According to the World Health Organization (WHO), 1.8 billion people (almost a quarter of the world’s population) currently live in conflict-affected areas worldwide. The public health consequences of such a reality are enormous.
War leads to an increase in mortality rates, the wrecking of social and economic systems, starvation, multiple disruptions to health services, the failure of medical supply chains, the fleeing of healthcare professionals, and dire epidemic outbreaks. The emergence of deadly, resistant bacteria has been linked to military operations, giving birth to new classifications such as “pathologies of intervention”. Psychological consequences of war are disastrous, with the prevalence of post-traumatic stress disorder (PTSD), anxiety disorders, depression, and somatoform disorders increasing greatly in war and post-conflict settings. A recent assessment highlighted that, in 2017, at least 10% of women and 16% of children worldwide were either displaced by conflicts or lived dangerously close to conflict areas. This also makes them vulnerable to sexual violence, early marriage, harassment, isolation, and exploitation.
But war does not only affect people; it also brings about environmental disruptions. Air and water pollution are common consequences of battles, while critical damages to local ecosystems are inflicted by the use of heavy off-road vehicles, the construction of camps and fortifications, the use of guns and bombs, forest clearing for military operations, and the strategic ignition of oil wells, among others.
Wars, in addition, almost never exclusively affect local areas but have international reverberations. As the recent conflict in Ukraine has painfully shown, the global consequences of war range from food and energy crises to increased inflation and financial speculation, extending the repercussions of conflicts beyond national borders.
It is no accident that the Ottawa Charter lists peace as the first determinant of health. Peace is in fact a prerequisite for all other determinants: decent housing, education, food, income, a stable ecosystem, sustainable resources, social justice, and equity. Public health professionals have a key role to play when armed conflicts are considered: making the devastating effects of war widely known, advocating for peace, and working for the prevention of war outbursts and their worst consequences.
War and conflicts will be a key theme of the 17th World Congress on Public Health, when we will have the opportunity of engaging in a meaningful discussion with Dr. Wahid Marjooh, Former Minister of Public Health of Afghanistan.