Why do people leave home and seek asylum? Conflict, war, and persecution, living in fragile states, being trafficked, and climate change may all play a part.Global statistics of forced displacement are reviewed.

Types of journeys and attendant experiences are considered, and reasons for how and why people may come to the United Kingdom.

We then review developments in international refugee policy and law, and problems with the current approach, including the role of socioeconomic status, the difficulties in how initiatives are funded, and the lack of long-term perspectives.There are barriers to resettlement in wealthier third countries.Restrictive and punitive asylum policies have a high human cost.There are limits to international cooperation.

This all matters to health professionals because understanding someone’s context explains much about individual behaviour.It enables relevant enquiries to be made, and appropriate help offered. Some possible misapprehensions are considered.

This chapter explores the evolution of the governance of so-called “fragile states” as a case of change in the architecture of global governance. Reduced funding from states and broader ideational trends about managerialism and effectiveness have rendered international organizations (IOs) less important in defining policy responses and assigning roles to other actors. This change in the governance architecture has engendered more networked and market-based forms of governance, with different stripes of professional networks becoming more important. The chapter argues that this transformation helps explain substantive changes in how fragile states are governed: in the 1990s and into the early 2000s, the treatment of fragile states was dominated by a “peacebuilding” approach focused on building institutions to support the rule of law and democracy, and with IOs such as the UN and the World Bank in authoritative roles. Gradually, over the course of the 2000s and 2010s, this approach became bifurcated, which reflects the prominence of professional networks and the reduced authority of IOs to define an overarching framework: military professionals in states advanced “stabilization” and counterterrorism – focused on fighting insurgents and conducting anti-terrorism operations – while networks consisting of humanitarian and human rights professionals advanced a focus on protection of civilians.