Why the health consequences of war extend far beyond the battlefield

Professional Perspective · Global Health · Conflict & Health · Health Systems · Emergency Preparedness

The public-health consequences of armed conflict are often described through numbers of people killed or injured. These are the most immediate and visible consequences, but they represent only one part of the health burden created by war.

Contemporary conflicts affect entire health systems.

Hospitals may be damaged or overwhelmed. Health workers may be killed, injured, displaced or unable to reach their workplaces. Supply chains become unreliable. Vaccination, antenatal care, tuberculosis treatment, dialysis, cancer therapy, mental-health services and management of diabetes and hypertension may all be interrupted.

The result is an important public-health reality:

The health burden of conflict extends far beyond the injuries directly caused by violence.

WHO’s 2026 Health Emergency Appeal illustrates the scale of the challenge. An estimated 239 million people face humanitarian need due to conflict, climate shocks and disease outbreaks, and WHO is responding across 36 major health emergencies.  

Conflict damages systems, not merely facilities

A functioning health system depends on much more than buildings.

It requires health workers, electricity, water, laboratories, medicines, blood supplies, oxygen, transport, communications, surveillance systems, referral networks and functioning supply chains.

Conflict can disrupt several of these simultaneously.

Ukraine provides a striking example. WHO reported in May 2026 that it had verified more than 3,000 attacks on health care since the beginning of the full-scale invasion. These incidents have affected facilities, ambulances, health workers and pharmaceutical infrastructure.  

The public-health consequence is therefore larger than the physical damage itself. When a hospital, laboratory or ambulance service becomes unavailable, an entire network of patients may lose access to timely care.

Displacement changes the geography of health need

Conflict also moves populations.

People may be internally displaced, cross national borders or repeatedly move between temporary settlements. This changes where health services are required and places additional pressure on health systems in receiving communities.

Displacement can interrupt treatment for tuberculosis, HIV, diabetes, hypertension, epilepsy and other chronic diseases. Pregnant women may lose continuity of antenatal care. Children may miss vaccinations. Medical records and referral pathways can disappear during movement.

The consequences can persist even when displaced populations eventually return home.

Ukraine illustrates this continuing burden: WHO estimates that 4.1 million people will require health assistance in 2026, alongside substantial mental-health, rehabilitation and chronic-care needs.  

Infectious diseases exploit disrupted systems

War does not create microorganisms, but it can create ideal conditions for their transmission.

Crowded shelters, damaged water and sanitation systems, interrupted vaccination, malnutrition and weakened disease surveillance can allow previously controlled diseases to return.

This is particularly dangerous when laboratory networks and surveillance systems are simultaneously weakened.

WHO’s current emergency assessments describe recurrent threats from cholera, measles and other communicable diseases across several conflict-affected settings. In Sudan, for example, cholera, measles, malaria and dengue are circulating while a large proportion of health infrastructure remains non-functional.  

The lesson is important:

Disease surveillance is not a secondary activity during conflict. It is part of the emergency response itself.

Chronic diseases become emergency conditions

Humanitarian health responses have traditionally concentrated on trauma, infectious diseases, nutrition and maternal-child health.

All remain essential.

But modern conflicts increasingly occur in populations where noncommunicable diseases account for a substantial share of normal health-care demand.

A patient requiring insulin, dialysis, antihypertensive medicines, chemotherapy or oxygen cannot simply wait for stability to return.

Recent conflict in the Middle East has demonstrated this problem clearly. WHO has highlighted how disruption of health services affects people requiring dialysis, insulin and other life-sustaining treatment, while disruption of air and maritime routes can also affect the movement of medicines and medical equipment beyond the immediate conflict zone.  

Emergency preparedness therefore needs to include continuity of essential chronic care, not merely casualty management.

Mental health may become one of the longest-lasting burdens

The psychological consequences of conflict can continue for decades.

People experience bereavement, injury, displacement, loss of livelihood, family separation and prolonged uncertainty. Children may spend formative years exposed to violence and instability. Health workers themselves operate under extraordinary psychological pressure.

WHO estimates that the mental-health crisis associated with the war in Ukraine affects approximately 10 million people.  

Mental-health and psychosocial support therefore cannot remain an optional component added after immediate humanitarian needs have been addressed.

It must be integrated into primary care, community services and long-term reconstruction.

Health workers and health facilities require protection

Perhaps one of the most concerning features of contemporary conflict is the continuing exposure of health care itself to violence.

WHO reports that more than 1,400 confirmed attacks on health care occurred during 2025 in emergency-affected countries and fragile settings.  

Every attack has consequences beyond the immediate casualties.

A damaged ambulance may mean delayed emergency care. A threatened health worker may leave an affected region. A destroyed laboratory can weaken disease surveillance. Damage to a pharmaceutical warehouse can interrupt treatment across multiple facilities.

Protecting health care is therefore simultaneously a humanitarian obligation and a public-health necessity.

Conflict is increasingly interconnected with other emergencies

Another important change is that conflicts rarely occur in isolation.

Climate shocks, food insecurity, outbreaks, displacement, economic instability and conflict increasingly overlap.

Sudan illustrates this convergence particularly starkly. WHO estimates that 33.7 million people will require humanitarian assistance in 2026, while displacement, food insecurity and multiple infectious-disease outbreaks are occurring alongside severe disruption of health services.  

Public-health planning therefore cannot treat conflict, epidemics, climate emergencies and health-system resilience as independent domains.

They increasingly form a single interconnected risk environment.

What should public health learn from this?

The first lesson is that health-system resilience must be built before crises occur.

Countries require redundant supply chains, resilient laboratories, emergency stock systems, interoperable health information, mobile service capacity and health facilities capable of functioning during interruptions to electricity, communications and transportation.

The second lesson is that continuity of essential services must be considered part of emergency preparedness.

Maternal care, immunization, tuberculosis services, chronic disease treatment, diagnostics and mental-health services cannot simply stop because emergency medicine becomes the immediate priority.

The third lesson is that surveillance systems must remain functional during conflict.

Outbreak detection, laboratory confirmation and rapid epidemiological investigation become even more important when populations are displaced and routine services deteriorate.

The fourth lesson concerns health workers.

Protecting, supporting and retaining the health workforce is as important as protecting infrastructure. Buildings can eventually be reconstructed; rebuilding an experienced health workforce may take considerably longer.

And finally, public health needs to be part of recovery from the beginning rather than introduced after hostilities cease.