The world is witnessing a worrying resurgence and intensification of armed conflicts, leading to massive humanitarian crises and unprecedented strain on healthcare systems. In 2022 alone, a staggering 55 armed conflicts were documented globally, marking the highest number of battle-related deaths since 1984.
The repercussions of these conflicts are staggering; disproportionately affecting over a billion people residing in fragile settings and displacing millions of people. In these increasingly turbulent times of armed conflict, the healthcare sector is pushed to a breaking point.
This strain manifests in both direct ways, with influx of people in dire need of health care services casualties, and indirect ways, through disruptions to supply chains and dwindling resources. In the face of such immense challenges, building health system resilience is paramount. Put simply, while health systems may be vulnerable in crises/conflict contexts, we still need them to respond and recover rapidly.
Therefore a health system should not just react and respond during a crisis, but also enhance its preparedness for any future crisis and (ideally) emerge stronger. Healthcare needs are constantly evolving, and no system is perfect. However, by focusing on three key phases – absorbing the initial impact, adapting through response efforts, and transforming to be better prepared for future crises – healthcare systems can build resilience.
Armed conflicts not only lead to immediate large-scale health crises but also exacerbate existing vulnerabilities, leaving communities susceptible to epidemics and disease outbreaks. In conflict zones, where infrastructure and healthcare delivery are often disrupted, the emphasis on essential services becomes even more critical. However, essential healthcare services, such as maternal health, chronic care treatments and vaccinations, often face severe disruptions in these contexts.
The breakdown of infrastructure compounds challenges leaving populations at heightened risk with weakened healthcare, as seen in countries like Sudan and Palestine, where infectious disease outbreaks among displaced populations have been widespread. Maintaining essential healthcare services to deliver critical medical care and emergency health supplies is paramount for health system resilience.
Thus, medical emergency care and essential health services are both needed to assist people affected by armed conflict, epidemics, and those excluded from healthcare.
Beyond the immense strain caused by conflict itself, healthcare systems also face deliberate attacks, violating fundamental human rights and International Humanitarian Law (IHL]. These attacks manifest in various forms, including physical violence against healthcare workers and patients, threats, intimidation, and disruptions to essential services like blocking ambulances, which hinder efforts to deliver critical care.
Protecting humanitarian health workforce, who serve as the backbone of healthcare and risk their lives daily to provide essential needs is of utmost importance in conflict settings. While upholding protections and rights may pose a challenge during conflict, equipping healthcare workers with proper training, equipment, protection and implementing measures for security is vital for ensuring they can continue their crucial work.
Also, armed conflicts are not isolated events; they have far-reaching implications beyond borders. Disease outbreaks in conflict zones can swiftly spread across borders through refugees and asylum seekers, posing significant threats to global health security. This necessitates a global response, rather than isolated efforts confined to individual country conflict zones.
While international response and health governance are often perceived as separate entities, their synergy is essential for a swift and unified response to health emergencies during conflicts. This collaboration ensures that essential medical resources, assistance, and aid reach those in need in a timely manner.
Building health system resilience requires a multi-pronged approach at all levels – local, national, and international. While the challenges are daunting, fostering resilience in conflict zones is essential to ensure healthcare systems can continue to be a lifeline for people in desperate need of healthcare.
The SheffWHO 2024 simulation conference provides a timely platform to reflect on the theme: “Navigating Turbulent Times: Health Systems Resilience in Armed Conflict” and explore effective strategies for strengthening health systems in conflict-affected areas.
