’re losing visibility on tens of millions of people whose conditions have not improved, but for whom there will not be enough resources to even attempt to scale or recognize their needs.

There are some remarkable statistics about these 20 countries. They comprise 12 percent of the world’s population, but 89 percent of those in humanitarian need. So actually, it’s a very concentrated population. They constitute four in every five displaced people, whether internally displaced or refugees, and 96 percent of the 617 aid workers killed, kidnapped, or wounded over the last year.

The most alarming fact of all, though, is not a statistic. It’s the fact that as the world has become more connected, empathy seems to have become more divided, and as needs have grown, support for grant aid has been systematically withdrawn. This is ultimately what needs to be understood, confronted, and in our view, reversed.

The countries on the watch list are a challenge to all of us. I was in Somalia last week. The country suffers from conflict, drought, corruption, while the people show resilience, ingenuity and entrepreneurship, but 6 million people are in humanitarian need in Somalia. Four million are at high levels of food insecurity.

Famine struck in 2011 as some of you will know, 250,000 people died before famine was declared even in that year, and staved off in 2018 and 2021-22. But now famine is threatening again, and the aid appeal, the U.N. aid appeal, is 28 percent funded. In other words, 72 percent unfunded.

In September, I was in Sudan, top of the watch list for the third year in a row, the biggest humanitarian crisis today, and the biggest ever recorded. Over 30 million people in humanitarian need, 20 million facing crisis levels of food insecurity, 12 million displaced. Yet even this, the most acute aid crisis in the world—the humanitarian crisis in the world is only 35 percent funded.

And globally, the figures on humanitarian need are really quite shaming. 1.4 million people are facing the international phase classification, the measure of food insecurity, level five, which is catastrophic, or famine-like conditions in six countries. Fifty-seven countries—I said fifty-nine on the “Morning Joe” Show this morning, so I slapped myself over the wrist for that—fifty-seven countries are facing measles outbreaks around the world. Malaria cases are up by 11 million, and climate shocks displaced 45 million people just in 2024, the last year for which figures are available.

Meanwhile—and this is the sort of scissors effect of very high needs, but declining efforts to address them—projected aid cuts in 2025 total over $30 billion. That’s total aid cuts. And humanitarian aid funding, which was about 26 billion in the previous year, has been cut by 50 percent, so 12 (billion dollars) or $13 billion. Lifesaving programs have not been spared. And you know things are bad when you have to recognize that headline crises like Ukraine are quote-unquote “lucky “to receive just under half of their assessed funding needs.

One element of the aid spend that I think doesn’t have sufficient attention is that rising numbers of donor countries in Europe, including my own, I’m very sad to say, are using quote-unquote “overseas aid funds” to host refugees in their own country—in other words, not to spend on overseas aid. It’s about 20 or 25 percent of the aid budget is being spent on domestic refugee needs because the disaster the accounting body allows you to spend for the first year in your own country on refugees who arrive. The U.S., once responsible for thirty cents of every aid dollar, has led the way in funding reductions, cutting 83 percent of its programs.

The Lancet estimate that these funding cuts are going to lead to 1.8 million excess deaths just in this year alone. And I know that I should have said at the beginning that I’m really grateful to the CFR, to the Council on Foreign Relations, for the invitation and for recognizing that humanitarian needs are, in a way, the flip side of the coin of political or foreign policy failure. And in foreign policy circles, there’s sometimes a temptation to discuss the breakdown of the post-World War II international order in a kind of abstract or theoretical academic way. In the watch list countries for our teams, the breakdown of that order is a lived reality. And the best way I think I can put it is that the aspiration of the post-World War II order was that there would be rules regulating the activities of countries and rights underpinning the lives of people. What we’re seeing is that rules and rights are increasingly being ignored by states and by non-state actors.

The core argument of the watch list—and this is why I think the partnership today with the CFR is important—is that every humanitarian emergency is actually a political emergency, not just in the response to it, but in the origins of it. That is the origin, this political emergency, of the disorder that we explain in the watch list today. The new world disorder in our story is driven by shifts in political power, the breakup of long-term alliances, and a new transactionalism that has usurped basic protections for people.

In a sentence, there are more rivals and more risks, shifting alliances, and power-based deal making in war zones, often led by external actors. And these trends fuel three incredibly destructive tendencies that we see in the thirty to forty countries that we work in.

First, shared goals like climate mitigation adaptation, or sustaining global rules, or controls on arms supply are being undermined. It’s a classic—some of you may remember Charles Kindleberger, very famous American economist—this dilution of shared effort on shared goals is a classic of the Kindleberger trap, a power vacuum where critical global public goods are not provided, and which Charles Kindleberger argued often happen when a preeminent power was giving way to a rising power.

Secondly, profit from conflict is being legitimized and normalized. Sudan is a case study as gold and other natural resources fuel the conflict. The new economics of war are a feature of the watch list this year, probably for the first time.

And then, third, basic rights and protections for the most vulnerable are being trampled. This is evident in the 50,000 civilian deaths recorded in 2024, and most significantly, I think, more than eighteen countries recording more than 1,000 conflict-related deaths in 2025.

The new world disorder phrase speaks to something distinctive, that the old order has clearly disappeared, but a new order has not been created. This, in our view, needs to be called out and its dangers recognized.

I want to emphasize that we don’t view the past with rose-tinted spectacles. We never declared a golden age of the rules-based order. The basic rights of people enunciated in the U.N. Charter and elsewhere after the Second World War were universal on paper, but not universal in reality. They were honored in breach as well as in observance.

However, the list of rights, and above all, protections from harm, provided a global standard against which to judge the actions of state and non-state actors. When that is lacking, as it is now, impunity is given license, and that’s a threat to us all.

For the last part of my remarks, I just want to dwell for a few minutes on the fact that the watch list is not just intended to sound the alarm, although it is intended to do that. Its argument is that while the problems are real, the mitigations—I don’t say solutions—the mitigations are not beyond reach.

The watch list addresses three questions, and I want to spell them out and give you briefly our answer to them.

The first question is, how can we shift the balance from profit to protection in war zones? Our argument is that peace processes won’t work until they recognize how cross-border financial flows fuel conflict. Our argument is that peace processes need to be inclusive of new and rising powers. It’s that the evidence is clear that durable peace needs to be built from the bottom up, as well as from the top down, with women and women-led organizations at the table, according to the evidence making for greater chance of success, and also that the gridlock in the U.N. Security Council, with forty-nine vetoes in the last decade, more than a doubling of the previous decade requires support for the French and Mexican proposal, now supported by 120 countries around the world, that the veto should be suspended in cases of mass atrocity around the world.

The second question is, how do we shift the balance from danger to dignity for people caught up in crisis, civilians caught up in crisis. We argue that all states should support and fully fund U.N. accountability mechanisms such as the commissions of inquiry and fact-finding missions, which may sound pedantic, but are absolutely fundamental to any notion of accountability. If you think about Sudan and Al Fashir today, it’s absolutely key to get hold of the evidence.

We argue that governments should firewall humanitarian access from political and military negotiations in light of the massive constraints on humanitarian access in thirty-six countries in the last year. We call out also the extraordinary levels, and we’re informed by the Sudan testimony that our teams in Tawila—which is about forty kilometers to the west of Al Fashir in Darfur—we call out the extraordinary levels of gender-based violence in conflict and the appallingly low level of support for survivors.

We also argue that the rights of those seeking refuge are basic, not grandiose, and should be prioritized in making migration management fair, fast, and effective.

And the third and final question we address is, how do we shift the balance from retreat to recommitment when it comes to the future of aid?

And that’s really our core business. We argue that we are in a new era of aid. We shouldn’t ignore that. Our budget is $400 million lower than it was a year ago. We have 6,000 fewer staff than we had a year ago.

But we’re an organization which is very much on the front foot. We’re not looking back. We’re actually marching forward quite strongly, because we think there needs to be and we think we have a new focus, new partnerships, and new evidence on cost effectiveness, underpinned by a drive for innovation to maximize the benefit of technological advancements for those in danger of being most left behind.

I’m incredibly proud that although we’ve had to cut $400 million from our budget, today, we’re using AI in the Democratic Republic of Congo to diagnose monkey pox by comparing photographs of lesions against a data set, so that instead of blood samples being sent to Kinshasa to decide whether someone has monkey pox or not, we’re able to diagnose it in five minutes. We want to do that for 200 other rare diseases in Africa. That’s our aim for the years ahead.

We think all of this is possible. Fragile states should be the focus of aid, because that’s where most of the extreme poor are now living. At the moment, only 25 percent of aid goes into the fragile states.

Proven cost-effective interventions like the IRC’s $2 a shot immunization drive in East Africa need to be scaled because they’re the fastest route to impact, and aid needs to anticipate crisis, especially extreme climate events, because that anticipation has been shown to have outsized influence. You can’t give an ex-politician an audience like this without expecting him to go on longer than he should have done, but I’m going to wind up, finish up in the next sixty seconds on the following note.

The new world disorder is not only a description, it’s a warning. And warnings are only useful if they prompt action. The watch list shows where risk is greatest, but also where resolve can still make a difference. The forces that are pulling part apart the world are strong. We recognize that. But they’re not inexorable. Protection can be rebuilt, dignity restored, commitment renewed. The task is to match the courage of those living through crisis with leadership worthy of their resilience and to prove that even in an age of disorder, humanity still has choices, and those choices matter.

Thanks very much for your attention and really look forward to the discussion. (Applause.)

MITCHELL: Thank you so much, David, for the work, first of all, of the IRC, for this incredible data, and for bringing this to us, to the world today through the Council on Foreign Relations.

First of all, many countries on your new watch list are also on the president’s—on President Trump’s travel ban. How much does that travel ban now further the crisis that you’ve already evaluated?

MILIBAND: Well, I would—I think it’s always better to try and make the answers as practical as possible. So let me pick one example. Afghanistan is an important country for us because we made a commitment after the military withdrawal in 2021 that we would stay with the people of that country. And we are continuing to deliver services there, although all American aid support has been zeroed out in Afghanistan for us.

But here, the Afghan case study provides a very interesting example, a very tangible and difficult example, because of the terrible event that happened in this city three weeks ago, and we are strong supporters both of the commitment at the heart of the SIV program, the Special Immigrant Visa Program, that says that the commitment that was made to Afghans who worked with American military and American diplomats, that there would be a place for them to go if the if the worst happened. We are very strongly of the belief that that commitment should be upheld, and also of the belief that the SIV screening program is a strict and serious screening program, and that the misdemeanors of one person shouldn’t poison the life chances of a whole group of people.

And so I think that’s the most telling example where the travel—I think, to be fair, it’s we’re holding on to the idea it’s more of a pause than a ban. But obviously, if the travel ban remains in place, no Afghan SIVs will be allowed to come here. There’s a pause in the processing. And so I think that’s the most tangible case where the travel ban can have a direct impact.

MITCHELL: And in the case of Afghanistan and several other places, the temporary protective status is also being withdrawn, facing a deadline. So people already here, many of whom are women—and I’ve done a lot of interviews with Afghan veterans, U.S. military veterans, who have been for years concerned that the promises made to the SIVs who even got here are not being delivered in terms of jobs.

MILIBAND: And yes, I mean, I know that there’s been a lot of focus on, if you like, unregulated quote-unquote illegal migration, but the issue of people who are here completely legally but are now fearful of the reviews that are happening is very serious.

MITCHELL: You’ve said that of the twenty countries now on your list, on your watch list, they represent just 12 percent of the global population, but 89 percent of those in dire need, and so with 83 percent of USAID cut, and PEPFAR outside of USAID, how does the world community fill that gap?

MILIBAND: Well, thank goodness that the European Union has seven-year budgets. So I know there are many things that are thought to suggest that the EU is sometimes slow, but the fact that it has seven-year budgets means that the EU budget is actually guaranteed till 2028 and the European Commission’s proposal for the future of its international engagement is for it to go up rather than down in the 2028 to 2035 period.

I think that—Tom Hart is here from the ONE Campaign. It would be interesting to know what he thinks about this. I feel, in some ways, shame on us for the following reason. The polling shows that 89 percent of the American public, including 84 percent of Republicans and 94 percent of Democrats, support the idea that 1 percent of the federal budget should go on overseas aid, $99 in every hundred spent at home.

MITCHELL: They misunderstand that it is only 1 percent.

MILIBAND: Well, exactly. Well, they don’t—I’m not sure misunderstand. They don’t realize it. They don’t know that. More than 50 percent think that 20 percent of the federal budget goes on overseas aid.

So I think that we have—those of us who are running aid agencies, we’ve got to ask ourselves, how has that common sensical, big-hearted but also smart-headed American view that $1 in every hundred for overseas aid is a good investment, how have we ended up in a situation where 83 percent of the grants and contracts got canceled? I think it’s about being much clearer about data like the $2 a vaccine shot. We’ve got to make far more practical the best programs.

Our approach over this period is to highlight the ten to twelve best programs that we run, the most evidence based, the most innovative, the most cost effective, and say these are the best buys in programming. And honestly, it’s very hard to again say that that argument, and I hope we can make that argument on a bipartisan basis, both for money to be allocated in Congress, and I have to say for then it to be spent on those by the administration on the things that it’s intended for.

MITCHELL: There was bipartisan support for, I think, one of the signature legacies of the George W. Bush administration, positive legacies, which was PEPFAR. And you know, I worked with the ONE campaign, with the World Bank when it was under Jim Wolfensohn, with Laura Bush, George Bush, post-presidency, and there was strong support in both houses and both parties.

MILIBAND: Yeah.

MITCHELL: How did PEPFAR get—save 26 million lives?

MILIBAND: Yes. So it’s been a tremendously successful program, a fantastic program. Here’s the thing that I think we have to think about. The geography of poverty has changed over the last twenty-five years since PEPFAR was created. In 2000, 2005, 10, 15, maybe 20 percent of the world’s extreme poor lived in conflict states. Today, 53 percent, 55 percent of the extreme poor live in conflict states.

And the geography of programs has to update itself, because some countries that in the 2000s were recipients of PEPFAR money, their own national economic situation, their own ability to make domestic resource commitments is different than it was twenty-five years ago. And so I think that we’ve got to defend the program but not defend the idea that a program doesn’t need to adapt.

And even our most precious programs, they’re intended for their clients, and they’re intended to be sustainable in the long term. And so I’m not an expert on PEPFAR, but if I think about other programs that have been run, for example, this point that so much of our programming in the humanitarian sector, even in the food security area, is reactive rather than proactive, we’ve got to get ahead of the game, rather than always be chasing it.

So I sort of feel, let’s—in some areas, there are things that are beyond our control, and we have to argue for others to do things differently. We should certainly defend the PEPFAR program. When there are things that are within our control, we’ve got to reform ourselves so that we’re better able to be an attractive investment.

MITCHELL: But even with PEPFAR, there was—I’m told by leadership on the Hill on the specific committees, that there was built-in sustainability deadlines for those countries like South Africa who could go towards 2030, for instance, not Sudan, or Somalia.

MILIBAND: Yeah, I mean the debate about quote-unquote “burden sharing,” I don’t really like the phrase, but just to be comprehensible.

MITCHELL: It was a scale.

MILIBAND: It’s got two aspects to it. One is that the G-7 group of countries account for about 70 to 75 percent of global aid, but we’re not 70-75 percent of the global economy. So there’s a real burden sharing argument that needs to be changed there or addressed there, then there’s a quote-unquote “burden sharing argument” about what should be international financing, what should be domestic financing.

My own view—and I explained this in a speech at the University of Notre Dame in October—is that the truth is that development is not powered in the main by aid. Development is powered by property rights, good governance, markets that work, etc. There can be a concessional loan aspect to that, but the grant aid needs to be focused not on development, but on tackling extreme poverty.

And in our report that we’re publishing today, we say if 55 percent of the world’s extreme poor live in fragile and conflict states, then 55 percent or so of the aid budget should go to those conflict states. We don’t have that at the moment.

A: I was—obviously, Sudan, for the third year in a row, is leading your list. Al Fashir has fallen to the RSF.

I was at the Chad border two years ago with Linda Thomas-Greenfield, when she went on a U.N. trip, and we flew into a dirt strip, a U.N. strip on a U.N. plane, and had to leave before dark. But it was—the refugees crossing were just women and children. One in ten children were dying, there was a Doctors Without Borders tent, not even a full encampment yet.

And Declan Walsh in the New York Times, two months later, reported that there was a military grade airstrip 200 miles to the north, built by one of the participants in the quad group that was supposedly working on a solution to the civil war to ship weapons into the RSF, and that was built by the UAE.

So when you have powerful players from the Gulf—and there were two Gulf states, UAE and Saudi, fighting the civil war through proxies and others participating. And you mentioned the transactional nature of profiteering for gold and other minerals—how does the world community deal with these open secrets? And this was all confirmed. The New York Times reporting won the Pulitzer, and this was all confirmed to me by multiple sources. It’s been discussed openly now.

MILIBAND: Well, look, this phenomenon of the internationalization of civil wars, I mean, I think, just for the clarity, we should probably not call them—first of all, they’re not civil at all. They’re very uncivil. But the internationalization of so-called internal conflict is obviously a feature of the new geopolitics. That’s significant.

Every single neighbor of Sudan has chosen a side—and there are, by the way, more than two sides—and a number of countries across the Middle East are also choosing sides, and they’re split. What’s striking is that those countries care much more than the international system—those who are relatively neutral about the outcome—than—they care more, and that is a fundamental problem that we have. I raised the issue about the vetoes in the Security Council. They’ve been used in a range of areas, but that means mass atrocity like Al Fashir is not addressed.

Now, I just want to make one point that I think has not been widely understood. All of the estimates were that about 200,000 people were in Al Fashir before it fell. Since its fall, the estimates are that 10(,000) to 15,000 people have left, many to come to Tawila. The mystery of what’s happened to those 180,000 people, how many people have been massacred, how many people—was the original number lower, that is a massive question.

This week, a U.N. team are going into Al Fashir for the first time.

MITCHELL: Because you can see mass graves from satellites.

MILIBAND: You can see mass graves, and you could also—there’s this chilling phrase that was used that you could see the blood on the grounds—and see people nodding, they heard this, absolutely chilling—from the piles of bodies. And when I talk about accountability, impunity feeds on the lack of accountability.

MITCHELL: You spoke of the measles epidemic. This is, you know, completely curable, and we now have cases in South Carolina. We’ve had two deaths of children in Texas. But how does the American posture—withdrawing from the WHO and the CDC’s changes and the new advisories on vaccinations—how does that affect because of the megaphone that the U.S. inevitably has in terms of global perceptions?

MILIBAND: I made a point last week when I was in Somalia visiting a health clinic to ask clients and staff and people I met about precisely this point.

Now, interestingly, they were saying, I suppose—in my mind’s eye, I can see a young woman, she must have been twenty-three, twenty-five, who was having her fourth kid, we asked her about vaccination. She said, I came, I got a vaccination, and it’s served me well. I’m determined my kids have vaccinations. So, it was interesting that whatever is the social media fake news about this, it hadn’t reached there.

Now, of course, she was in a health center. So what about the people who are not in the health centers? It’s a really good point you make. Our own experience is that a trusted face-to-face explanation beats social media, if you can do it at sufficient scale. We’ve had quite a lot of experience. In my mind is the Rohingya crisis and the vaccinations drivers that we’ve done there. But obviously it’s a daily battle to win confidence.

MITCHELL: The crisis, the two wars, Gaza, Ukraine nearing four years, have those two crises, you know, exhausted the EU and the U.S. and the other major donors in terms of ability to respond to these humanitarian catastrophes elsewhere?

MILIBAND: Well, the very precise thing is that Ukraine is exhausting European financial capacity in a very, very serious way. That is very, very significant. And the level of European commitment is very, very—European, I speak about Europe to include the U.K. for these purposes. I don’t know why anyone’s laughing about that. But including the U.K. and Norway for these purposes, the European commitment strikes me as very high.

I mean, the National Security Strategy last week said that European publics were losing their appetite to support Ukraine. I haven’t seen that at all, but there’s no question that the requirements around Ukraine are playing into the debate about Europe’s role in the overall aid system. And so I think there’s a very practical element to that.

Equally, I mean, my own government, the British government, are reducing their overall aid budget, but they’re not reducing the amount that’s going to Gaza. So I think it’s quite a complicated picture.

MITCHELL: And you mentioned the transactional nature being one of the new trends in these conflicts. This certainly seems to be the case in both Gaza and in Ukraine with the players who are at the negotiating table. You’ve got hedge fund people, and you’ve got non diplomats, you know. There’s been criticism of diplomats, and there are many diplomatic friends and veterans here in the room. But there is a skill set to diplomacy which does not involve billions of dollars that go into profiting from these conflict zones. And you know, is there a problem that you see in the way these things are being negotiated?

MILIBAND: Well, I’m going to body swerve that question very, very determinedly. (Laughter.) Look, when I became foreign minister, people said, well, what do you know, what have you done. So I think, you know, one has to be careful to say how much experience is necessary, what’s the balance of politics and diplomatic experience. And so I want to be careful on that score as well.

I mean, what counts, as our survey shows, in the end, the ability to share power, the ability to have political institutions that work, the ability to create functioning politics, that, in the end, is the only way to quote-unquote “solve these crises.”

Why I drew the distinction in my remarks between mitigating a crisis and solving a crisis? Obviously, the only solution to a political emergency is a political solution. The mitigation that we can offer is real.

But now, I’ll never forget the first time I went to Afghanistan in 2007, the last king of Afghanistan, it happened to be the time of his funeral, and all of Afghanistan came there, and it was the most potent demonstration of why there’s only ever a political solution. There can’t be a military solution. And I didn’t win the argument over the next three years that Afghanistan needed a political solution. But obviously, if you want to talk about solutions in our sector, you can only think about that with politics.

And so I’m not going to throw any stones at people who are trying their best to try and resolve things. What we document in the paper is that there are money flows, even in conflict, even in resource poor areas, that can end up driving the conflict rather than driving a solution.

MITCHELL: And you also mentioned that 239 people in geopolitical need around the world are 70 million less than last year, but that’s because fewer people are being counted. How do you deal with a problem on this scale without a proper count?

MILIBAND: Yeah, that’s a good that’s a good point. If you say 240 million, or if you say 300 million, in my experience, that’s just a big number for people. Now, the danger of both those numbers is that people think, oh, my God, that’s so many people. How on earth can you mitigate that level of humanitarian need?

That’s why I think this twenty countries thing is important. When you say there’s twenty countries, parts of which have got—you know, if you think about Nigeria, the conflict areas of Nigeria, it’s one of the biggest countries we work in, but the conflict areas are not the whole countries, parts of the country—these are localized, concentrated areas of need and conflict. And it makes them more addressable of you describe it as twenty conflict areas, rather than 239, or 305, million people. 305 million people or 239 million people sounds like we’re asking people to climb Mount Everest. Twenty countries, let’s say 45 million children today acutely malnourished, that’s actually manageable since 85 percent of them are in those places, and we know how to get to them.

And just I know you want to get to questions from the audience, but just give me 30 seconds on this. Gavi, the Global Alliance on Vaccines and Immunization, fantastic organization, they came to us and they said, we’ve reached a plateau in immunizing kids. I said, yeah, it’s because the kids that you can’t reach are in conflict zones. They said, yeah, we reached 85 percent and we want to give you $50 million to go and find 2 million zero dose kids in four war torn countries in East Africa: Somalia, Sudan, South Sudan ,and Ethiopia, parts of those countries. They said, there are 157 administrative districts, and at the moment, there’s access for health workers to 16 percent of those districts. We said, good, we’ll do that.

Four years on, 96 percent of those districts we’re reaching the unvaccinated. We’ve delivered 21 million doses of vaccine to 1.9 million kids at $2, $2.10 a shot. So changing the way in which we think about these places, making manageable sort of the mountains that we’re—(inaudible)—I think is really important and is part of the purpose of this watch list.

MITCHELL: What’s happened to Gavi, though, in the past year?

MILIBAND: Well, Gavi have lost, I think—well, there are five-year budgets, but so their funding is lower than they wanted.

But there’s still a $9 billion operation over the next five years, and we want to work with them really closely. We want to maximize the use of these community-based initiatives that reach people beyond the last mile, two miles, five miles, ten miles.

I know I met with a young journalist from Sudan who’s doing extraordinary work and was recognized here in Washington by the International Women’s Media Foundation. And I’m also aware of these emergency rescue groups that are homegrown. They are grassroots operations in Sudan. It’s extraordinary, the courage of these people.

MILIBAND: They’re called emergency rescue rooms—I mean, emergency response rooms. I’m sorry. Emergency response rooms. And I’m so proud that when the war started, the first thing we did was to fund them with our own money.

MITCHELL: And briefly, before we get to questions, I want to ask you about the, you know, incredible number of refugees seeking a place to go and they can’t go home. And the U.S. has now in the Federal Register reduced what at its high a number of years ago was 125 million people accepted.

MILIBAND: Thousand.

MITCHELL: Excuse me, 125,000 people accepted to 7,500. And of the 7,500 now capped, 7,000 are white Afrikaners who are suffering from—South Africa is denying, you know, what has been described by administration officials as genocide. That has not been declared at all, and even the discrimination has not been established by at least South African, you know, figures. So how does the richest country in the world justify 7,500 refugees, of which 7,000 are white Afrikaners?

MILIBAND: No, this is an important part of the story. So, there are 45 million refugees in the world today, and the most vulnerable are identified for refugee resettlement, which is the planned and organized transfer of people. There’s a pipeline. Actually, 100,000 people around the world have gone through the U.S. vetting system, which is when John Brennan’s here and will know it well, involves fourteen or fifteen different government agencies. It’s the most difficult way to get to—

MITCHELL: And then there’s the U.N. system on top, right?

MILIBAND: Well, no, the U.N. system is the first filter. It’s the U.S. vetting is the dispositive element in whether anyone’s allowed to come in.

MITCHELL: OK.

MILIBAND: And it’s a very successful program, not just in terms of helping, on average, 95,(000), 100,000 people a year since Ronald Reagan admitted the most refugees of any American president, it’s been economically productive. It’s been socially productive. As you say, the administration has reduced it down to effectively zero for this year.

Our argument is very simple. Focus this program on what the Refugee Act of 1980 said, which is that people who are the most vulnerable of the 45 million refugees should be allowed to come in on refugee resettlement and expand that to other parts of the world. That’s the argument we’re making. And the SIV, the Special Immigrant Visa for Afghans, is seen in that context.

MITCHELL: But many of those refugees are from countries that are now on the ban list.

MILIBAND: Yeah, exactly. So I mean, our argument has always been blanket bans on countries are not the way in which—they are not compatible with fulfilling the requirements of the Refugee Act and the associated commitments with it.

MITCHELL: Well, now I want to open it up to questions, first from those in the room.

Yes, right here. You have the microphone.

Q: Mr. Miliband, you spoke about 45 million refugees. How much money do we need to take care of them?

MILIBAND: Well, that’s a complicated question to answer, because a refugee from Ukraine in Europe costs much more than a refugee from Sudan in South Sudan. So the average figures don’t work very well. As you know, Ukraine is one of the largest refugee crises in the world. Venezuelans who’ve left, many of them are classified as refugees. So one reason you can’t answer your question is there’s no average cost.

Secondly, it depends what you mean by help them. You can keep them alive. But that’s actually not our definition of what it means to be a humanitarian. Our definition is that you have to help people thrive, not just survive. And obviously that costs more.

So I don’t want to give a sort of how long is a piece of string answer to your question, but I’m going to give a how long is a piece of string answer to your question. It depends what you want to do for them. That will determine the cost.

Q: Any idea?

MILIBAND: Well, it depends what you want to do with them. If your aim is simply to keep them alive, it’s obviously much, much cheaper than helping them thrive. If you’re committed to helping them thrive, that doesn’t all mean public money. The most successful schemes for refugee integration, for example, in Uganda, and actually some in Germany, they have public cost and private cost. So it depends, are you talking about taxpayer cost or national cost?

The other thing to say, of course, is what timeline are you thinking about? Because you can have a cost of resettling a refugee over a year. The available evidence from places like the U.S. is that over eight to ten years, they more than pay back in tax revenues what they cost in social welfare.

MITCHELL: Yes, ma’am.

Q: Hi, thank you so much.

My name is Daphne McCurdy, and I spend a lot of my time these days engaging with skeptics of aid, and what I hear from them is not so much a lack of recognition that these countries that you’ve listed here so thoroughly are in crisis, but actually precisely because they’ve been in crisis for so long, and that there are these conflicts that are so protracted, is an indictment of aid, that we have been throwing money at these problems for decades, and look, they continue. And so I have my own answers, but I’d love to hear from you how you would push back against that criticism.

And then, if I can just squeeze in a quick second question, because you mentioned cost effectiveness. I’m curious how you and IRC navigates the tension between cost effectiveness, on the one hand, and also delivering aid for the most in need, which are oftentimes not the most cost-effective places to work.

MILIBAND: Yeah, so on the first, the purpose of aid is not to solve conflicts. The purpose of diplomacy is to solve conflicts. So it’s right to say that conflicts are burning for way too long, but that is a failure of politics and diplomacy, not a failure of aid. The fact that 26 million people have been kept alive by the PEPFAR program, that’s a triumph of the aid, even amidst conflict. So I think that it’s a real play to blame the aid system for something that it was never set up to resolve. That would be part one of my Ph.D. thesis answer to that, but we haven’t got time for that.

The second question was about cost effectiveness. I really ask you to look at the—we have this coalition of NGOs called Dioptra. It’s all online, and it’s how we do cost effectiveness and cost efficiency, and then obviously the difference between the two.

One of the interesting points—and this vaccination example I gave about the $2 shot in East Africa, a lot of the places where there isn’t a government health system are presumed to be more expensive, but actually, the growing concentration of need in those places means you can reach a lot of people once you get there. So it’s not actually true that going the last mile means it’s more cost inefficient or cost ineffective. Actually, we think we’re more than competitive going beyond the last mile, because we’re using community-based initiatives.

Someone online, I think.

MITCHELL: Yeah, we wanted to bring in some of the questioners online.

OPERATOR: We’ll take the next question from Anne Richard.

Q: Hello to everyone, and thank you very much for—

MITCHELL: Did we lose—

MILIBAND: When Anne worked for the IRC, I would never have dared to turn her microphone off. (Laughter.)

Q: Thank you very much for allowing me to ask a question.

I want to say that I can imagine the spirit of Madeleine Albright sitting between the two of you, because I know what a great friend she was to both of you. And of course, she was a refugee who came to the United States, and as David Miliband’s father was a refugee who came to the U.K. So again, another example of the talent that refugees can bring.

David, you’ve, I know, recently had an opportunity to chat with Barham Salih, the former Iraqi President, who has been put forward as the next High Commissioner for Refugees. Next year will also be time to select a new Secretary-General. In both those jobs, they’re kind of impossible, don’t you think? What kind of advice are you—would you give to the people who are brave enough to go for these jobs?

MILIBAND: Well, the first thing that Barham Salih, who I saw over the weekend—the first thing he’d say is, I’ve been selected for nomination to the General Assembly. So please don’t say anything until the General Assembly votes on my nomination, on his nomination, so he’s not yet been, what’s the word—

MITCHELL: Confirmed?

MILIBAND: Confirmed as the—thank you—as the U.N. High Commissioner for Refugees.

I think, I mean, I can only speak to the way in which I’ve tried to do the jobs that I do. And the more I—the older I get, I’m a big believer that you—strategy beats everything. It’s partly a sort of—Tim Geithner was our co-chair for a long time. Plan beats no plan. My rider to that is good plan beats bad plan.

And be absolutely uncompromising in recognizing the reality that you’re facing. Be bold in setting the goals that you are trying to achieve. Be clear about the means that you have at your disposal and how you want to put them together, and then bike that bicycle as fast as possible so that people can’t knock you off.

MITCHELL: Great answers.

And we have time for one more question online, and we’ll try to take a few more in here.

OK, so we’ll stay in the room. Yes, ma’am,

Q: Hi. I’m Lesley Warner.

One can argue that scarcity is the mother of innovation, and this is not by means of saying that scarcity is a good thing or that I endorse it, but just when you have fewer resources, you have to kind of figure out a new accommodation.

So in your remarks you talked about the use of AI in the DRC with monkey pox. And I was just wondering if you could give us additional examples of how in the past year, with these aid cuts, how you have really used innovation in a way that has been really impactful.

MILIBAND: I’ve got to be careful, because if it suggests we had no impulse for innovation before the cuts, that wouldn’t be a good thing. So I’m so proud, ten years ago, eleven years ago, we set up the Airbel Impact Lab in the IRC. Airbel was the name of the safe house that we set up in Marseille in 1940 to issue fake passports. And today, Airbel is our safe house for new ideas. It’s now a $25 million a year research and development arm of the IRC. It’s semi-independent. It’s IRC staff, but it has its own board, reports to me. And so I would want to plead for your recognition that we have been bold on the innovation front before the necessity. We redouble our efforts.

I mean, I’m very excited about some work we’re doing on innovative finance, which is taking some steps forward. We’ve got a proposal for the world’s first humanitarian debt swap. There have been debt swaps for environment, but never for humanitarian. I’m quite excited. We think we’ve cracked some of the difficulties with computer aided learning for kids whose learning is interrupted, working with an Indian software company on that called AprendIA. So I’m quite excited about that.

We’re also—this is maybe where the necessity has been very sharp. I know our supply chain teams have really worked to make their money go further. So we’re doing some internal changes. I hope no one who gives us a grant thinks that our grant applications are written by AI, but we do use computers now and again to help sharpen our thinking. So I think that we’re trying to be frugal in the way that we go about things.

MITCHELL: OK, here. Yes, sir.

Q: Hi. Sam Worthington.

One of the consequences of the 83 percent cut with AID and the way it was done, which was an abrupt cessation of resources, was a tearing of trust at the local community level, across the world of local organizations, community organizations. What do you think needs to be done to sort of rebuild that trust? And where, for example, has the IRC found ways to maintain trust with local groups? Because at some point we may be back into this game, but the U.S. withdrew awfully abruptly, in a way that hurt many people.

MILIBAND: I mean, Sam, you’re very, very wise on all this.

I think that I’ll give you a slightly unexpected answer maybe. The people who we are serving have suffered so many reverses and have shown such resilience that I think we have to be careful not to elevate our own policy or the policy decision that was made here to a status beyond that which it deserves.

If you’re a client of ours, nothing tells you that your long-term prospects are safe and secure. You’re living day by day. And that’s not to excuse what’s happened, but it’s just to provide just a bit of, I don’t know, the humility that I feel in saying, will you ever trust us again? There’s been—the people who we’re helping have been the victims of so much abuse, I suppose, is the way I’m putting it, and they’re so resilient on the basis of their own efforts that I think that the next person who comes along credibly offering to help them, they’ll suss out do I trust you or not? OK, let’s go for it.

So I don’t think—I mean it’s a good argument for multi-year financing. We thought that the financing that had been secured before January 20 would be followed through. We didn’t expect that it would be taken back. But I think if we come back, there’ll be some partners there.

MITCHELL: We have time for one more question.

Yes.

Q: Grateful for the work and the discussion. Thank you so much.

Monique Mansoura, and I just want to pull on a couple of threads that you drew out. One is this arc of refugee to survive to thrive, and the other is this idea of being proactive versus reactive.

So in this whole ecosystem and the ROI really that you talked about when people thrive, the benefits that accrued to a community, to a country, in 1999 we saw for the first time a linkage between the HIV pandemic and national security. So I wonder, as we’re talking about these issues through a health lens, the benefits or the potential linkages and upside of economic security, economic development and national security, and the handoffs and the transitions between the investors—IRC, the World Bank, Ajay talks often about getting people out of poverty through work—and how we can really build a narrative and a story about the system and the benefits that accrue, not only to the individuals in need, but to their communities.

MITCHELL: Maybe we can answer just that in the minute or two we have left.

MILIBAND: One of the things I’ve learned in America is that people often say that’s a great question,

and it often means they don’t know the answer. So, I mean, there’s so much in there.

Just give me another shot. What would you like me to talk about?

MITCHELL: If you could do that—

Q: The transitions, the handoffs, the assistance. So let’s imagine success of IRC, and then the next piece, the handoff, maybe the World Bank and jobs. You know, how do you get from thrive to survive?

MILIBAND: Yeah, I’ll tell you where I am. I’ll just give you my answer on that, which is that there are many systems, not just one. We shouldn’t kid ourselves about what role global systems play relative to local systems or family systems. That’s very much in my head from being in Somalia last week.

But when you educate a woman in Afghanistan, or vaccinate a kid in Ethiopia, no one can take that away from them. When you help a woman survive, recover from sexual violence, you don’t undo the violence, but you give them quite a big boost for the rest of their lives, and people can’t take away those resources for recovery.

And I used to worry that thinking that way meant you never reach scale. And there is a version of that approach where you end up with loads of boutique programs that aren’t scalable. What I think the experience I’ve learned shows is that actually you can work at scale. We helped 36 million people last year. You can reach scale by starting from the bottom up, rather than the top down.

And I would say, let’s give people resources. Let’s give a lot of people a lot of resources to make their way in the systems that surround them, rather than trying to over structure something that is beyond our own capacity, like your question about solving a peace process. I’d love to do that, but that was my old job. And so I think let’s focus on what we can do, let’s focus on what’s within our locus of control, and let’s recognize what role we’re playing in helping arm people—that’s maybe not quite the right word for a humanitarian to use—so that we resource people or support people to make their own way.

And I think that’s a powerful message. It’s one that actually is aligned with what Ajay Banga is saying, because he’s talking about jobs, but jobs are for individuals. And so I think that we should build our systems around the outcomes that we want individuals to achieve for themselves and be clear about what we can do to help them do so.

I’m really proud, if you go to our strategy map on the IRC website, clients are at the center, not as a kind of piece of rhetoric, but actually that’s because of how we organize ourselves. The mission of the organization is to help people whose lives are shattered by conflict and disaster survive, recover, and gain control of their lives. The vision is to help 20 million people directly with our services in 2028 and 40 million, directly and indirectly by 2033.

The outcomes are clear, set out. Every IRC program is working towards one of five overall outcomes, seventeen sub-outcomes.

And the priorities are also set out there about how our teams are going to deliver, what balance of data, evidence, innovation is going into it, and so that clients at the center, I think, disciplines the way I would try and answer your question.

MITCHELL: That’s a powerful message on which to close, and an optimistic one.

MILIBAND: Thank you.

MITCHELL: And we appreciate all that you and the IRC are doing. And we want to thank the Council for hosting this very important discussion today. Thank you all. (Applause.)

(END)

This is an uncorrected transcript.