Reverse migration and the health emergency among Afghan returnees: a call for regional action

The current geopolitical situation in the Middle East suggests a growing trend of reverse migration, where migrants and refugees may be gradually returned to their home countries. This large-scale return, exemplified by the movement of Afghan migrants from Iran and Pakistan and the potential return of Syrians, places immense pressure on the healthcare systems of their native countries, which already face numerous challenges. This manuscript synthesizes literature through 30 June 2025 and primary agency situational and flow reports, including IOM border and flash updates, WHO-EMRO returnee health situation reports, and UNHCR emergency updates, to document the 2025 return surge and its health impacts. The recent mass return of over thousands Afghan migrants from Iran in 2025 can lead to a crisis. Driven by the return process and arduous journeys, these returnees face a profound public health crisis. Physical ailments like malnutrition, dehydration, and infections are prevalent, compounded by psychological trauma including anxiety, depression, and post-traumatic stress disorder. This influx overwhelms Afghanistan’s already fragile and underfunded healthcare system, which struggles with limited resources and infrastructure. Therefore, during the reverse migration and return of migrants, attention to the health systems in the countries of origin is as crucial as it was during the initial migration. Urgent, coordinated international medical aid, psychosocial support, and disease prevention strategies are needed to address this crisis.