This chapter presents an international perspective that focuses on the evolution of the approach health specialists have used to reduce the health consequences linked to disasters. It highlights some of the main aspects of humanitarian disaster response training and disaster risk reduction. The chapter explores how disaster management has evolved to its present status. Both governmental and regional institutions have significantly improved their disaster management efforts over the last 30 years. The agency within the ministry of health is the designated entity for protecting health from the consequences of disasters. The rate at which disasters occur has a substantial impact on institutional development of these agencies. The humanitarian reform movement has generated the concept of dividing humanitarian assistance into several topic specific groups called clusters. Finally, the chapter explores avenues for future growth, and discusses examples of developments in emergency medicine education and research.