Zaatari camp, the largest Syrian refugee camp in the world, sits less than 12 kilometers away from the border between Syria and northern Jordan. Rows of houses disappear into the desert, making it hard to tell where the camp begins and ends. Metal containers pieced together like patchwork are home to around 80,000 refugees. The remnants of tattered UNHCR tents cover holes in the walls. Almost seven years after the camp opened, this dusty sea of tin roofs has evolved into a permanent settlement.

Fears of Central American caravans and Saharan smugglers keep European and U.S. leaders up at night. Desperate to manage migration, they turn to short-term fixes, which include blocking borders and supporting authoritarian leaders to contain people—their own citizens and others—before they get close to Europe or the United States. This bit of political theater appeals to some, but has limited effects in overall numbers. The long game consists of addressing root causes so people no longer feel compelled to move at all. But this too will do little to prevent migration north. If anything, it will encourage more people to move.

Once again, we find ourselves witnessing another calamitous hurricane event in the United States, just weeks after a George Washington University report estimated that nearly 3,000 more people died in the 6 months following last year’s Hurricane Maria than would have without the hurricane. We have been here before, too many times. With each and every major disaster, the scientists who study public health in crises ask ourselves, is what we have learned and shared being taken seriously—or is it just being ignored? The response to Hurricane Maria, which devastated Puerto Rico last year, is just one more example where we have to ask if our work is valued by those who have the political power to improve public health. The staggering number of excess deaths—most of whom died after the storm—point to a deadly lack of prevention and preparedness, particularly in the public health system.

When I arrived at Bangladesh’s Cox’s Bazar in July, the infamous monsoon was well underway. The rain was intense, roads were muddy, and it was very difficult to move around. Cox’s Bazar—the closest big town to the Rohingya refugee camps—is now the base city for most of the humanitarian agencies working with the refugees. The distance between Cox’s Bazar and Kutupalong Camp—the world’s largest refugee camp—is barely 30 kilometers. However, due to the rain and the area’s hilly terrain, it seemed like it took ages to get there.

“At the heart of…USAID’s transformation, is the core belief that each country must lead its development journey, and finance and implement solutions to its development challenges,” said Susan Fine of USAID at a recent Center for Global Development event introducing USAID’s new “Journey to Self-Reliance ” indicators.