This chapter highlights the issues and challenges of disaster responses in the twenty-first century. Leading agencies of the global clusters are responsible for setting standards and policy-setting, building response capacity and carrying out operational support. United Nations Children's Fund (UNICEF) and World Food Programme (WFP) coordinated the provision of food and the response nutritional needs during the emergency situation. In the twenty-first century, climate change, environmental degradation, poverty and urbanisation have posed many challenges for disaster response stakeholders. An epidemiological study found a clear dose-response relationship between drinking water salinity and the risk of pre-eclampsia and hypertension in pregnant women. Given the potential cost of disasters, disaster response planning is crucial to maximising the cost-effectiveness of response. Although the cluster approach launched in 2005 by the Inter-Agency Standing Committee has facilitated disaster response for the past decade, local response still faces the lack of standardised, measurable performance indicators for reporting, accountability, coordination and professionalism of relief efforts.