With 20 million refugees and 40 million internally displaced people globally, issues of forced displacement have hit the top of the political and economic agenda, including the World Economic Forum discussions in Switzerland this week. In a keynote address to an Independent Commission on Multilateralism retreat on humanitarian engagement, International Rescue Committee President David Miliband said the escalating crisis required not just more, but also better, humanitarian aid.

“The need for better aid comes from the fact that the conditions that people are living in are changing,” Mr. Miliband said during an interview on the margins of the retreat. “It’s not just that the causes of their displacement have changed: so have the conditions in which they’re displaced.”

Speaking with International Peace Institute Senior Adviser Warren Hoge, he said that the United Nations refugee agency was clear that its first responsibility lay with responding to the needs of refugees, rather than internally displaced persons (IDPs).

“But I think that it’s very, very important—speaking for a humanitarian NGO that works for IDPs as well as refugees—to recognize that those 40 million people are tomorrow’s refugees,” Mr. Miliband said. “And they don’t really care which agency takes care of them; what drives them mad is that no agency is taking care of them.”

Listen to the interview:

There is a question about whether the humanitarian system is broke, or broken. If it is broke, it can be solved, presumably by extra funding. But if it is broken, how is it broken? And what are the mismatches you have encountered between the system and the needs it has to meet?

I think it’s very clear that at a time of escalating flows of refugees and internally displaced people, there’s a desperate need for more aid, but there’s also a need for better aid. The need for better aid comes from the fact that the conditions that people are living in are changing. It’s not just that the causes of their displacement have changed: so have the conditions in which they’re displaced.

We have a system founded on the idea of the iconic image of a refugee being someone in a refugee camp, but 59% of refugees are now in urban areas. We have a tradition of extraordinary social service at the heart of the humanitarian system, but in a time when the average refugee is out of their own country for 20 years according to UN statistics, it’s desperately important that there’s an economic component, because you can never have a sustainable 20-year social program unless it has an economic dimension. Thirdly, some issues like education, in the context of short-term displacement may seem like a luxury, but when you’re talking about long-term displacement, they’re an absolute lifeline.

I think in a range of areas there is a need to stand up for what I would call better aid, not just more aid. It’s vital that those of us in the humanitarian sector, who are committed to the humanitarian principles, are big enough and open enough to advocate the case for reform, not just to advocate the case for more investment.

Another mismatch is that the UN gets involved in situations where people are victims of wars between states, but that’s not the case with refugees is it?

The history, obviously, is that refugees came from wars between states. But today, the 20 million refugees and 40 million IDPs are the consequence of wars within states: new wars in Syria, relatively new wars in South Sudan, long-term conflicts in Congo, Somalia, and in Afghanistan. The UN obviously has a United Nations High Commission for Refugees (UNHCR), and I guess what you’re implying is, where is the UN High Commission for IDPs?

I think it’s important to acknowledge that the recently retired head of UNHCR, António Guterres, pushed the envelope on what UNHCR did. He extended their work, but he was always very clear that in a situation like you’ve got in northern Iraq—where there are refugees and there are IDPs—the first responsibility of UNHCR is to the refugees, and the camp for the refugees is of a completely different order than the camp for the IDPs.

Obviously, that speaks to very core issues of democratic legitimacy and who’s responsible for citizens of different countries. But I think that it’s very, very important—speaking for a humanitarian NGO that works for IDPs as well as refugees—that those 40 million people are tomorrow’s refugees. The 40 million IDPs are tomorrow’s refugees. The people I meet who are IDPs—in Niger or Nigeria most recently—they all become refugees if their situation is not properly addressed. And they don’t really care which agency takes care of them; what drives them mad is that no agency is taking care of them.

Another exercise in semantics is whether the humanitarian system is indeed a system, or is it the humanitarian sector? If it is to become a system, or systematized, what must happen?

My perspective is that we have a humanitarian sector, and I think that there are some severe consequences of being a sector rather than a system. There are some standards of the minimum number of releases of water that someone is supposed to receive if they are displaced, but there aren’t agreed outcomes that measure success of the disparate activities of the different actors. There aren’t agreed and common accountability metrics. There aren’t common activities on things like research and development, which I think are very important.

I think that it’s going to be really important in the next decade to think, how can we work as humanitarians in a more systematic way? That doesn’t mean that we become a completely single organization, but I do think we need to be much more systematic in the way we pursue agreed outcomes, measure success, report on performance, and promote the use of evidence, which I think is incredibly important. We say in the IRC that all our programs will become evidence-based or evidence-generating. I think it’s high time donors started saying that they want to back all programs that are evidence-based or evidence-generating. And, to the extent that that can help provide a degree of alignment—which reduces duplication, reduces bureaucracy, increases the sharing of ideas and services—that’s a good thing.

When you look at the IRC through that same lens—outcome-driven, evidence-based—you have come up with a series of five outcomes, I think, that all your programs meet. Can you talk about those, and why do you need to have outcomes?

We’ve been through a really significant process in the last 18 months to two years. In 2014, we agreed the five outcomes that we would measure ourselves by: survival, health, education, income—we want to measure ourselves by how much we’re doing for the incomes of the beneficiaries that we support—and also, what are we doing to shift the dial on the power of beneficiaries to have voice and choice about the issues that affect them? We’ve been through a real process of diligence in trying to develop what we call our Outcomes and Evidence Framework, which will be the template against which all of our country programs work.

Obviously, in an area like health it’s not one outcome: there’s mental health, there’s environmental health, there’s maternal health. But associated with clarity about outcomes is then evidence about what works in promoting different outcomes, and we want to make sure that as we are proposing programs, as we are doing our work, we’re following the best evidence to achieve the outcomes that we’ve set. I think it all starts with outcomes. Unless you’re clear what you’re trying to achieve, there’s no way of knowing whether or not you’re succeeding in achieving it. From my point of view, it is not enough just to say, “We want to keep people alive.” We are here as humanitarians to do more than that, although obviously survival is absolutely core. In some ways, you can measure it more easily, but for me the outcome focus creates a degree of discipline, a degree of candor, a degree of openness that is very, very positive.

What’s interesting for me is that over the last year our strategy has come into contact with reality. All of our country programs have been trying to think, what are the implications of an outcomes and evidence-based approach for the work we do? And what it’s led to is some really interesting conversations about where we work. Are we actually needed in this field office? Shouldn’t we be trying to expand another field office? If another agency is doing really well in pursuing some outcome, then we don’t need to do everything everywhere. We want to make sure we’re adding value at each stage, and it’s promoting some work around monitoring and evaluation that I think is going to be very beneficial. We want to do it in a very open way. There’s no point in hoarding the information. But we’re now in the process of making sure that we match the aspirations of our field programs, for tuning their work to an outcomes and evidence perspective, with some central support when able to do so.