The number of refugees and internally displaced persons in need of protection and assistance has increased from 30 million in 1990 to more than 43 million today.

War and civil strife have been largely responsible for this epidemic of mass migration that has affected almost every region of the world, including Europe.

Since 1990, crude death rates (CDRs) during the early influx of refugees who crossed international borders have been somewhat lower than CDRs reported earlier among Cambodian and Ethiopian refugees.

Nevertheless, CDRs among refugees arriving in Ethiopia, Kenya, Nepal, Malawi, and Zimbabwe since 1990 ranged from five to 12 times the baseline CDRs in the countries of origin.